International Journal of Psychology

International Journal of Psychology, 2021

DOI: 10.1002/ijop.12796

Clinical symptoms of anxiety disorders as predictors

of political attitudes: A prospective cohort study
Vilja Helminen1 , Marko Elovainio1,2 , and Markus Jokela1
1 Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki,
Finland
2 National Institute for Health and Welfare, Finland

C onservative political ideologies have been suggested to correlate with elevated sensitivity to threat. However, it
is unclear whether the associations between threat sensitivity and political attitudes can be observed with clinical
measures of mental health. We examined how anxiety disorders predicted attitudes on several political issues. Participants
were 7253 individuals from the 1958 British Birth Cohort study. Symptoms of generalised anxiety disorder, phobia
and panic were assessed in a clinical interview at age 44, and opinions about political issues were self-reported by
the participants 6 years later. Anxiety symptoms were associated with higher concerns about economic inequality,
preservation of the environment, distrust in politics and lower work ethic. No associations were observed with racist
or authoritarian attitudes, or support for traditional family values. We also assessed how political attitudes at ages 33 and
42 predicted anxiety disorder symptoms at age 44, revealing a possible bidirectional association between concern for
economic inequality and anxiety disorder symptoms. These findings do not support an association between conservative
political attitudes and elevated threat sensitivity. Rather, elevated anxiety may increase concerns about social inequality
and the environment.
Keywords: Political attitudes; Threat; NCDS; Fear; Anxiety.

According to the ‘motivated social cognition’ theory
of political ideology, differences in political ideology
and attitudes partly reflect psychological differences in
sensitivity to threat (Altemeyer, 2006; Duckitt, 2001). In
particular, conservative beliefs have been suggested to
defend an individual against psychological threats by ful-
filling the individual’s heightened needs for security and
certainty (Jost et al., 2003; Jost et al., 2007). Conservative
people are suggested to be more sensitive to threatening
and ambiguous stimuli than people with liberal attitudes,
and this may help to explain why they find conservative
political views more appealing. However, it is unclear (1)
whether the associations between threat sensitivity and
ideology extend to other sociopolitical attitudes besides
conservatism, and (2) whether these associations can be
observed also with clinical measures of threat sensitivity,
that is, measures of anxiety disorder.
Political ideology is often represented as liberal-
conservative or left–right continuum. The liberal or
left side is generally associated with such things as
equal opportunity, more just distribution of wealth and
the rights of minorities. The conservative or right side,
by contrast, is associated with free enterprise, capital-
ism, authoritarianism and traditional values. Elevated
threat sensitivity has been associated with conser-
vative political ideology in many different research
designs (Jost et al., 2003; Onraet et al., 2013). Most
studies have focused only on conservatism, which
has often been assessed with self-identification on
a one-dimensional liberal-conservative continuum
(e.g., Jost et al., 2007), right-wing authoritarianism
(e.g., Duckitt & Fisher, 2003), or party affiliation and
support for conservative or liberal political candidates
(e.g., Ogilvie et al., 2008).

Correspondence should be addressed to Vilja Helminen, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland. (E-mail:
vilja.helminen@helsinki.fi)
The analyses in this work are based wholly or in part on analysis of data from the National Child Development Study (NCDS). The data was deposited
at the UK Data Archive by the Centre for Longitudinal Studies at the Institute of Education, University of London. NCDS is funded by the Economic
and Social Research Council (ESRC).
Vilja Helminen: Conceptualisation, methodology, formal analysis, writing—original draft.
Marko Elovainio: Methodology, writing—review and editing.
Markus Jokela: Conceptualisation, methodology, writing—review and editing, supervision.

