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Professors share 5 myths students believe about college, how to write a character analysis essay, anxiety among students: what do teachers think about it, dorm overbooking and transitional housing: problems colleges are trying to solve, causes of social anxiety disorder essay sample, example.

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Although the environment we live in definitely has an effect on how people feel, it is important to consider the biological factors leading to social anxiety disorder (SAD). In particular, biologists believe SAD is related to a dysfunction of brain circuits responsible for regulating emotions and the “fight or flight” response center ( WebMD ). There is a brain structure called the amygdala; it is known to play a role in controlling the fear response. If a person has an overactive amygdala, they often display an excessive “fear” type of emotional response; therefore, whenever a situation occurs that can be interpreted as even slightly uncomfortable, a person with SAD will overreact in terms of fear ( Mayo Clinic ). In addition, genetic factors should also be considered when studying the causes of SAD, because social anxiety may occur when it was also present in a first-degree relative: parent, sibling, or child.

Another significant group of factors responsible for the development of SAD is a group of environmental factors, including psychological climates. The first social interactions people make in their lives are usually connected to parents; from them, people learn basic social rules, what is acceptable and what is not, how it is like to be loved and to be ignored, and so on. Based on what happened in their childhood, people construct their personal systems of beliefs, including assumptions on what other people think about them. Commonly, if a child is loved and respected by parents, he or she later assumes that other people treat them in the same way; however, if a child is often criticized, it prevents him or her from developing a sense of personal value, and for such people, it is more difficult to become socially confident ( Overcoming ).

In addition, the way parents deal with different life situations also influences children’s personality. According to Cheryl Carmin, a psychiatrist and director of the clinical psychology training program at the Ohio State University Wexner Medical Center, parents are often responsible for developing social anxiety in a child. “A parent or a significant adult figure may model that it’s appropriate to be anxious in situations where your performance will be evaluated […]. For example, a parent who is commenting on being nervous about a performance review or who tells their child to not be anxious before their first “show and tell” may be priming the child to, in fact, be anxious in that situation. It’s also quite possible that any number of these factors interact,” says Dr. Carmin ( Live Science ).

The reasons why people develop social anxiety are different, but generally they can be divided into two categories: biological and environmental. A biological group of reasons includes dysfunctions in brain work, as well as excessive “fight or flight” reactions. Environmental factors include psychological influences caused by parents on their children, as well as the models that parents provide in the form of teaching their children consciously or unconsciously.

“Social Anxiety Disorder (social Phobia).” Mayo Clinic. N.p., n.d. Web. 09 June 2015. <http://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/basics/causes/con-20032524>

“What is Social Anxiety Disorder? Symptoms, Treatments, & More.” WebMD. WebMD, n.d. Web. 09 June 2015. <http://www.webmd.com/anxiety-panic/guide/mental-health-social-anxiety-disorder?page=2>

“Understanding Social Anxiety and Shyness.” Overcoming. N.p., n.d. Web. 09 June 2015. <http://www.overcoming.co.uk/single.htm?ipg=8622>

Zimmermann, Kim Ann. “Social Anxiety Disorder: Causes, Symptoms and Treatment.” LiveScience. TechMedia Network, 28 Aug. 2014. Web. 09 June 2015. <http://www.livescience.com/45267-social-anxiety-disorder.html>

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The Causes of Anxiety

Reviewed by Psychology Today Staff

The true cause of anxiety is being a human being, gifted with the capacity to imagine a future. As a mental state of apprehension about what might, or might not, lie ahead, anxiety reflects uncertainty about future circumstances, whether regarding one’s own health, job, or love life, or climate change or a downturn in the economy. It can be triggered by events in the real world—an upcoming doctor’s visit, relationship conflict, a rent increase—or generated wholly internally, through thoughts of real or imagined threats (not knowing what to say when the boss calls on you in a meeting).

Occasional bouts of anxiety are entirely normal and one of the unavoidable costs of being alive; anxiety alerts us to danger, compels our attention, and urges us to make necessary preparations to protect ourselves. But sometimes worries intensify or persist, endlessly caroming through the brain without engaging problem-solving mechanisms, or overwhelming them, and impairing the ability to function. Many factors can contribute to prolonged rumination—worry, the cognitive component of anxiety— over uncertain outcomes.

On This Page

  • What are the most common causes of anxiety?
  • Can stress bring on anxiety?
  • Why are rates of anxiety increasing?
  • What is the difference between fear and anxiety?
  • Is anxiety ever good?
  • Who is prone to anxiety?
  • Do genes cause anxiety?
  • Can uncertainty cause anxiety?
  • Does personality play a role in anxiety?
  • What biological factors influence anxiety?
  • Are there risk factors for anxiety?
  • What happens in the brain with anxiety?
  • Why does anxiety so often occur with depression?

Anxiety is a response to uncertainty and danger, and the trigger can be almost anything, or nothing in particular, just a generalized, vague sense of dread or misfortune. High on the list of anxiety-generating situations is having to give a talk or presentation or being called on in class, where people risk loss of social standing by being judged negatively.

People can feel anxious because their neural circuitry has become so sensitized it perceives threat where it doesn’t exist. Too, there are substances—caffeine is one—and medications that stimulate the same physical sensations as anxiety. People differ in their susceptibility to anxiety, as a result of their biological makeup, their parental inheritance, their own life history, personality factors, and the coping skills they acquire or cultivate.

Anxiety and stress are intimately related; anxiety is a reaction to stress. Anxiety is the name we give to the internal sensations of warning generated by the body’s reaction to a mental or physical threat. The sensations are set in motion by the stress response (or fight-or-flight) system, whose job is to alert us to and protect us from danger. Without waiting for us to make a conscious assessment of any danger, it swiftly sends out chemical warning signals, such as cortisol and adrenaline, to various organs. The physical discomfort of anxiety is like a bodyguard ; its job is to protect us by jolting us into action. But it can persist and, by altering the function of neural circuits in the brain, overwhelm the ability to exert rational control.

Anxiety in its several forms, including phobias and social anxiety, is the most common mental health disorder in the U.S. Population-based surveys indicate that about a third of adults in the U.S. will grapple with disabling anxiety at some point.

High as the number is, there is some—and sometimes conflicting—evidence that the prevalence of anxiety (and depression as well) is increasing, especially among the young. Several factors are thought to be responsible for a rise in prevalence. In general, as the middle class erodes, there is growing economic uncertainty for much of the population. The high cost of health care also creates a burden of chronic worry about getting sick. In addition, a lack of coping skills, emotion regulation skills notably among them, is said to be making younger people vulnerable to a number of mental health disorders, particularly anxiety and depression.

Social media are singled out for their especially pernicious effect on young teens, because they introduce a means of constant social comparison and, through it, self-doubt—and that self-doubt drives further social media use , with compounding negative effects. In addition, dating and mating practices are far less structured than in past eras, and digital forms of communication create so much ambiguity that young people are often clueless about where they stand in romantic relationships . Ambiguity typically breeds anxiety.

Anxiety differs from fear in several important ways. Fear is a response to present danger; it is usually highly focused, attached to a very specific thing or circumstance, and meant to mobilize fast action. Anxiety doesn’t require an external stimulus; it is a response to real or imagined future threat, and it is typically more diffuse, setting in motion the need for constant vigilance in anticipation of some calamity. Fear is contagious, marked by characteristic features—widened pupils, pale skin —that signal others to be afraid. Anxiety is highly subjective. While anxiety shares some of the physiological signs of fear—heightened awareness and fast heart rate, similarly set off by the hormones of the stress response—it carries a heavy cognitive load of worry, a form of rumination about what might possibly go wrong in the future.

Anxiety is the reason your ancestors survived, enabling you to be reading these words now. Anxiety reflects the sensations that are triggered in body and brain in response to perceiving a threat; they’re intended as an alarm, to jolt you into paying attention and taking appropriate action to head off possible danger. In short, anxiety protects you. But the system is built to err on the side of caution, which is why we feel anxious even in the absence of a real threat. The sensitivity of the alarm can be reset by traumatic experience so that it is always on. Further, the threats can be wholly invented by your own imagination—thoughts of ways any situation could possibly go wrong. Neither flaw in the system diminishes the value of anxiety—to keep you alive.

