Figure 4 |. Symptom progression model of anxiety disorders.

a | Symptom progression models describe the developmental pathways of vulnerability and risk factors over time that are typical of the expression of subclinical and transient early signs, the onset of the clinical disorder and the typical onset of complications and comorbidities associated with a persistent course of the disorder, if untreated. For anxiety disorders, broadly speaking, three main symptom onsets can be identified: subthreshold anxiety symptoms (trajectory 1), threshold anxiety disorders (trajectory 2) and secondary complications and comorbidities (trajectory 3). b | Targeted preventive therapies in the preclinical stages of anxiety could reduce the prevalence of clinically relevant anxiety disorders (black arrows). Targeted interventions after the onset of the disorder, such as cognitive–behavioural therapy, could reduce the severity of complications (blue arrows). Adapted with permission from REF. 227, Elsevier.