© 2021 The Authors. International Journal of Psychology published by John Wiley & Sons Ltd on behalf of International Union of Psychological Science.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any
medium, provided the original work is properly cited.
2 HELMINEN, ELOVAINIO, JOKELA
To test whether threat sensitivity is broadly related
to different aspects of conservative beliefs, it is neces-
sary to examine specific subscales of political attitudes
instead of broad measures of ideology; it is possible that
the associations between threat sensitivity and conser-
vatism are driven by specific domains of political atti-
tudes. For example, threat sensitivity has been linked to
attitudes towards out-groups, including negative attitudes
towards immigrants and Muslims (e.g., Golec de Zavala
et al., 2010; Van de Vyver et al., 2016) and opposition to
affirmative action, less support for multiculturalism, and
the promotion of equal rights (e.g., Renfro et al., 2006;
Verkuyten, 2009).
While conservatives tend to hold more negative atti-
tudes towards out-groups than liberals (Jost et al., 2009),
the general attitude towards outgroups is not a defining
feature of conservative political ideology which encom-
passes a broader set of political positions. It is therefore
important to examine whether threat sensitivity is system-
atically related to multiple political attitudes related to the
conservative/liberal axis, or whether the associations are
related to more narrow domains of political attitudes.
It is also important to broaden the measures of threat
sensitivity. Threat sensitivity may represent reactions of
fear and anxiety. Fear occurs when the threat is imminent
and the fear response usually dissipates quickly. Anxi-
ety is a sustained response to uncertain threats (Sylvers
et al., 2011).
There are individual differences in how easily and how
strongly these threat responses arise (Sylvers et al., 2011).
Extreme reactivity can develop into clinical anxiety disor-
ders, such as generalised anxiety disorder (GAD), panic
disorder, specific phobia, or social anxiety. These disor-
ders manifest as excessive fear and worry either in relation
to specific situations or in a more free-floating manner, as
well as somatic symptoms such as physiological arousal,
muscle tension, fatigue and sleep disturbances (Sylvers
et al., 2011). Anxiety disorders can be divided into
two sub-dimensions of distress (sometimes also called
anxious-misery) and fear, so that phobias are more closely
related to fear, GAD to distress and panic disorder equally
to both depending on the specific symptom profile (e.g.,
Eaton et al., 2013; Vaidyanathan et al., 2009).
The evidence on clinical measures and political atti-
tudes is very limited. Hatemi et al. (2013) found that
recent phobic fear and lifetime social phobia correlated
with conservative self-identification and more negative
out-group attitudes, suggesting that clinical symptoms
related to threat sensitivity may be associated with more
conservative political orientation.
The purpose of the present study was to extend previ-
ous research by using a broader assessment of political
attitudes and a clinical assessment of threat sensitivity.
We used data from a large longitudinal cohort study to
examine whether symptoms of anxiety and fear assessed
in a clinical interview were longitudinally associated with
© 2021 The Authors. International Journal of Psychology published by John Wiley & Sons Ltd on behalf of International Union of Psychological Science.
seven different domains of political attitudes assessed
6 years later. We also examined the reverse temporal
direction, that is, whether political attitudes assessed
two and 9 years earlier predicted the presence of anxiety
symptoms in the clinical interview.
Based on the theory of motivated social cognition and
previous studies, it would be expected that anxiety dis-
order symptoms are associated with those attitudes that
are usually considered to reflect right-wing or conser-
vative political ideology, or at the very least with atti-
tudes concerning out-groups if not conservative attitudes
more broadly. Alternative hypotheses are also plausible:
anxiety proneness might be related to generalised worry
over different life domains, in which case the associations
could be observed also in attitudes unrelated to conserva-
tive beliefs. We assume that the associations would be as
strong, or even stronger, with the clinical measures of fear
and anxiety than with the previously used measurement
instruments of threat, as clinical measures assess extreme
tendency to experience fear and anxiety.
METHODS
Sample
Participants were from the National Child Development
Study (NCDS; Power & Elliott, 2006), which follows
18,558 participants from Great Britain born in one partic-
ular week in 1958. Since the first survey, there have been
nine follow-up surveys at the ages of 7, 11, 16, 23, 33, 42,
46, 50 and 55. An additional biomedical survey for 12,069
of the cohort members in 2002–2003 at age 44 also cov-
ered biomedical risk factors and current health condition,
including mental health. The present study utilises data
from the 8th follow-up survey conducted in 2008–2009
at age 50, the biomedical survey conducted in 2002–2003
at age 44, as well as the 5th and 6th follow-up surveys
conducted in 1991 at age 33 and in 1999–2000 at age
42, respectively (University of London, Institute of Edu-
cation, Centre for Longitudinal Studies, 2008a, 2008b,
2009, 2012).
The current sample comprised those cohort mem-
bers selected for the additional biomedical survey. The
selection was based on the response to previous three
follow-up surveys leaving 12,069 participants out of the
original 18,558 cohort members. A total of 9377 partic-
ipants answered the biomedical survey. Compared to the
surviving cohort, those with behavioural problems, lower
social class and lower cognitive ability in childhood are
somewhat under-represented in the biomedical survey
(Atherton et al., 2008).
A total of 1182 of those who answered the biomedical
survey had not participated in the 8th follow-up survey,
and were therefore excluded from the analyses. Further
942 had not answered some of the relevant mental health,