To a large degree, people who are prone to clinical depression are also vulnerable to clinical anxiety. The conditions have many features in common . Chief among them is a history of adverse childhood experience, such as abuse or neglect. The reason is that maltreatment can indelibly alter the stress system so that it is hypersensitive to danger and reacts with an outpouring of alarm signals that overwhelm the capacity for emotion processing. Scoring high on the personality trait of neuroticism also inclines an individual to anxiety. Neuroticism reflects a tendency to respond to stressful experiences most readily and intensely with negative emotions and to perceive threats where they do not exist. In addition, people who lack the skills of emotion regulation are vulnerable to anxiety; they can be easily overwhelmed by situations that create uncertainty or stir any negative feelings.

No one has ever identified an “anxiety gene,” and it is unlikely that one will ever emerge; anxiety proves to be a complex condition that arises through many pathways. Some studies estimate that the heritability of generalized anxiety is no more than 30 percent. As with the transmission of depression-prone styles of thinking, families lastingly shape their children by many means. For example, the adults may display and, by the power of repeated example, silently pass on to their children skills for coping with the kinds of emotionally disruptive experiences that can trigger anxiety—or they may become disorganized and unable to function by such experiences. Nevertheless, studies indicate that genes lay a foundation for anxiety primarily by contributing to the personality trait of neuroticism, characterized by volatility of the negative emotion system. It is observable in the readiness to perceive the negative aspects of challenging situations and to react to them with negative emotions.

Uncertainty doesn’t cause anxiety but it creates breeding grounds for anxiety, and the rise of uncertainty in much of public (jobs, national security, pandemics) and private (relationships) life may be one reason why anxiety has become the most prevalent mental health condition today. Worry, the cognitive component of anxiety, is activated by the mere possibility of a bad outcome—and for many modern concerns, possibility can almost never be ruled out entirely. But of course, possibility does not equal probability. Anxiety with its payload of worry can be seen as an attempt to avoid uncertainty —to dispel the discomfort it creates. The better approach, say experts, is to learn to tolerate some uncertainty and recognize that most of life is not black or white but shades of gray.

There is a type of personality consistently associated with anxiety—those who exhibit the trait of neuroticism . One of the so-called Big Five personality traits, it describes a broad tendency to respond to experience with negative emotions and to be roiled by them. In study after study, neuroticism predicts susceptibility to both anxiety and depression and, to a lesser degree, all other mental disorders. Scientists believe that neuroticism reflects emotional reactivity that is especially attuned to threat. Some facets of neuroticism —perfectionism stands out—are virtually free tickets to anxiety. Perfectionists may seem like they’re on a path to success but in fact they are driven by a desire to avoid failure; as a result, much of their mental life is devoted to worrying about mistakes they could possibly make and imagining dire consequences of those mistakes..

The state of a person’s health, past or present, plays a large role in triggering anxiety. Those with chronic conditions such as diabetes or heart disease are at risk of constant worry about getting sick or sudden death. In fact, having a heart attack is known to raise the risk of health anxiety by 20 to 30 percent. People with breathing problems such as asthma or who have severe allergies to common substances may live with chronic worry about exposure to triggering substances. Some people are highly sensitive to internal body sensations—interoception—and may devote so much mental energy to monitoring, say, their heartbeats that every variation becomes a source of doubt and concern. A large number of people—in some estimates, as many as 20 percent of the population—are said to be highly sensitive; having a low threshold of nervous system arousal, they overrespond to both internal and external stimuli and can be easily overwhelmed emotionally. Their reactivity is linked to the personality trait of neuroticism, one of the strongest risk factors for anxiety.

There are multiple factors that create vulnerability to anxiety under stressful circumstances. On a purely psychological level is the ability to manage negative emotions. People lacking emotion regulation skills are at heightened risk of both anxiety and depression. Having a history of adverse life experiences during childhood , such as intense maltreatment or bouts of serious illness, also predisposes people to anxiety. It doesn’t change the makeup of genes but it can permanently alter their level of activity so that that the brain is constantly on the lookout for and perceiving potential threats. Perhaps the strongest risk factor for anxiety is having the personality trait of neuroticism. It denotes the degree to which the negative affect system is readily activated. People high in trait neuroticism are dispositionally inclined to find experiences distressing and to worry.

Neuroimaging studies reliably show changes in brain function among those who experience chronic anxiety, and they involve dysfunction of connectivity among areas of the brain that work together to orchestrate emotional response. Under normal circumstances the brain region known as the amygdala flags threats and, in an act of protection, sends out a signal to many parts of the brain. The stress response system kicks in immediately, preparing the body for action. On a slower track, signals travel to the prefrontal cortex, the so-called thinking brain, where the threat can be evaluated and, if needed, action planned to ameliorate any potential danger. But in anxiety, often because the amygdala has been sensitized by early adverse experience, it overresponds, overwhelming the capacity of the PFC to rationally assess and manage any threat, however remote or hypothetical.

Researchers have recently identified a tiny brain region known as the BNST, the bed nucleus of the stria terminalis, as a major node in brain circuits of anxiety . About the size of a small sunflower seed, it is considered an extension of the amygdala. Its primary function is to monitor the environment for vague, psychologically distant, or unpredictable threats—say, imagining that you’ll stumble badly and embarrass yourself when you give that upcoming talk. And when activated, it sends out alarms prompting alertness and hypervigilance to potential danger—the hallmarks of anxiety.

Depression and anxiety share much in common—they both derive from overresponsiveness of the negative affect system, the distinguishing feature of the personality trait of neuroticism. People with the trait of neuroticism tend to react to experience most readily and most strongly with negative emotions, such as irritability, anger, and sadness. Many of the same brain regions malfunction in both conditions, most notably the amygdala (overactivated) and prefrontal cortex (underactivated). But there are important differences. Anxiety is an alarm intended to energize people to avoid possible future danger they sense; depression shuts people down when they feel overwhelmed, disinclining them to ongoing activity and focusing their attention on losses and other negative experiences in the past. Stress can trigger both responses. And anxiety itself can lead to depression. In fact, nearly 70 percent of people who suffer from depression also have anxiety, and 50 percent of those with anxiety have clinical depression.

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Cause And Effect Essay Guide

Cause And Effect Essay Examples

Caleb S.

Best Cause and Effect Essay Examples To Get Inspiration + Simple Tips

cause and effect essay examples

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How To Write A Cause and Effect Essay - Outline & Examples

230+ Cause and Effect Essay Topics to Boost Your Academic Writing

How to Create a Cause and Effect Outline - An Easy Guide

You need to write a cause and effect essay for your assignment. Well, where should you start?

Establishing a relationship between causes and effects is no simple task. You need to ensure logical connections between variables with credible evidence.

However, don't get overwhelmed by the sound of it. You can start by reading some great cause and effect essay examples. 

In this blog, you can read cause and effect essays to get inspiration and learn how to write them. With these resources, you'll be able to start writing an awesome cause and effect paper.

Let’s dive in!

Arrow Down

  • 1. What is a Cause and Effect Essay?
  • 2. Cause and Effect Essay Examples for Students
  • 3. Free Cause and Effect Essay Samples
  • 4. Cause and Effect Essay Topics
  • 5. Tips For Writing a Good Cause and Effect Essay

What is a Cause and Effect Essay?

A cause and effect essay explores why things happen (causes) and what happens as a result (effects). This type of essay aims to uncover the connections between events, actions, or phenomena. It helps readers understand the reasons behind certain outcomes.

In a cause and effect essay, you typically:

  • Identify the Cause: Explain the event or action that initiates a chain of events. This is the "cause."
  • Discuss the Effect: Describe the consequences or outcomes resulting from the cause.
  • Analyze the Relationship: Clarify how the cause leads to the effect, showing the cause-and-effect link.

