Understanding Anxiety in Adolescents with Chronic Illness: A Longitudinal Study of the Moderating Role of Parental Anxiety and Classmate Support

Abstract

Adolescents with chronic illnesses are at increased risk of developing anxiety symptoms. However, little is known about underlying mechanisms important to consider specifically for this population. This longitudinal study contributes to our understanding of these mechanisms by examining whether parental anxiety and classmate support moderate the association between chronic illness and generalized anxiety in adolescents. Data from the TRacking Adolescents’ Individual Lives Survey (TRAILS) were used (N = 2230), with measurements at mean ages 11.1 and 16.3. Inconsistent with the first hypothesis, adolescents with chronic illness did not report a stronger increase in anxiety symptoms over time. Also inconsistent with the second hypothesis, parental anxiety did not moderate the effect of chronic illness on adolescents’generalized no anxiety symptoms. In contrast, classmate support was found to be a moderating factor, which supports the third hypothesis. These findings suggest that the relationship between chronic illness and anxiety symptoms is primarily present among adolescents who receive high levels of classmate support.This provides evidence for the importance of considering that peer support doest not have the same protective effect on all adolescents. The present study adds to the literature by emphasising that the psychological impact of chronic illness is not uniform but most importantly shaped by environmental and illness-related factors. Future research should explore perceived parenting as a moderator to better understand how to support adolescents witha chronic illness. For practice, this study suggests that considering the context of peer support may improve interventions for adolescents with chronic illnesses.