political attitude, or personality questions and were
excluded, leaving the final sample to be 7253 (48.1%
men) for the analyses examining how clinical levels of
fear and anxiety at age 44 predict political attitudes at age
50. Of these 7253 participants, 626 had not responded
to some of the relevant political attitude questions at age
33 or 42 and were excluded from the analyses examining
how earlier political attitudes predict clinical levels of
fear and anxiety at age 44, leaving the final sample for
these analyses to be 5823 (52.3% men).
We examined attrition using logistic regression to see
if participants’ gender or GAD, phobia and panic symp-
toms predicted non-participation in the 8th follow-up sur-
vey. Assessed separately, panic, phobia, GAD (ps < .05)
and gender (p < .001) all predicted attrition statistically
significantly. Controlling for other predictors, only panic
was not a significant predictor of attrition. The odds ratios
showed one-point increase in participant’s GAD, panic, or
phobia score increasing the risk of non-response in the 8th
follow-up survey 1.1-fold.
Ethical approval for the NCDS was obtained from the
London Multi-centre Research Ethics Committee for sur-
veys at age 50 and 42, South-east Multi-centre Research
Ethics Committee for the biomedical survey at age 44,
and internally for the survey at age 33 which predates the
establishment of Multi-centre Research Ethics Commit-
tees (University of London, Institute of Education, Centre
for Longitudinal Studies, 2014). Study was performed in
accordance with the ethical standards as set forth in the
1964 Declaration of Helsinki and its later amendments.
Written informed consent was obtained from all indi-
vidual adult participants of the biomedical survey at age
44, and all participants were given information about and
the opportunity to opt out of the surveys at ages 33, 42 and
50 (University of London, Institute of Education, Centre
for Longitudinal Studies, 2014).
Measures
GAD, phobia and panic
GAD, phobia and panic disorder symptoms were
assessed at age 44 using the CIS-R (Lewis et al., 1992), a
widely used standardised interview for assessing common
mental health disorders. Each symptom category com-
prised four questions about the symptoms experienced
past week (e.g., ‘On how many of the past seven days
have you felt generally anxious/nervous/tense?’). A score
ranging from 0 to 4 was calculated for GAD, phobia and
panic symptoms separately, based on the reported severity
and frequency of symptoms, with higher scores indicat-
ing more severe and frequent symptoms. A mean score
consisting of GAD, phobia and panic symptoms was also
calculated to assess overall anxiety disorder symptoms.
For GAD, phobia and panic symptoms we used a cut-off
of two points out of four to divide participants into two
© 2021 The Authors. International Journal of Psychology published by John Wiley & Sons Ltd on behalf of International Union of Psychological Science.
ANXIETY DISORDERS PREDICTING ATTITUDES 3
categories: two points or more were considered clinical
levels of symptoms (Lewis et al., 1992).
Political attitudes
Political attitudes were assessed at ages 50, 42 and
33 with 21 statements covering, among others, attitudes
towards environmental issues, the severity of punishments
and marriage (e.g., ‘Schools should teach children to obey
authority’). Participants indicated to what extent they
agreed with the statements on a scale from 1 (strongly
agree) to 5 (strongly disagree). For the purposes of this
study, items were reverse coded for more intuitive inter-
pretation.
Level of education
For the analyses examining how anxiety disorder
symptoms at age 44 predict later political attitudes partic-
ipants’ level of education was categorised based on infor-
mation from the previous follow-up surveys as follows:
none (0), bad O-levels or CSE 2–5 (1), good O-levels or 1
A-level (2), 2 or more A-levels (3), sub-degree (4), degree
(5) and higher degree (6). For the analyses examining how
attitudes at age 33 predict later anxiety disorder symp-
toms, we used participants’ level of education at age 33
categorised as follows: none (0), CSE 2–5 (1), O-levels
(2), A-levels (3), professional qualifications (4), degree
level or higher (5).
Statistical analyses
The underlying structure of the attitude variables mea-
sured at age 50 was first examined with exploratory
factor analysis using maximum likelihood extraction
and oblimin rotation. The resulting attitude factors were
calculated as mean scores (not weighted by factor load-
ings) in further analyses. The associations of anxiety,
phobia and panic scores with later political attitudes were
estimated with linear regression. First, we used the mean
score of the three anxiety variables to predict the attitude
scales. We then examined each of the three subscales sep-
arately. In model 1, the mean anxiety disorder symptom
score was regressed on the attitude summary scores. In
model 2, the dummy variables indicating the presence of
clinical levels of each GAD, panic and phobia symptoms
were regressed on the attitude summary scores. Both,
models 1 and 2 were tested by running seven separate
linear regressions with the anxiety and fear variables as