Cause and effect essays are common in various academic disciplines. For instance, studies in sciences, history, and the social sciences rely on essential cause and effect questions. For instance, "what are the effects of climate change?", or "what are the causes of poverty?"

Now that you know what a cause and effect is, let’s read some examples.

Cause and Effect Essay Examples for Students

Here is an example of a well-written cause and effect essay on social media. Let’s analyze it in parts to learn why it is good and how you can write an effective essay yourself. 

Do you know that the average person now spends over two hours a day on social media platforms? Social media has become an integral part of our daily lives. Whether it's Facebook, Instagram, or Twitter, these platforms have revolutionized the way we connect, communicate, and share our experiences with the world. However, while they offer many advantages, the excessive use of social media can have detrimental effects on our mental health. In this essay, we will explore the causes and effects of this relationship, shedding light on the profound influence social media has on our well-being.

The essay begins with a compelling hook that grabs the reader's attention. It presents a brief overview of the topic clearly and concisely. The introduction covers the issue and ends with a strong thesis statement , stating the essay's main argument – that excessive use of social media can negatively impact mental health.

The rise of social media has led to an unprecedented increase in screen time. According to recent statistics, the average person spends over two hours per day on social media platforms. This surge is largely due to the addictive nature of these platforms, which are designed to keep us engaged. Endless scrolling, constant notifications, and the desire for likes and comments contribute to a compulsive need to check social media. This excessive use of social media is the first point to examine.

The first body paragraph sets the stage by discussing the first cause - excessive social media use. It provides data and statistics to support the claim, which makes the argument more compelling. The analysis highlights the addictive nature of social media and its impact on users. This clear and evidence-based explanation prepares the reader for the cause-and-effect relationship to be discussed.

As social media usage has surged, so too has the number of people reporting symptoms of anxiety and depression. Studies have shown a significant correlation between the time spent on social media and the likelihood of experiencing these mental health issues. Constant exposure to carefully curated, idealized representations of others' lives can lead to unfavorable social comparisons. We start to measure our worth by the number of likes and followers we have, and we often fall short, which leads to anxiety and depression.

The second body paragraph effectively explores the effect of excessive social media use, which is increased anxiety and depression. It provides a clear cause-and-effect relationship, with studies backing the claims. The paragraph is well-structured and uses relatable examples, making the argument more persuasive. 

A second cause of the negative impact of social media on mental health is the phenomenon of social comparison. When we scroll through our feeds and see our friends and acquaintances posting photos of their exotic vacations, happy relationships, and personal achievements, we can't help but compare our own lives. The fear of missing out (FOMO) is a real and growing concern in today's digital age. We are constantly bombarded with images and stories that make us feel like we are missing out on the excitement and fulfillment that others seem to be experiencing.

The third body paragraph effectively introduces the second cause, which is social comparison and FOMO. It explains the concept clearly and provides relatable examples. It points out the relevance of this cause in the context of social media's impact on mental health, preparing the reader for the subsequent effect to be discussed.

Social comparison and FOMO have tangible effects on our mental health. People who engage in these comparisons often feel isolated and alone. The constant exposure to others' seemingly perfect lives can lead to a sense of inadequacy and decreased self-esteem. We start to question our own choices and accomplishments, believing that we are falling short in comparison to our peers.

The fourth body paragraph effectively explores the second effect of social comparison and FOMO, which is isolation and decreased self-esteem. It provides real-world consequences and uses relatable examples. 

In conclusion, the impact of social media on our mental health is undeniable. The excessive use of social media leads to increased anxiety, depression, and feelings of inadequacy, while the fear of missing out amplifies these negative emotions. It's crucial to acknowledge these challenges and their effect on our well-being. As we navigate this ever-evolving digital landscape, finding a healthier balance in the digital age becomes essential. We must consider limiting our social media use, curating our online experiences, and promoting digital detox. By taking these steps, we can protect our mental health and ensure that the benefits of social media are enjoyed without the accompanying harm.

The conclusion effectively summarizes the key points discussed in the essay. It restates the thesis statement and offers practical solutions, demonstrating a well-rounded understanding of the topic. The analysis emphasizes the significance of the conclusion in leaving the reader with a call to action or reflection on the essay's central theme.

This essay follows this clear cause and effect essay structure to convey the message effectively:

Read our cause and effect essay outline blog to learn more about how to structure your cause and effect essay effectively.

Free Cause and Effect Essay Samples

The analysis of the essay above is a good start to understanding how the paragraphs in a cause and effect essay are structured. You can read and analyze more examples below to improve your understanding.

Cause and Effect Essay Elementary School

Cause and Effect Essay For College Students

Short Cause and Effect Essay Sample

Cause and Effect Essay Example for High School

Cause And Effect Essay IELTS

Bullying Cause and Effect Essay Example

Cause and Effect Essay Smoking

Cause and Effect Essay Topics

Wondering which topic to write your essay on? Here is a list of cause and effect essay topic ideas to help you out.

  • The Effects of Social Media on Real Social Networks
  • The Causes And Effects of Cyberbullying
  • The Causes And Effects of Global Warming
  • The Causes And Effects of WW2
  • The Causes And Effects of Racism
  • The Causes And Effects of Homelessness
  • The Causes and Effects of Parental Divorce on Children.
  • The Causes and Effects of Drug Addiction
  • The Impact of Technology on Education
  • The Causes and Consequences of Income Inequality

Need more topics? Check out our list of 150+ cause and effect essay topics to get more interesting ideas.

Tips For Writing a Good Cause and Effect Essay

Reading and following the examples above can help you write a good essay. However, you can make your essay even better by following these tips.

  • Choose a Clear and Manageable Topic: Select a topic that you can explore thoroughly within the essay's word limit. A narrowly defined topic will make it easier to establish cause-and-effect relationships.
  • Research and Gather Evidence: Gather relevant data, statistics, examples, and expert opinions to support your arguments. Strong evidence enhances the credibility of your essay.
  • Outline Your Essay: Create a structured outline that outlines the introduction, body paragraphs, and conclusion. This will provide a clear roadmap for your essay and help you present causes and effects clearly and coherently.
  • Transitional Phrases: Use transitional words and phrases like "because," "due to," "as a result," "consequently," and "therefore" to connect causes and effects within your sentences and paragraphs.
  • Support Each Point: Dedicate a separate paragraph to each cause and effect. Provide in-depth explanations, examples, and evidence for each point.
  • Proofread and Edit: After completing the initial draft, carefully proofread your essay for grammar, punctuation, and spelling errors. Additionally, review the content for clarity, coherence, and flow.
  • Peer Review: Seek feedback from a peer or someone familiar with the topic to gain an outside perspective. They can help identify any areas that need improvement.
  • Stay Focused: Avoid going off-topic or including irrelevant information. Stick to the causes and effects you've outlined in your thesis statement.
  • Revise as Needed: Don't hesitate to make revisions and improvements as needed. The process of revising and refining your essay is essential for producing a high-quality final product. 

To Sum Up , 

Cause and effect essays are important for comprehending the intricate relationships that shape our world. With the help of the examples and tips above, you can confidently get started on your essay. 

If you still need further help, you can hire a professional writer to help you out. At MyPerfectWords.com , we’ve got experienced and qualified essay writers who can help you write an excellent essay on any topic and for all academic levels.

So why wait? Contact us and request ' write an essay for me ' today!

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cause and effect essay guide

How to Write a Cause and Effect Essay: Full Guide

cause and effect of anxiety essay

Ever wondered how things are connected in our world? Think of the butterfly effect—where a butterfly's wings in Brazil can set off a tornado in Texas. It's a quirky idea, but it shows how events are intertwined. Writing a cause and effect essay is like unraveling these connections, connecting the dots to reveal how things influence each other and shape our experiences.

In this guide, experts from our paper writing service will explore the concept of causality and share practical tips for creating great cause and effect essays. These essays won't just provide information—they'll leave a lasting impression on your readers.

What Is a Cause and Effect Essay

A cause and effect essay is a form of writing that aims to explore and explain the relationships between different events, actions, or circumstances. The central idea is to investigate why certain things happen (causes) and what results from those occurrences (effects). It's like peeling back the layers to reveal the interconnectedness of events, understanding the domino effect in the narrative of life.

