Diurnal variation in anxiety and activity is influenced by chronotype and probable anxiety-related disorder status
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Anxiety symptoms vary moment-to-moment within a day. One factor that may influence these variations is chronotype. Evening chronotypes prefer to engage in activities (e.g., sleep, physical and social activity) later in the day, and evening chronotype is implicated in psychopathology, including anxiety-related disorders. However, it is unknown whether chronotype influences diurnal variation in anxiety symptoms and whether these effects are amplified in individuals with a probable anxiety-related disorder. We examined the diurnal variation in anxiety symptoms and daily activities in morning and evening chronotypes with and without probable generalized anxiety disorder (GAD) or obsessive-compulsive disorder (OCD) in a community sample of adults (N = 410). Evening chronotypes reported higher anxiety symptoms, particularly in the evening hours, and lower engagement in daily activities, predominantly in the morning hours. Evening chronotypes with probable GAD or OCD reported worse anxiety symptoms in the evening. Our findings indicate that anxiety symptoms and engagement in daily activities fluctuate considerably across the day, and these patterns differ depending on chronotype. Evening chronotypes have more anxiety symptoms in the evening, despite preferring this time of day. Personalized treatment approaches that consider chronotype and target certain times of day may be efficient in alleviating peaks in anxiety symptoms.
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Eveningness chronotype is associated with worst anxiety symptoms in the evening among non-clinical adults with self-reported anxiety or OC symptoms.
“Cox et al. [47] found eveningness chronotype was associated with worst anxiety symptoms in the evening among non-clinical adults with self-reported anxiety or OC symptoms.”
From The rollercoaster of obsessive-compulsive disorder: How chronotype and time of day affect behavioral inhibition in adults with OCD (2025) · cites this paper as [47]
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Self-citation
- Authors
- Cox, R. C., Wright, K. P., Axelsson, J., & Balter, L. J. T.
- Affiliations
- University of Colorado Boulder (US)
- Stockholm University (SE)
- Corresponding author
- Balter, Leonie J.T.
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2024-08
- Volume
- 338
- Pages
- 116006
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W4399272645
- Cited by
- 13
- References
- 67
- Citations by year
- 2026: 6 · 2025: 7
- FWCI
- 5.34
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psychiatry Research (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL149646)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- chronotype, diurnal variation, anxiety symptoms, generalized anxiety disorder, obsessive-compulsive disorder, evening chronotype, personalized treatment, circadian rhythm
- MeSH terms
- Chronotype, Activities of Daily Living, Adolescent, Adult, Anxiety, Anxiety Disorders, Circadian Rhythm, Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Sleep, Young Adult
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