predictors together with gender and level of education
as control variables. Regression results are reported as
unstandardised regression coefficients (B) and standard-
ised regression coefficients (β). No power analysis was
conducted before analysing the data. All analyses were
conducted using R version 3.6.1. Package psych was used
4 HELMINEN, ELOVAINIO, JOKELA
Figure 1. Scree plot showing eigenvalues for each factor of political
attitudes at the age of 50.
for the exploratory factor analysis. The analysis code is
available upon request.
RESULTS
We retained seven factors in the exploratory factor analy-
sis based on the results of parallel analysis and the exam-
ination of the scree plot (Figure 1). Table 1 shows the
factor loadings after rotation. Together, the seven fac-
tors explained 46.90% of the total variance and the com-
munalities ranged between .06 and .77. We interpreted
the factors to capture attitudes concerning (1) economic
inequality, (2) distrust in politics, (3) racism, (4) attitudes
concerning authority, (5) protecting the environment, (6)
family values and (7) work ethic. The solution is simi-
lar to the ones obtained in previous studies (e.g., Cheng
et al., 2012).
The factor loadings of one item (‘All women should
have the right to choose abortion’) was remarkably low,
with the highest loading being −0.23, so this item was not
included in any of the attitude scores. One item (‘Politi-
cians are in politics for self, not community benefit’) had
similar loadings on factors of inequality and distrust in
politics. We included the item in distrust in politics, as the
item content fitted the interpretation of the factors better.
The association between the mean anxiety disorder
symptom score and political attitudes (model 1), and
GAD, phobia and panic symptoms and political atti-
tudes (model 2) are shown in Tables 2 and 3. The mean
symptom score predicted higher concern about inequal-
ity (unstandardised B = 0.17, p < .001), distrust in poli-
tics (B = 0.09, p < .001) and concern for the environment
(B = 0.07, p < .001) and lower work ethic (B = −0.08,
p < .001).
Of the specific factors, GAD and phobia predicted
higher concern for economic inequality (GAD: B = 0.14,
© 2021 The Authors. International Journal of Psychology published by John Wiley & Sons Ltd on behalf of International Union of Psychological Science.
p < .001; phobia: B = 0.18, p < .001), and environmental
concern (GAD: B = 0.07, p = .041; phobia: B = 0.11,
p = .016). Phobia also predicted higher distrust in politics
(B = 0.12, p = .021), and lower work ethic (B = −0.10,
p = .026).
Tables 4 and 5 shows how political attitudes at age
33 and 42 predicted anxiety disorder symptoms at age
44. Of the attitudes at age 42, concern about economic
inequality and authoritarian attitudes predicted higher
likelihood of GAD and panic disorder; higher scores on
family values predicted lower likelihood of GAD and
panic; and concern about economic inequality predicted
higher likelihood of phobias. Of the attitudes at age 33,
concern about economic inequality and work ethic were
associated with higher likelihood of GAD; and concern
about economic inequality was associated with higher
likelihood of phobia.
DISCUSSION
We examined whether clinically assessed anxiety disor-
ders (generalised anxiety disorder, phobia and panic dis-
order) were longitudinally related to political attitudes
and vice versa. Higher scores on anxiety symptoms were
associated with higher concerns about economic inequal-
ity, distrust in politics, environmental concern, as well as
lower work ethic. These associations were observed par-
ticularly with symptoms of generalised anxiety disorder
(GAD) and phobia, whereas symptoms of panic disor-
der did not have independent associations with political
attitudes. Most of these associations were small in magni-
tude (B < 0.20). Higher concern about inequality assessed
years before the clinical interview also predicted higher
likelihood of GAD and phobia symptoms, suggesting a
possible bidirectional association.
The findings suggest that the previously reported asso-
ciations between threat sensitivity and political ideology
(e.g., Jost et al., 2003; Onraet et al., 2013) may not gen-
eralise to clinical measures of anxiety disorders or may
be limited to only some political and cultural contexts. In
fact, the current associations between anxiety disorders
and political attitudes were opposite to the hypothesis of
conservatism and heightened threat sensitivity, because
concerns about inequality and the environment tend to
be associated with liberal and left-wing political ideol-
ogy (e.g., Cheng et al., 2012; Poortinga et al., 2011), and
these attitudes were associated with higher scores on anx-
iety disorders. Lower work ethic and distrust in politics
were also associated with anxiety disorders. Lower work
ethic would probably be related to more liberal than con-
servative attitudes, whereas distrust in politics is more
ambiguous—insofar as it reflects a distrust towards gov-
ernmental decision making, it might represent more con-
servative than liberal attitudes on the conservative–liberal
axis.
 ANXIETY DISORDERS PREDICTING ATTITUDES 5