What is a Cause and Effect Essay

Here's a breakdown of the key components:

  • Causes: These are the factors or events that initiate a particular situation. They are the reasons behind why something occurs. For instance, if you're exploring the cause of obesity, factors like unhealthy eating habits and lack of physical activity could be identified as causes.
  • Effects: The effects are the outcomes or consequences that result from the identified causes. Following the obesity example, effects could include health issues, reduced quality of life, or increased healthcare costs.
  • Connection: The heart of a cause and effect essay lies in demonstrating the link between causes and effects. It's not just about listing events but explaining how one event leads to another in a logical and coherent manner.

When crafting such an essay, you're essentially acting as a storyteller and investigator rolled into one. Your goal is to guide the reader through the web of interconnected events, providing insights into the 'why' and 'what happens next.'

How to Write a Cause and Effect Essay with Easy Steps

Understanding how to write a cause and effect essay is like putting together a puzzle. Here are ten simple steps to help you write an engaging essay that looks into how things are connected.

How to Write a Cause and Effect Essay with Easy Steps

1. Select a Specific Topic

  • Choose a cause and effect relationship that sparks your interest.
  • Ensure your topic is focused and manageable for a thorough exploration.

2. Explore Causal Links

  • Conduct thorough research to uncover hidden connections and supporting evidence.
  • Look beyond the obvious to identify intricate relationships between causes and effects.

3. Craft a Clear Thesis Statement

  • Develop a precise thesis that clearly articulates the main cause and the resulting effects.
  • Your thesis serves as the roadmap for your essay, guiding readers through your analysis.

4. Organize Chronologically or by Significance

  • Structure your essay in a logical order, either chronologically or by the significance of events.
  • This organization enhances clarity and helps readers follow the cause-and-effect progression.

5. Utilize Transitional Phrases

  • Employ transition words and phrases to ensure seamless flow between causes and effects.
  • Clear transitions enhance readability and strengthen the coherence of your essay.

6. Support Arguments with Credible Evidence

  • Back up your claims with relevant data, examples, and statistics.
  • Strong evidence adds credibility to your analysis and reinforces the cause-and-effect relationships you present.

7. Illustrate Chain Reactions

  • Show how a single cause can trigger a chain of effects, and vice versa.
  • Illustrate the ripple effects to emphasize the complexity of the relationships.

8. Analyze Root Causes

  • Move beyond surface-level explanations and explore the underlying factors contributing to the cause-and-effect scenario.
  • Deep analysis adds depth and nuance to your essay.

9. Consider Alternative Causes

  • Address potential counterarguments to showcase a comprehensive understanding.
  • Acknowledging alternative causes strengthens your essay's overall credibility.

10. Conclude with Impact

  • Summarize key points and emphasize the broader significance of your analysis.
  • Leave your readers with a thought-provoking conclusion that ties together the cause-and-effect relationships explored in your essay.

Cause and Effect Essay Structure Types

When setting up your essay, you can choose from different structures to make it organized. Let's look at two common types of cause and effect essay structures:

Cause and Effect Essay Structure Types

  • Block Structure:

The block structure is a clear and organized way to present causes and effects in your essay. Here, you dedicate one section to discussing all the causes, covering multiple causes within each category. After that, you have another section to explore all the effects. This separation makes your ideas easy to understand.

Using the block structure allows you to dive deep into each category, thoroughly looking at causes and effects separately. It's handy when you want to give a detailed analysis and show the importance of each part of the causal relationship. This way, readers can fully grasp each element before moving on.

  • Chain Structure:

On the other hand, the chain structure focuses on how events are connected and create ripple effects. It highlights how one cause leads to a specific effect, and that effect becomes the cause of more effects in an ongoing chain. This method is potent for illustrating the complexity of causal relationships.

The chain structure works well when you want to emphasize the sequence of events or deal with intricate cause-and-effect scenarios. It allows you to show how actions trigger a series of reactions, displaying the domino effect that leads to a specific outcome.

Regardless of the structural style you choose, if you require assistance with your academic paper, reach out to us with your ' write my paper for me ' request. Our experienced team is ready to tailor your paper to your specific requirements and ensure its excellence.

Cause and Effect Essay Outline

Creating an effective cause and effect essay begins with a well-structured outline. This roadmap helps you organize your thoughts, maintain a logical flow, and ensure that your essay effectively conveys the causal relationships between events. Below, we'll outline the key components of the essay along with examples:

I. Introduction

  • Hook: Start with an engaging statement or fact. Example: 'Did you know that stress can significantly impact your overall health?'
  • Background Information: Provide context for your topic. Example: 'In today's fast-paced world, stress has become an increasingly prevalent issue.'
  • Thesis Statement: Clearly state the main cause and its corresponding effects. Example: 'This essay will explore the causes of stress and their profound negative effects on physical and mental health.'

II. Body Paragraphs

  • Topic Sentence: Introduce the first cause you'll discuss. Example: 'One major cause of stress is heavy workload.'
  • Supporting Details: Provide evidence and examples to support the cause. Example: 'For instance, individuals juggling multiple job responsibilities and tight deadlines often experience heightened stress levels.'
  • Transition: Link to the next cause or move on to the effects.
  • Topic Sentence: Introduce the first effect. Example: 'The effects of chronic stress on physical health can be devastating.'
  • Supporting Details: Present data or examples illustrating the impact. Example: 'Studies have shown that prolonged stress can lead to cardiovascular problems, including hypertension and heart disease.'
  • Transition: Connect to the next effect or cause.

C. Causes (Continued)

  • Topic Sentence: Introduce the next cause in a new cause and effect paragraph. Example: 'Another significant cause of stress is financial strain.'
  • Supporting Details: Explain how this cause manifests and its implications. Example: 'Financial instability often results in anxiety, as individuals worry about bills, debts, and their financial future.'
  • Transition: Prepare to discuss the corresponding effects.

D. Effects (Continued)

  • Topic Sentence: Discuss the effects related to financial strain. Example: 'The psychological effects of financial stress can be profound.'
  • Supporting Details: Offer real-life examples or psychological insights. Example: 'Depression and anxiety are common consequences of constant financial worries, affecting both mental well-being and daily life.'

III. Conclusion

  • Restate Thesis: Summarize the main cause and effects. Example: 'In summary, the heavy workload and financial strain can lead to stress, impacting both physical and mental health.'
  • Closing Thoughts: Reflect on the broader significance of your analysis. Example: 'Understanding these causal relationships emphasizes the importance of stress management and financial planning in maintaining a balanced and healthy life.'

Cause and Effect Essay Examples

To help you grasp cause and effect essay writing with clarity, we have prepared two distinct essay examples that will guide you through the intricacies of both block and chain structures. Additionally, should you ever find yourself requiring assistance with academic writing or descriptive essays examples , simply send us your ' write my research paper ' request. Our expert writers are here to provide the support you need!

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Cause and Effect Essay Topics

Choosing a good topic starts with recognizing cause and effect key words. Here are 10 interesting topics that let you dig into fascinating connections and their important consequences:

  • The Relationship Between Lack of Exercise and Mental Health in Older Adults
  • Effects of Sleep Deprivation on Workplace Productivity
  • The Impact of Cyberbullying on Adolescents' Emotional Well-being
  • Influence of Social Media Advertising on Consumer Purchasing Decisions
  • Consequences of Oil Spills on Coastal Ecosystems
  • How Noise Pollution Affects Concentration and Academic Performance in Schools
  • The Connection Between Fast-Food Marketing and Childhood Obesity
  • Effects of Urbanization on Water Quality in Local Rivers
  • The Relationship Between Indoor Plants and Air Quality in Homes
  • Impact of Plastic Pollution on Wildlife in Urban Environments
  • The Effect of Meditation on Stress Reduction in College Students
  • How Increased Screen Time Affects Teenagers' Attention Span
  • The Impact of Single-Use Plastics on Marine Microorganisms
  • The Relationship Between Smartphone Use and Sleep Quality in Adults
  • Effects of High-Fructose Corn Syrup on Metabolic Health
  • The Consequences of Deforestation on Local Biodiversity
  • Influence of Social Media Comparison on Body Dissatisfaction in Adolescents
  • The Connection Between Air Pollution and Respiratory Health in Urban Areas
  • Effects of Excessive Gaming on Academic Performance in High School Students
  • The Impact of Fast Food Consumption on Childhood Obesity Rates

Final Words

Knowing what a cause and effect essay is and how to write it helps you uncover connections in different topics. With this guide, you can share your ideas in a clear and impactful way.

