title: Associations between household and neighborhood income and anxiety symptoms in young adolescents.
abstract: BACKGROUND
  A better understanding of the role of both family- and neighborhood-level socioeconomic characteristics in the development of anxiety disorders is important for identifying salient target populations for intervention efforts. Little research has examined the question of whether associations between anxiety and socioeconomic status (SES) differ depending upon the level at which SES is measured or way in which anxiety manifests. We studied associations between both household- and neighborhood-level income and four different manifestations of anxiety in a community sample of young adolescents.
  
  
  METHODS
  We conducted a cross-sectional analysis of data on 498 subjects aged 11-13 from a cohort study of Seattle-area middle school students. Generalized estimating equations were used to examine the association between both annual household income and neighborhood median income and each of four anxiety subscale scores from the multidimensional anxiety scale for children (MASC): physical symptoms, harm avoidance, social anxiety, and separation/panic anxiety.
  
  
  RESULTS
  A negative association was found between household income and scores on two of the four MASC subscales--physical symptoms and separation/panic anxiety. In contrast, at equivalent levels of household income, adolescents living in higher income neighborhoods reported higher physical and harm avoidance symptom scores.
  
  
  CONCLUSIONS
  The role that SES plays in the development of childhood anxiety appears to be complex and to differ depending on the specific type of anxiety that is manifest and whether income is evaluated at the household or neighborhood level.
authors.affiliation: Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA. mvine@u.washington.edu
authors.forename: Michaela
authors.initials: M
authors.lastname: Vine
authors.forename: Ann
authors.initials: A
authors.lastname: Vander Stoep
authors.forename: Janice
authors.initials: J
authors.lastname: Bell
authors.forename: Isaac C
authors.initials: IC
authors.lastname: Rhew
authors.forename: Gretchen
authors.initials: G
authors.lastname: Gudmundsen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McCauley
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D012923:Social Class; D014861:Washington / Q000453:epidemiology