TABLE 1
Factor analysis of political attitude items at the age of 50

Loadings
Item F1 F2 F3 F4 F5 F6 F7 h2

Ordinary working people do not get their fair share of 0.53 0.01 0.05 0.17 0.10 −0.01 −0.00 0.37
the nation’s wealth
There is one law for the rich and one for the poor 0.89 −0.02 0.00 −0.02 −0.01 −0.02 0.01 0.77
Management will always try to get the better of 0.45 0.11 −0.09 0.06 0.02 0.04 0.03 0.33
employees if it gets the chance
Politicians are mainly in politics for their own benefit 0.38 0.33 −0.04 0.06 −0.11 0.04 0.01 0.46
and not for the benefit of the community
None of the political parties would do anything to 0.06 0.72 −0.02 0.01 −0.03 −0.01 −0.01 0.59
benefit me
It does not really make much difference which political −0.04 0.81 0.03 0.02 0.02 −0.01 0.01 0.63
party is in power in Britain
I would not mind working with people from other races 0.01 0.01 0.81 0.00 0.00 0.02 0.04 0.66
I would not want a person from another race to be my 0.04 −0.01 −0.78 −0.02 0.01 0.04 0.03 0.62
boss
I would not mind if a family from another race moved in 0.06 0.01 0.70 −0.09 0.02 0.02 −0.02 0.50
next door to me
People who break the law should be given stiffer 0.01 −0.01 0.01 0.81 −0.02 0.01 −0.00 0.66
sentences
School should teach children to obey authority −0.01 −0.03 −0.01 0.54 0.07 0.10 0.06 0.34
For some crimes the death penalty is the most 0.04 0.09 −0.11 0.61 −0.04 −0.05 −0.02 0.49
appropriate sentence
Problems in the environment are not as serious as 0.04 0.14 −0.03 0.04 −0.58 0.11 −0.03 0.41
people claim
We should tackle problems in the environment even if 0.03 −0.04 0.04 0.00 0.74 0.03 −0.02 0.57
this means slower economic growth
Preserving the environment is more important than any 0.01 0.19 −0.07 −0.00 0.62 0.04 0.00 0.40
other political issue today
Marriage is for life −0.04 −0.04 0.14 0.12 −0.01 0.52 0.02 0.31
Couples who have children should not separate −0.01 −0.01 −0.05 −0.02 0.00 0.75 0.00 0.56
All women should have the right to choose to have an 0.04 −0.03 0.08 0.10 0.04 −0.23 0.03 0.06
abortion if they wish
Having almost any job is better than being unemployed −0.08 0.02 0.09 0.16 0.01 0.05 0.46 0.28
If I did not like a job I’d pack it in, even if there was no 0.06 0.04 −0.02 −0.01 0.02 0.12 −0.63 0.39
other job to go to
Once you have got a job it’s important to hang on to it 0.10 0.04 −0.05 −0.04 0.01 0.0 0.66 0.49
even if you do not really like it
Eigenvalues 1.60 1.51 1.86 1.54 1.31 0.96 1.08
% of variance 7.6 7.2 8.9 7.3 6.2 4.6 5.1
α 0.74 0.75 0.80 0.69 0.66 0.46 0.60