Meanwhile, if you're in need of a reaction paper example , rest assured we have you covered as well. So, seize this opportunity, put your thoughts on paper logically, and witness your essays leaving a lasting and influential mark.

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Daniel Parker

is a seasoned educational writer focusing on scholarship guidance, research papers, and various forms of academic essays including reflective and narrative essays. His expertise also extends to detailed case studies. A scholar with a background in English Literature and Education, Daniel’s work on EssayPro blog aims to support students in achieving academic excellence and securing scholarships. His hobbies include reading classic literature and participating in academic forums.

cause and effect of anxiety essay

is an expert in nursing and healthcare, with a strong background in history, law, and literature. Holding advanced degrees in nursing and public health, his analytical approach and comprehensive knowledge help students navigate complex topics. On EssayPro blog, Adam provides insightful articles on everything from historical analysis to the intricacies of healthcare policies. In his downtime, he enjoys historical documentaries and volunteering at local clinics.

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Home — Essay Samples — Nursing & Health — Anxiety — Research of Social Anxiety Disorder: Symptoms, Causes, Effects and Treatments

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Research of Social Anxiety Disorder: Symptoms, Causes, Effects and Treatments

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Published: Sep 1, 2020

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Introduction, the causes of sad, the impacts of sad on people, treatments for sad.

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Anxiety and depression are increasing

  • Social, political, and environmental causes are likely implicated in an increase in the number of teens each year who have had a depressive episode, up 37% between 2005 and 2014. [8]
  • High school students today have more anxiety symptoms have more anxiety symptoms and are twice as likely to see a health professional as teens in the 1980s. [9]

Review of Literature

Rationale of the study.

  • American Psychiatric Association
  • STANFORD CHILDREN'S HEALTH 2020
  • World health organization
  • World Health Organization
  • Mendelson T, Greenberg MT, Dariotis JK, Gould LF, Rhoades BL, Leaf PJ. Feasibility and preliminary outcomes of a school-based mindfulness intervention for urban youth. Journal of abnormal child psychology. 2010 Oct 1;38(7):985-94.
  • Child mind org
  • Mojtabai R, Olfson M, Han B. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics. 2016 Dec 1;138(6):e20161878.
  • Twenge JM, Sherman RA, Wells BE. Changes in American adults’ sexual behavior and attitudes, 1972–2012. Archives of Sexual Behavior. 2015 Nov 1;44(8):2273-85.
  • Steinberg L, Brown BB, Dornbusch SM. Beyond the classroom. Simon and Schuster; 1997 Oct 17.
  • Felman A. Everything you need to know about nicotine. Medical News Today. 2018 Jan.
  • Siegel RS, La Greca AM, Harrison HM. Peer victimization and social anxiety in adolescents: Prospective and reciprocal relationships. Journal of Youth and Adolescence. 2009 Sep 1;38(8):1096-109.
  • Kessler RC, McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, Aguilar-Gaxiola S, Alhamzawi AO, Alonso J, Angermeyer M, Benjet C. Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. The British journal of psychiatry. 2010 Nov;197(5):378-85.
  • Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. The Lancet. 2006 May 27;367(9524):1747-57.
  • Egger HL, Costello EJ, Erkanli A, Angold A. Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches. Journal of the American Academy of Child & Adolescent Psychiatry. 1999 Jul 1;38(7):852-60.
  • Windfuhr K, While D, Hunt I, Turnbull P, Lowe R, Burns J, Swinson N, Shaw J, Appleby L, Kapur N, National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. Suicide in juveniles and adolescents in the United Kingdom. Journal of Child Psychology and Psychiatry. 2008 Nov;49(11):1155-65.
  • Hawton K, Van Heeringen K. Suicide. Lancet [Internet]. 2009 [citado 22 mar 2012]; 373 (9672): 1372-81.
  • Kessler RC, Avenevoli S, Merikangas KR. Mood disorders in children and adolescents: an epidemiologic perspective. Biological psychiatry. 2001 Jun 15;49(12):1002-14.
  • Green H, McGinnity A, Meltzer H, Ford T, Goodman R. Mental health of children and adolescents in Great Britain, 2004. London: ONS. The Stationery Office. 2005.
  • Zuckerbrot RA, Jensen PS. Improving recognition of adolescent depression in primary care. Archives of pediatrics & adolescent medicine. 2006 Jul 1;160(7):694-704.
  • Kelleher KJ, Wolraich ML. Diagnosing psychosocial problems. Pediatrics. 1996 Jun 1;97(6):899-901.
  • Kovacs M, Akiskal HS, Gatsonis C, Parrone PL. Childhood-onset dysthymic disorder: Clinical features and prospective naturalistic outcome. Archives of general psychiatry. 1994 May 1;51(5):365-74.
  • Weller P. The Universality of Public Sector Reform: Ideas Meanings Strategies. Davis, G. 1996.
  • Wang C, Pan R, Wan X, Tan Y, Xu L, McIntyre RS, Choo FN, Tran B, Ho R, Sharma VK, Ho C. A longitudinal study on the mental health of the general population during the COVID-19 epidemic in China. Brain, behavior, and immunity. 2020 Apr 13.
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Anxiety, Depression and Quality of Life—A Systematic Review of Evidence from Longitudinal Observational Studies

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This review aimed to systematically review observational studies investigating the longitudinal association between anxiety, depression and quality of life (QoL). A systematic search of five electronic databases (PubMed, PsycINFO, PSYNDEX, NHS EED and EconLit) as well as forward/backward reference searches were conducted to identify observational studies on the longitudinal association between anxiety, depression and QoL. Studies were synthesized narratively. Additionally, a random-effects meta-analysis was performed using studies applying the mental and physical summary scores (MCS, PCS) of the Short Form Health Survey. The review was prospectively registered with PROSPERO and a study protocol was published. n = 47 studies on heterogeneous research questions were included, with sample sizes ranging from n = 28 to 43,093. Narrative synthesis indicated that QoL was reduced before disorder onset, dropped further during the disorder and improved with remission. Before onset and after remission, QoL was lower in comparison to healthy comparisons. n = 8 studies were included in random-effects meta-analyses. The pooled estimates of QoL at follow-up (FU) were of small to large effect sizes and showed that QoL at FU differed by disorder status at baseline as well as by disorder course over time. Disorder course groups differed in their MCS scores at baseline. Effect sizes were generally larger for MCS relative to PCS. The results highlight the relevance of preventive measures and treatment. Future research should consider individual QoL domains, individual anxiety/depressive disorders as well as the course of both over time to allow more differentiated statements in a meta-analysis.

1. Introduction

The World Health Organization [ 1 ] estimates that 264 million people worldwide were suffering from an anxiety disorder and 322 million from a depressive disorder in 2015, corresponding to prevalence rates of 3.6% and 4.4%. While their prevalence varies slightly by age and gender [ 1 ], they are among the most common mental disorders in the general population [ 2 , 3 , 4 , 5 , 6 ]. During the COVID-19 pandemic, multiple challenges have arisen for many, such as loneliness [ 7 ] or financial hardship. A meta-analysis showed a prevalence of anxiety of about 32% (95% CI: 28–37) and a prevalence of depression ( n = 14 studies) of about 34% (95% CI: 28–41) in general populations during the COVID-19 pandemic [ 8 ].

