Dynamics of Fear-Generalization Processes and Their Predictive Value for the Development of Anxiety-Related Psychopathology in Adolescents and Adults: A Study Protocol for a Longitudinal Study.

OBJECTIVES

Anxiety disorders involve abnormal fear learning and exaggerated generalization, proposed as potential risk factors. However, it is unclear whether these processes reflect stable vulnerability markers or symptoms of psychopathology, as most research relies on cross-sectional correlations and few longitudinal studies assess their predictive role in anxiety. Furthermore, little is known about the test-retest reliability of fear learning paradigms, despite their suggested function as trait-like markers for anxiety.

METHODS

This longitudinal study reassesses initially healthy adults after 3-12 years, and children first examined at ages 8-12, then 12-16, and now at 16-22. Participants repeat the "screaming lady" paradigm, including fear acquisition and generalization. We integrate fear learning, psychometrics, HPA-axis activity, and (epi)genetics to assess the stability of fear generalization, its predictive value for later anxiety, and the link of fear learning to the HPA system.

CONCLUSION

Our findings will clarify the long-term stability of fear learning paradigms and evaluate their value as markers of anxiety risk. In addition, a random forest model will explore multiple risk factors and their interaction in anxiety symptomatology. This may improve understanding of anxiety disorders and support early detection and prevention.

TRIAL REGISTRATION: Retrospectively registered on AsPredicted.org (#238,927).