Note. Loadings ≥ |0.30| are in bold.

Based on the theory of motivated cognition (Jost
et al., 2003), we would have expected the anxiety symp-
toms to predict more racist attitudes, more authoritarian
leanings and more support for traditional family values,
but these attitudes were not associated with anxiety disor-
der symptoms. Our results are in contrast to the study by
Hatemi et al. (2013) in which clinically assessed social
phobia was associated with more negative out-group atti-
tudes. Our lack of specific measure of social phobia, or
differences in the measurement of racism and out-group
attitudes, might explain the differing results. However,
our findings are in line with the few studies that have
concluded that anxiety might not lead to more conser-
vative political attitudes (e.g., Huddy et al., 2005; Ray
& Najman, 1987). At least two recent studies (Bakker
et al., 2020; Osmundsen et al., 2019) also found no
support for the link between conservatism and threat
reactivity using psychophysiological measures, which
casts further doubt on the motivated social cognition
explanation of conservatism.
It is also worth noting that there is evidence indicat-
ing that the association between threat sensitivity and
political orientation is a far more complex phenomenon
than the theory of motivated cognition suggests. A recent
cross-cultural study by Brandt et al. (2021) found that the
way feelings of threat affect political orientation might
depend on the type of threat and content of political
beliefs under study, and there also seems to be significant

© 2021 The Authors. International Journal of Psychology published by John Wiley & Sons Ltd on behalf of International Union of Psychological Science.
6 HELMINEN, ELOVAINIO, JOKELA

TABLE 2 TABLE 4
Mean anxiety disorder score at the age of 44 predicting political Political attitudes at the ages of 42 and 33 predicting anxiety
attitudes at the age of 50 disorders at the age of 44

