# Testing Dual Mechanism Model of Adolescent Anxiety and Related Sex Differences

> **NIH NIH P20** · DELAWARE STATE UNIVERSITY · 2020 · $213,480

## Abstract

Anxiety remains one of the most common forms of mental illness and the 6th leading cause of disability. 
Anxiety tends to emerge during early adolescence, and this occurs differentially between sexes: rates are 
equal pre-puberty and become 2-fold greater in females. Thus, identifying factors that predispose towards 
anxiety is crucial for identifying as-risk individuals early. We have proposed that the development of anxiety 
in adolescence is due, in part, to differences in the maturation of brain networks supporting emotion 
regulation. However, mechanisms that influence the development of these networks, and their implications 
for anxiety, are not well understood. We will test a model incorporating two risk factors (pubertal testosterone 
and axonal myelination) by collecting neuroimaging data from individuals transitioning into adolescence, half 
of whom are at high risk for developing anxiety . Aim 1: Work from our lab and others in healthy adolescents/ 
adults indicates that testosterone dampens the effectiveness of key emotion-regulation circuitry, and this 
dampening predicted anxiety increases. However, it is unclear if this impacts pathological levels of anxiety. 
Additionally, white matter integrity in this circuitry is weaker in anxiety, likely disrupting the efficiency of 
communication. Unfortunately, the mechanism by which this occurs remain unknown; we have proposed that 
weaker integrity impacts anxiety by exacerbating the impact of testosterone. Importantly, a key driver of 
white matter integrity is myelination, and these circuits begin myelinating during adolescence. Therefore, Aim 
1 uses a novel multi-modal myelin measure to test whether testosterone and myelination impact anxiety, as 
mediated by changes in emotion-regulation circuitry. Aim 2: The mechanisms that confer greater risk for 
anxiety in females remain unknown. Our work suggests that females have a higher sensitivity to testosterone 
in key emotion-regulation circuitry. Thus, Aim 2 tests whether testosterone has a greater impact on emotionregulation 
circuitry/pathological anxiety in girls. In sum, this project aims to identify mechanisms responsible 
for the development of adolescent anxiety. This work has the potential for tremendous public health impact 
by harnessing cutting-edge methods to uncover and validate novel risk trajectories for anxiety.

## Key facts

- **NIH application ID:** 10247844
- **Project number:** 5P20GM103653-09
- **Recipient organization:** DELAWARE STATE UNIVERSITY
- **Principal Investigator:** Jeffrey Martin SPIELBERG
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $213,480
- **Award type:** 5
- **Project period:** 2020-09-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10247844

## Citation

> US National Institutes of Health, RePORTER application 10247844, Testing Dual Mechanism Model of Adolescent Anxiety and Related Sex Differences (5P20GM103653-09). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10247844. Licensed CC0.

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