Anxiety and depression have been associated with adverse societal and individual correlates, including higher health care costs [ 9 , 10 , 11 ] and an increased risk for physical comorbidities, such as cardiovascular illnesses [ 12 , 13 ]. Moreover, they have been linked to a reduced quality of life (QoL) in numerous cross-sectional as well as longitudinal studies in which they significantly predicted QoL outcomes [ 14 , 15 , 16 , 17 , 18 ]. Other studies have reported a reverse association, whereby QoL was predictive of mental health outcomes [ 19 ] or a bi-directional association [ 20 , 21 ]. Some very recent studies also examined these associations among quite different samples (e.g., [ 22 , 23 , 24 , 25 ]).

Looking at longitudinal rather than cross-sectional data from observational studies has several advantages. It allows for the identification of trajectories over time within the same individuals rather than focusing on group differences at one point in time only [ 26 ]. Moreover, when appropriate methods are applied to longitudinal data, intraindividual heterogeneity can be taken into account, resulting in more consistent estimates [ 27 ]. This has previously been demonstrated in QoL research [ 28 ]. A need to analyze longitudinal changes in QoL domains in QoL research in people with mental disorders has also been previously identified [ 29 ]. Beyond individual longitudinal studies suggesting a link between anxiety or depression and QoL, several systematic reviews have synthesized longitudinal evidence on these associations and mostly reported negative associations between the variables. These reviews have tended to focus on specific age groups, such as older adults [ 30 ], samples with specific diseases [ 31 , 32 ], or have investigated the effect of specific treatments on QoL in patients with anxiety [ 33 ]. Investigating these associations in samples without these limitations could reduce the effect of specific conditions and treatments on the association and strengthen the conclusions that can be drawn.

In light of the previous findings, this study aims to add to the present literature by systematically synthesizing evidence from observational studies on the longitudinal association between anxiety, depression and QoL across all age groups in samples who do not have other specific illnesses and do not receive specific treatments.

2. Materials and Methods

This review was registered with PROSPERO (CRD42018108008) and a study protocol was published [ 34 ].

2.1. Search Strategy

Five electronic databases from several fields of research (PubMed, PsycINFO, PSYNDEX, NHS EED and EconLit) were examined until December 2020. Where possible, search terms were entered as Medical Subject Headings (MeSH) or as keywords in the title/abstract. The PubMed search strategy was: (anxi*[Title/Abstract] or depress*[Title/Abstract] or anxiety disorder[MeSH] or depressive disorder[MeSH]) and quality of life[MeSH] and longitudinal study[MeSH]. Please note that “*” is a truncation symbol. Time or location were not restricted. In addition, we applied backward and forward reference searches of included studies to identify additional references. The forward reference search was conducted until January 2021 using Web of Science to identify cited papers.

2.2. Study Selection Process

The study selection process is displayed in Figure 1 . Most identified studies were screened in a two-step process (title/abstract; full-text screening) independently by two reviewers (J.K.H., E.Q.) against defined criteria (see Table 1 ). The last updated literature screening before submission was conducted by one reviewer (J.K.H.) and encompassed 9% of the studies included for title/abstract screening. Before the final criteria were applied, they were pretested and refined. Disagreements during the selection process were resolved through discussion or by the inclusion of a third party (A.H.) if a consensus could not be reached.

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Object name is ijerph-18-12022-g001.jpg

Study flow (PRISMA flow chart).

Study selection criteria.

Studies were eligible for inclusion if they:
(i) Were observational studies analyzing the longitudinal association between anxiety or depression (disorders as well as symptom severity) and QoL,
(ii) Analyzed samples without a specific disease or disorder other than anxiety and depression,
(iii) Applied appropriate, validated measures for the main variables (e.g., for anxiety/depression: psychiatric diagnosis according to criteria of the International Classification of Diseases (ICD), the Diagnostic and Statistical Manual of Mental Disorders (DSM), or using a valid self-report screening tool), and
(iv) Were published in English or German in a peer-reviewed journal.
Studies were excluded if they:
(i) Analyzed samples where participants were suffering or recovering from conditions other than anxiety/depression,
(ii) Analyzed samples receiving or recovering from a specific intervention or treatment,
(iii) Had no observational study design,
(iv) Used a measure for the main variables other than those defined, or
(v) Had publication characteristics that were different than those defined (e.g., were published in a language other than German or English, as well as not published in a scientific, peer-reviewed journal).
After pre-testing, the following refinements were made to the screening criteria (ii) and (iii):
(ii) Regarding the samples of interest, we decided to exclude studies analyzing dyads such as caregivers or partners to ill family members, due to possible spillover-effects on the individual’s QoL, which has been demonstrated in previous studies [ , ]. Additionally, samples consisting exclusively of people with anxiety or depressive disorders may receive some unspecific type of care for their mental health problems. We eliminated studies evaluating the effects of treatments using pre–post-treatment comparisons. Only studies where some naturalistic treatment that is usual for mental health problems that began prior to study baseline (BL) were included. Studies indicating that treatment was initiated at or after study BL (e.g., before or at admission to a psychiatric clinic) were excluded.
(iii) Lastly, we specified the QoL assessments. In health and medicine research, numerous QoL instruments are used [ ]. Guided by previous literature reviews [ , , ]), we compiled a list of ten validated QoL assessments that have been used in children, adolescents or adults from the general population and/or samples with mental health problems, and that are frequently used in QoL research. Versions of the following instruments were included: Short Form Health Survey (e.g., SF-36, SF-12), EuroQol (e.g., EQ-5D, EQ-5D-Y), WHOQOL (e.g., WHOQOL-100, WHOQOL-BREF), Quality of Well-Being Scale, Quality of Life Scale, Pediatric Quality of Life Inventory, KIDSCREEN, KINDL, Quality of Life in Depression Scale, and the Quality of Life Enjoyment and Satisfaction Questionnaire.

Abbreviations: QoL = quality of life; ICD = International Classification of Diseases; DSM = Diagnostic and Statistical Manual of Mental Disorders; BL = study baseline; KIDSCREEN = Health Related Quality of Life Questionnaire for Children and Young People and their Parents; KINDL = German generic quality of life instrument for children

2.3. Data Extraction and Synthesis

We extracted information regarding the study design, operationalization of the variables, sample characteristics, statistical methods and results regarding the research question of interest. If several analyses were presented for the same research question, we extracted the final covariate-adjusted model for narrative synthesis. Data were extracted by one reviewer (J.K.H.) and cross-checked by a second reviewer (E.Q.). If needed, extracted data were standardized (e.g., by calculating the weighted average means when combining groups) to present comparable information. If clarification was needed, the corresponding authors were contacted.

For the narrative synthesis, all studies were first grouped by research question, e.g., whether disorders or the degree of symptoms were analyzed, which comparison groups were used, which QoL domains were considered, and at which waves the variables of interest were considered in the analyses. Because research questions and analyses were heterogeneous, a concise narrative synthesis of the main results of all studies was not feasible. Therefore, we provide an overview of all identified studies in the tables and a detailed narrative synthesis of those studies, analyzing trajectories of disorders or changes in symptoms in association with changes in QoL over time.

Additionally, we examined whether data were appropriate for meta-analysis. The specific research questions, the operationalization of main variables and statistical methods were heterogeneous across studies and not all the statistical estimates needed could be obtained from covariate-adjusted analyses. Therefore, to enhance the comparability of the underlying data and the interpretation of the pooled estimates, we used descriptive information. Because most papers applied variations of the Short Form Health Survey and analyzed mental and physical component scores (MCS, PCS), we considered these studies as eligible for meta-analysis. The necessary information could be obtained for 8 publications. Random-effects meta-analysis was used for pooling. Heterogeneity was assessed by means of I 2 , with higher values representing a larger degree of heterogeneity in terms of variability in effect size estimates between studies [ 41 ]. Pooled estimates are reported as Hedge’s g standardized mean difference (SMD), representing the difference in mean outcomes between groups relative to outcome measure variability [ 42 ]. According to Cohen (as cited in [ 43 ]), SMDs can be grouped into small ≤0.20, medium = 0.50 and large effects ≥0.80. Stata 16 was used for meta-analyses.