Anxiety disorders Mean anxiety score

Predicted attitude B SE 𝛽 p B SE β p

Inequality 0.17 0.03 0.08 <.001 Age 42

Distrust in politics 0.09 0.03 0.04 <.001 Inequality 0.04 0.01 0.09 <.001
Racism 0.04 0.02 0.02 .057 Trust in politics 0.00 0.01 −0.01 .601
Authority 0.02 0.02 0.01 .516 Racism −0.02 0.01 −0.03 .036
Environment 0.07 0.02 0.04 <.001 Authority 0.02 0.01 0.04 .014
Family values −0.04 0.03 −0.02 .152 Environment 0.02 0.01 0.04 .002
Work ethic −0.08 0.02 −0.04 <.001 Family values −0.02 0.01 −0.05 <.001
Work ethic 0.00 0.01 0.00 .897
Note: Values are coefficients from seven separate linear regression
Age 33
models, adjusted for gender and education. Values are unstandardised
Inequality 0.03 0.01 0.08 <.001
regression coefficients (B) and standardised regression coefficients (β),
Trust in politics −0.00 0.01 −0.01 .575
SE is the standard error of the unstandardised coefficient.
Racism −0.00 0.01 −0.01 .653
Authority 0.00 0.01 0.00 .888
variation between countries in how these associations Environment 0.02 0.01 0.03 .029
Family values 0.00 0.01 0.00 .995
manifest. In our study, the political attitudes at age 50
Work ethic 0.01 0.01 0.02 .137
were measured in 2008–2009 when economic issues
were very salient in the wake of the global financial crisis Note: Values are coefficients from two separate linear regression models
and economic recession in Great Britain. This might have in which political attitudes were used to predict later anxiety symptoms.
Analysis at age 33 are adjusted for gender and education. Values are
amplified the relevance of perceived economic inequal- unstandardized regression coefficients (B) and standardised regression
ity and would be in line with the findings of Brandt coefficients (β), SE is the standard error of the unstandardized coeffi-
et al. (2021) that economic threats are generally asso- cient.
ciated with more left-leaning attitudes in the economic
domain. Regarding study limitations, the CIS-R queried the
Most notably, in the recent study by Brandt participants about their anxiety symptoms experienced in
et al. (2021), the associations between different types of the past week, which might have weighted the assess-
threats and different political beliefs were not consistent ment of anxiety symptoms towards short-term symptoms
between countries, with the threat being associated with and not long-term dispositions. However, many measures
more right-wing beliefs in some countries and more of mental health that assess symptoms in past weeks or
left-wing beliefs in others. Especially in this light, our months show considerable rank-order stability between
findings might indeed reflect a phenomenon constrained individuals (e.g., GHQ), so clinical measures do not mea-
to a specific country, period of time, or political context, sure only transient psychological states but also more
rather than more generalisable associations between persistent trait-like dispositions. Fourth, the observational
threat sensitivity and political attitudes. This makes our study design does not allow us to make causal conclu-
sample the most pressing limitation of our study, as it sions. Indeed, our findings suggest that the associations
included only a specific birth cohort from Great Britain. between anxiety disorders and political attitudes may be

TABLE 3
Symptoms of generalised anxiety disorder (GAD), panic disorder, and phobia at the age of 44 predicting political attitudes at the age of
50

GAD Panic Phobia

Predicted attitude B SE 𝛽 p B SE 𝛽 p B SE 𝛽 p

Inequality 0.14 0.04 0.04 <.001 0.02 0.08 0.00 .764 0.18 0.05 0.05 <.001
Distrust in politics 0.07 0.04 0.02 .085 0.06 0.08 0.01 .472 0.12 0.05 0.03 .021
Racism 0.04 0.04 0.01 .288 −0.03 0.07 −0.01 .672 0.05 0.04 0.01 .235
Authority 0.01 0.04 0.00 .779 0.05 0.08 0.01 .549 0.03 0.05 0.01 .492
Environment 0.07 0.04 0.02 .041 −0.11 0.07 −0.02 .128 0.11 0.04 0.03 .016
Family values −0.05 0.04 −0.01 .217 0.02 0.09 0.00 .829 −0.08 0.05 −0.02 .133
Work ethic −0.05 0.04 −0.02 .167 −0.08 0.08 −0.01 .303 −0.10 0.05 −0.03 .026

Note: Values are coefficients from seven separate linear regression models, adjusted for gender and education. Anxiety disorder symptoms are coded
0 (not presenting clinical levels of symptoms), 1 (presenting clinical levels of symptoms). Values are unstandardised regression coefficients (B) and
standardised regression coefficients (𝛽), SE is the standard error of the unstandardised coefficient.

© 2021 The Authors. International Journal of Psychology published by John Wiley & Sons Ltd on behalf of International Union of Psychological Science.
 ANXIETY DISORDERS PREDICTING ATTITUDES 7

TABLE 5
Political attitudes at the ages of 42 and 33 predicting anxiety disorders at the age of 44

