Anxiety and life-course mortality.

Anxiety is an unpleasant and common problem and many people attend their doctors asking for help. There are very effective medicines for reducing anxiety, but in humans and animals anxiety seems to involve noticing and escaping from danger so may be a useful characteristic.

I have already completed a study which showed that the less anxious half of a large group of British school children suffered many more accidents and fatal accidents in their young adult lives than the more anxious half of the group. This is the first scientific work showing that anxiety is useful for people.

I plan to follow on from this work, looking at different, larger groups of people from different countries, whose anxiety was measured in different ways at different stages in their lives. I hope to find out more about the some of the useful and harmful things about anxiety, working towards a better understanding so that in the future doctors can be confident that when they reduce someone‘s anxiety with medicines they know they are really helping rather than harming that person.

Aims & Objectives:
To replicate the finding that high trait anxiety reduces risk of fatal accidents in young adult life.
To establish whether this effect is large enough to affect all-cause mortality.
To investigate this further by establishing if there is dose-response effect.
To establish whether chronic ‘case level anxiety‘ (anxiety disorder) represents a harmful or a protective level of anxiety in terms of mortality.
To determine whether this effect is the same in different settings and time periods.
To investigate causal pathways from low trait anxiety to increased accidents, especially use of alcohol.
Design & Methodology: Five longitudinal cohort studies will be used: the Swedish Twin Register, the Norwegian Nord-Trøndelag Health Study, the British National Child Development Study, the British Cohort Study and the British Health and Lifestyle Survey. These surveys have a total of 127,723 participants, born between 1928 and 1970, who have been followed up for between 4 and 26 years. The primary analyses will be survival analyses using Cox‘s Proportional Hazards Model. The exposures will be measures of neuroticism/trait anxiety from each of the sources of data. Results will be corrected for likely confounders and investigations of causal pathways will be undertaken, especially alcohol use.
Scientific & Medical Opportunities: Robust evidence connects high trait anxiety/neuroticism with poor outcomes. An evolutionary understanding predicts beneficial effects too. I hope to broaden the understanding of this concept by determining and evaluating these benefits.