2.4. Quality/Risk of Bias Assessment

Two reviewers (J.K.H., E.Q.) independently assessed the quality and risk of bias of the included studies using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, which was developed by the National Heart, Lung, and Blood Institute [ 44 ].

3.1. Selection Process

The literature search yielded 4027 unique references. After title/abstract screening, 215 studies were included for full-text screening. Finally, 47 publications were included in the final synthesis. During full-text screening, most studies were excluded because they exclusively analyzed data on a cross-sectional level (56.5%). For further details, see the PRISMA flow chart ( Figure 1 ).

3.2. Overview of Included Studies

Descriptive characteristics and quality/risk of bias assessment of the included studies are provided in Table S1 (Supplementary Material) . In short, sample size ranged from 28 to 43,093. Most studies focused on adults; only four analyzed children/adolescents. Regarding the settings, 17 of the analyzed samples were exclusively recruited in a health care setting, 12 of the studies analyzed general population samples, 14 recruited in another or in several settings, and all studies on children/adolescents recruited in schools ( n = 4). Twenty studies (42.6%) applied data from the same seven underlying datasets. Most studies reported on depression ( n = 36), less reported on anxiety ( n = 20) and some reported on the comorbidity between depression and anxiety ( n = 7). To assess mental disorders, half (48.9%) used structured interviews. Regarding QoL, most studies applied variations of the Short Form Health Survey (SF, n = 27) or the WHOQOL ( n = 12). A total of 38.3% of the studies were rated as “good”, 55.3% as “fair” and 6.4% as “poor” in the quality assessment.

3.3. Overview of Studies on the Association between Anxiety/Depression as Independent Variables and QoL Outcomes

Detailed results on all studies investigating the association between anxiety/depression as independent variables and QoL outcomes are reported in Table 2 . As described in the methods section, the following paragraphs give an overview of those studies focusing on disorder trajectories/changes in symptoms over time and changes in QoL outcomes over time, because they allow for more differentiated interpretations.

Studies on depression/anxiety as independent variables and QoL outcomes.

