Theory-of-mind, cognitive development, and children's interpretation of anxiety-related physical symptoms

The present study investigated developmental patterns in children's interpretation of anxiety-related physical symptoms and emotional reasoning, and to what extent these phenomena are influenced by children's level of cognitive development. A large sample of 4-13-year-old children (N=358) were exposed to vignettes in which the presence and absence of physical symptoms was systematically varied. In addition, children completed a series of conservation tasks and a theory-of-mind-test. Results demonstrated that from the age of 7, children were increasingly able to link physical symptoms to anxiety. Furthermore, cognitive development appeared to enhance children's ability to interpret physical symptoms as a sign of anxiety. Further, children's tendency to infer danger from vignettes with physical symptoms (i.e., emotional reasoning) was already prominent in 4-6-year-olds. The implications for physical symptom-based theories of childhood anxiety are briefly discussed.