GAD Panic Phobia

OR 95% CI p OR 95% CI p OR 95% CI p

Age 42
Inequality 1.32 [1.13, 1.54] <.001 1.54 [1.12, 2.14] <.001 1.58 [1.31, 1.92] <.001
Trust in politics 0.90 [0.77, 1.05] .179 1.09 [0.81, 1.49] .566 1.06 [0.88, 1.26] .551
Racism 0.87 [0.73, 1.03] .105 0.84 [0.59, 1.18] .319 0.95 [0.78, 1.15] .593
Authority 1.18 [1.01, 1.39] .037 1.46 [1.05, 2.06] .026 1.17 [0.97, 1.43] .099
Environment 1.18 [0.98, 1.41] .073 0.86 [0.60, 1.22] .395 1.8 [0.95, 1.46] .126
Family values 0.80 [0.70, 0.91] <.001 0.74 [0.57, 0.96] .026 0.88 [0.75, 1.02] .097
Work ethic 1.08 [0.94, 1.26] .284 0.80 [0.60, 1.06] .116 0.99 [0.84, 1.18] .935
Age 33
Inequality 1.40 [1.21, 1.63] <.001 1.34 [0.99, 1.84] .061 1.41 [1.18, 1.69] <.001
Trust in politics 0.92 [0.79, 1.08] .328 0.95 [0.69, 1.31] .750 0.98 [0.81, 1.18] .824
Racism 0.93 [0.78, 1.11] .431 1.14 [0.80, 1.59] .449 1.10 [0.90, 1.34] .335
Authority 1.02 [0.87, 1.19] .821 1.19 [0.85, 1.66] .314 0.95 [0.79, 1.15] .616
Environment 1.18 [0.99, 1.40] .073 1.13 [0.79, 1.63] .505 1.00 [0.81, 1.24] 1.00
Family values 0.98 [0.86, 1.13] .808 0.80 [0.60, 1.07] .129 1.07 [0.90, 1.26] .436
Work ethic 1.24 [1.07, 1.44] .005 0.95 [0.71, 1.27] .705 0.93 [0.78, 1.10] .404

Note: Values are odds ratios from six separate logistic regression models in which political attitudes were used to predict later symptoms of GAD,
panic disorder and phobia. Analyses at age 33 were adjusted for gender and education. Anxiety disorder symptoms are coded 0 (not presenting clinical
levels of symptoms), 1 (presenting clinical levels of symptoms).

bidirectional, and at least one previous study (Hatemi
et al., 2013) found evidence of a genetic correlation. Thus,
it is yet unclear whether anxiety disorders cause differ-
ences in political attitudes, or whether they represent the
result of common causes.
Together the current findings do not provide evidence
to support the theory of motivated social cognition (Jost
et al., 2003; Jost et al., 2007) according to which more
conservative attitudes would reflect heightened threat sen-
sitivity. Clinically assessed symptoms of anxiety disor-
ders were not associated with conservative political atti-
tudes in the British cohort under examination. Rather, they
were either unrelated to beliefs that correlate with conser-
vative vs. liberal ideology (e.g., racist and authoritarian
attitudes and traditional family values) or they predicted
more liberal or left-leaning attitudes of concerns over eco-
nomic inequality and preserving the environment, as well
as lower work ethic and higher distrust in politics.
Our analysis emphasises the need for multiple clin-
ical and non-clinical measures of threat sensitivity,
and more detailed measures of political attitudes than
the conservative–liberal axis, to better evaluate the
psychological underpinnings of political attitudes and
ideologies. Although the association between threat and
political orientation has been examined in a significant
number of studies, there are multiple aspects that have not
been given enough attention. As there is recent evidence
that the association depends on the type of threat as well
as the type of political beliefs (Brandt et al., 2021), future
studies could examine if there are differences in how
susceptible individuals are to different types of threat, and
how this in turn might affect their political leanings. As
previously mentioned, there is also evidence suggesting
that the way feelings of threat affect political orientation
differs significantly across countries. As the majority of
the previous studies regarding the association between
threat and political orientation have been conducted in
the United States or western Europe, little is yet known
about how the cultural and political context might affect
this phenomenon. Some studies have identified factors
such as ideological constraint, the economic conditions
and the ideological status quo as important determinants
of how threat is associated with political orientation (e.g.,
Malka et al., 2014), but at least one large cross-cultural
study failed to find significant support for any consistent
effects of country characteristics (Brandt et al., 2021).
This highlights the urgent need for both, studies using
more diverse cross-cultural samples, as well as a larger
and more diverse body of research examining this phe-
nomenon in more detail while taking into account the
specific political and cultural settings.
Manuscript received March 2021
Revised manuscript accepted July 2021
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