Clinical symptoms of anxiety disorders as predictors of political attitudes: A prospective cohort study. Vilja Helminen, Marko Elovainio, Markus Jokela. International Journal of Psychology, August 13 2021. https://doi.org/10.1002/ijop.12796
Abstract: Conservative 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.
DISCUSSION
We examined whether clinically assessed anxiety disorders (generalised anxiety disorder, phobia and panic disorder) were longitudinally related to political attitudes and vice versa. Higher scores on anxiety symptoms were associated with higher concerns about economic inequality, distrust in politics, environmental concern, as well as lower work ethic. These associations were observed particularly with symptoms of generalised anxiety disorder (GAD) and phobia, whereas symptoms of panic disorder did not have independent associations with political attitudes. Most of these associations were small in magnitude (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 associations between threat sensitivity and political ideology (e.g., Jost et al., 2003; Onraet et al., 2013) may not generalise 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 ideology (e.g., Cheng et al., 2012; Poortinga et al., 2011), and these attitudes were associated with higher scores on anxiety 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 conservative attitudes, whereas distrust in politics is more ambiguous—insofar as it reflects a distrust towards governmental decision making, it might represent more conservative than liberal attitudes on the conservative–liberal axis.
Based on the theory of motivated cognition (Jost et al., 2003), we would have expected the anxiety symptoms to predict more racist attitudes, more authoritarian leanings and more support for traditional family values, but these attitudes were not associated with anxiety disorder 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 attitudes. 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 conservative 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 indicating 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 variation between countries in how these associations manifest. In our study, the political attitudes at age 50 were measured in 2008–2009 when economic issues were very salient in the wake of the global financial crisis and economic recession in Great Britain. This might have amplified the relevance of perceived economic inequality and would be in line with the findings of Brandt et al. (2021) that economic threats are generally associated with more left-leaning attitudes in the economic domain.
Most notably, in the recent study by Brandt et al. (2021), the associations between different types of threats and different political beliefs were not consistent between countries, with the threat being associated with more right-wing beliefs in some countries and more left-wing beliefs in others. Especially in this light, our findings might indeed reflect a phenomenon constrained to a specific country, period of time, or political context, rather than more generalisable associations between threat sensitivity and political attitudes. This makes our sample the most pressing limitation of our study, as it included only a specific birth cohort from Great Britain.
Regarding study limitations, the CIS-R queried the participants about their anxiety symptoms experienced in the past week, which might have weighted the assessment of anxiety symptoms towards short-term symptoms and not long-term dispositions. However, many measures of mental health that assess symptoms in past weeks or months show considerable rank-order stability between individuals (e.g., GHQ), so clinical measures do not measure only transient psychological states but also more persistent trait-like dispositions. Fourth, the observational study design does not allow us to make causal conclusions. Indeed, our findings suggest that the associations between anxiety disorders and political attitudes may be 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 differences 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 sensitivity. Clinically assessed symptoms of anxiety disorders were not associated with conservative political attitudes in the British cohort under examination. Rather, they were either unrelated to beliefs that correlate with conservative 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 economic inequality and preserving the environment, as well as lower work ethic and higher distrust in politics.
Our analysis emphasises the need for multiple clinical 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 phenomenon in more detail while taking into account the specific political and cultural settings.
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