First Author (Year)Disorder or Symptoms Analyzed; QoL Domains AnalyzedResearch Question Regarding QoLMethodsResults
Årdal (2013) [ ]Controls and patients in the acute phase of recurrent MD and FU (DSM-IV, HDRS); SF-36 (physical functioning, role physical, vitality, bodily pain, mental health, role emotional, social functioning, general health, as well as summary scores PCS, MCS and total score)(a) Whether QoL scores differ between MD patients and healthy comparisons across domains over time.
(b) Whether QoL in patients with recurrent MDD differed between acute phase and recovery.
(a) ANOVA
(b) Paired-sample -tests
(a) There was a significant interaction effect between time, QoL domain and group, indicating that QoL scores differed between MD patients and controls over time. Compared to the healthy control group, the MDD group had reduced QoL in all domains at BL and reduced QoL in several domains at FU (significant for general health, social, emotional role, mental health, PCS, MCS and total score).
(b) In the MD group, QoL scores significantly improved during recovery from recurrent MDD in most domains (significant for physical functioning, physical role, vitality, social functioning, role emotional, mental health, PCS, MCS and total score).
Buist-Bouwman (2004) [ ] Onset, acute phase and subsequent remission from MDE (CIDI); comorbid anxiety disorder (CIDI); SF-36 (physical functioning, physical role, vitality, pain, psychological health, psychological role, social functioning and general health)(a) Whether incident MDE and recovery from MDE are associated with changes in QoL and whether pre- and post-morbid QoL scores in the MD group differ from the comparison group without MD.
(b) In the subgroup with worse QoL after MDE: whether the severity of depression and number of depressive episodes were associated with worse QoL.
(c) Whether comorbid anxiety during MDE is associated with reduced QoL (i.e., lower QoL after MDE compared to before MDE).
(a)–(c) Multivariate logistic regression(a) Incident MDE was associated with a drop in QoL (significant for vitality, psychological, psychological role and social functioning). Subsequent recovery from MDE was associated with an improvement in QoL (significant for physical role, vitality, psychological health, psychological role, social functioning and general health). Comparing pre- and post-morbid levels, QoL did not differ or was higher after MDE in some domains (significantly higher for psychological health and psychological role). Moreover, before MD onset, QoL was significantly lower compared to healthy controls in all domains. After remission from MDE, QoL scores in nearly all domains (not significant for psychological role) were significantly lower compared to healthy controls.
(b) About 40% of the MDE group had worse QoL after recovery from MDE compared to pre-morbid levels. The severity of depression was associated with worse QoL only for the psychological health domain, but no other domains. The number of depressive episodes was not significantly associated with worsening QoL in any domain.
(c) In the MDE cohort, comorbid anxiety was associated with a significant reduction in QoL (significant for physical role and psychological health).
Cabello (2014) [ ] Chronic MD (AUDADIS interview; summary score of the number of symptoms to identify severity); SF-12, “disability” (i.e., domain-specific reduced QoL, defined as score ≤ 25th percentile in the subscale; physical functioning, physical role, bodily pain, general health, vitality, social functioning, emotional role and mental health)(a) Whether chronic MD is associated with the incidence/persistence of “disability” (i.e., reduced QoL) in a general population sample.
(b) Whether the severity of depressive symptoms is associated with the incidence/persistence of “disability” (i.e., reduced QoL) in the MD subgroup of the sample.
Both (a) and (b) Generalized Estimating Equations and logistic regressions(a) In the general population, chronic MD was a significant risk factor for the persistence of disability (i.e., reduced QoL) in all domains and of the incidence of disability (i.e., reduced QoL) in all domains except for the physical role.
(b) In the chronic MD subgroup, the severity of depressive symptoms was associated with the persistence of disability (i.e., reduced QoL) (significant for general health, social functioning, emotional role and mental health) and not significantly associated with the incidence of reduced QoL in any domain.
Cerne (2013) [ ] Number of depressive episodes over time according to CIDI; number of episodes of panic and other anxiety syndromes over time (PHQ); SF-12 (PCS, MCS)Whether the pooled number of
(a) depressive episodes over time,
(b) panic and anxiety episodes over time are
are associated with the pooled QoL over time.
(a) and (b) Multivariate linear regression(a) A higher number of depressive episodes over time was associated with lower pooled PCS and MCS.
(b) a higher number of pooled panic episodes over time was associated with a lower mean MCS but not PCS. A higher number of pooled other anxiety syndrome episodes over time was not associated with the mean MCS or PCS.
Chin (2015) [ ]Depression according to PHQ-9 (>9), clinician’s diagnosis; SF-12v2 (PCS, MCS)(a) Whether depressive symptoms and a clinician’s detection of depression at BL are associated with QoL at FU.
(b) Whether a clinician’s detection of depression at BL is associated with a change in QoL.
(a) Multivariable non-linear mixed-effects regression
(b) Independent -tests
(a) Depressive symptoms and a clinician’s detection of depression at BL were not predictive of QoL at FU.
(b) A clinician’s detection of depression at BL was related to change (improvement) in MCS, but not PCS over time in a primary care sample screened as positive for depression.
Chung (2012) [ ]Depression diagnosis and symptoms (DSM-IV, HRSD depression scale, HADS depression scale); anxiety symptoms (HRSD anxiety scale, HADS anxiety scale; SF-36 (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, mental health, PCS and MCS)(a) Whether BL depressive symptoms are associated with QoL at FU.
(b) Whether BL depressive symptoms or changes in depressive symptoms are associated with changes in QoL over time.
(c) Whether BL anxiety symptoms are associated with QoL at FU.
(d) Whether BL anxiety symptoms or changes in anxiety symptoms are associated with changes in QoL over time.
(a)–(d) Hierarchical regression(a) BL depressive symptoms were not associated with any QoL domain at FU.
(b) BL depressive symptoms were not associated with changes in any QoL domain over time. Changes in depressive symptoms were significantly associated with changes in some QoL domains over time (significant for: general health, vitality, mental health and MCS).
(c) BL anxiety symptoms were not associated with any QoL domain at FU.
(d) BL anxiety symptoms were not associated with changes in any QoL domain over time. Changes in anxiety symptoms were significantly associated with changes in some QoL domains over time (significant for: bodily pain, general health and mental health).
Diehr (2006) [ ]Depression according to CIDI, CES-D (>16); QLDS, WHOQOL-Bref (environmental, physical, psychological and social), SF-12 (PCS, MCS)(a) Whether the quartile of change in depressive symptoms is associated with changes in QoL.
(b) Whether the remission of depression at FU is associated with changes in QoL.
Regression(a) No/little change in CES-D associated with changes in QoL over time (significant for SF-12 MCS). Every other quartile of change in depressive symptoms was significantly associated with changes in QoL in most scales/domains (significant for: QLDS, all domains of WHOQOL-Bref and SF-12 MCS), meaning a higher reduction in depressive symptoms was associated with a higher increase in QoL, and more severe depressive symptoms were associated with a reduction in QoL.
(b) Remission of depression at FU was associated with improvement in all QoL measures and domains (SF-12, QLDS and WHOQOL-Bref). There was no significant change in QoL in those with persistent clinical depression at FU.
Hajek (2015) [ ]Depressive symptoms (GDS); EQ-VASWhether an initial change in depressive symptoms is associated with a subsequent change in QoL in the whole sample and by sex.Vector autoregressive modelsNo significant association between an initial change in depression score and a subsequent change in QoL was found for the whole sample or stratified by sex.
Hasche (2010) [ ] Depression status at BL (according to DIS diagnosis and CES-D ≥ 9); SF-8 (PCS, MCS)(a) Whether depression status groups at BL differed according to QoL at FU.
(b) Whether depression status groups at BL differed according to QoL changes in score over time.
(a) -tests
(b) Linear mixed effects regression models
(a) At 6- and 12-month FU, those with and without depression at BL differed significantly in QoL scores, with the depression group reporting lower QoL at FUs (significant for MCS and PCS).
(b) While depression at BL was significantly related to improvements in MCS (but not PCS) scores over time, those with depression still reported lower QoL compared to those without.
Heo (2008) [ ]Depression (BDI ≥ 10); SF-36 (decrease in total score over time)Whether FU depression is associated with a reduction in QoL over time.Binary logistic regressionDepression at FU was associated with a significant reduction in QoL total score over time.
Ho (2014) [ ]Depression (according to GDS ≥ 5); SF-12 (PCS, MCS)Whether depression at BL is associated with QoL at FU.Linear regressionBL depression was associated with lower QoL at FU (significant for MCS and PCS).
Hussain (2016) [ ]Depressive disorders (SCID, MINI); current PTSD, specific phobias, other anxiety disorders (SCID, MINI); WHOQOL-Bref (general QoL and hrqol) (a) Whether current depressive disorders at BL predict QoL at FU.
(b) Whether current PTSD, specific phobias and other anxiety disorders at BL predict QoL at FU.
(a) and (b) Multiple linear regression(a) Depressive disorders at BL predicted reduced QoL at FU (significant for general QoL and hrqol).
(b) PTSD, but not specific phobias or other anxiety disorders, predicted reduced general QoL at FU. None of the anxiety disorders predicted hrqol at FU.
Joffe (2012) [ ]Lifetime history of depression (according to SCID); anxiety disorder (according to SCID); SF-36 (impaired QoL according to 25th percentile of SF-36; social functioning, role emotional, role physical, pain and vitality)(a) Whether a lifetime history of depression is associated with impaired QoL during FU.
(b) Whether a prior lifetime history of anxiety disorder (compared to no depression or anxiety) is associated with reduced QoL during FU.
(c) Whether a lifetime history of comorbid depression and anxiety is associated with impaired QoL during FU.
(a)–(c) Repeated measure multilevel regression(a) A history of depression only was associated with reduced QoL during FU (significant for social functioning and pain).
(b) Prior lifetime history of anxiety disorder was associated with reduced QoL (significant for physical role).
(c) A history of comorbid anxiety and depression was associated with reduced QoL during FU (significant for social functioning, emotional role, physical role and pain).
Johansen (2007)
[ ]
Level of PTSD symptoms according to IES-15; WHOQOL-Bref (physical health, psychological health, social relationships and environment)Whether PTSD symptoms predict QoL at FU.Structural equation modelMore severe PTSD symptoms predicted QoL at FU (significant positive association between FU1 and FU2).
Kramer (2003) [ ]Current or lifetime depression/PTSD (according to Q-DIS); SF-36 (energy/fatigue, emotional role, general health, mental health, pain, physical functioning, physical role and social)Whether QoL outcomes over time differed among the disorder groups.Random/fixed effects modelThere was no significant interaction between time and diagnostic group (no depression/PTSD, PTSD, depression and comorbid depression/PTSD) on QoL.
Comparing the adjusted means for all three times among the disorder groups showed significant differences between the groups in most domains. In comparison, those with depression at BL reported reduced QoL over time in several domains compared to the PTSD group and the group without PTSD/depression. In comparison, those with PTSD only showed higher QoL compared to those with depression or comorbid depression/PTSD in several domains.
Kuehner (2009) [ ]Depressive symptoms (MADRS); WHOQOL (overall, physical, psychological, social and environmental)Whether the lag in levels of depressive symptoms predicts future levels of QoL and whether the association differs by group (formerly depressed inpatients vs. community controls).Time-lagged linear modelsHigher depressive symptoms predict future lower QoL (significant for social). The association was not moderated by group status.
Kuehner (2012) [ ]Depression score (according to MADRS, FDD-DSM-IV); WHOQOL-Bref (physical, psychological, social and environment)Whether the lag in depressive symptoms predicted QoL at FU.Hierarchical, time-lagged linear modelsHigher depressive symptoms significantly predicted lower QoL at FU (significant for physical and psychological).
Lenert (2000) [ ]Remission or persistent depression (according to DSM-III criteria, DIS); SF-12 (PCS, MCS)Whether the remission of depression (compared to no remission) is associated with changes in QoL over time.OLS regressionRemission of depression was associated with improved QoL (significant for MCS) at FU1 and FU2.
Mars (2015) [ ]Asymptomatic, mild and high symptoms of depression (according to SCAN); EQ-5D (without anxiety/depression item)Whether depression symptom trajectories over time (asymptomatic, mild symptoms and chronic–high symptoms) are associated with QoL at FU.Latent class growth analysis with distal outcome modelsQoL at FU differed significantly among different depression symptom trajectories, with persons from the the chronic–high depressive symptom class showing lower QoL scores relative to the asymptomatic class.
Moutinho (2019) [ ]Depression at BL (according to DASS cut-off: 9); anxiety at BL (according to DASS anxiety scale cutoff: 7); WHOQOL-Bref at FU (physical, psychological, social and environment)(a) Whether BL depression predicted QoL at FU.
(b) Whether BL anxiety predicted QoL at FU.
(a) and (b) Stepwise linear regression(a) Depression at BL was significantly associated with reduced QoL at FU (significant for psychological functioning, social functioning and environmental).
(b) Anxiety at BL was associated with reduced QoL at FU (significant for physical).
Ormel (1999) [ ]Depression at BL (according to CIDI); “disability” (i.e., reduced QoL according MOS SF 6-item physical functioning scale ≥ 2)Whether depression at BL is associated with the onset of disability (i.e., reduced QoL) during FU.Logistic regression modelsCompared to the non-depressed group, people with depression at BL showed higher odds for the onset of disability (i.e., reduced QoL) during FU (significant for 12-month FU, but not 3-month FU).
Pan (2012) [ ]Depressive symptoms (CES-D); WHOQOL-Bref-TW (overall score, physical, psychological, social and environmental)Whether depressive symptoms were associated with QoL over time.Linear mixed-effects modelsHigher depressive symptoms were associated with lower QoL in MDD patients (significant for overall score, physical, psychological, social and environmental).
Panagioti (2018) [ ]Depressive symptoms (MHI-5); WHOQOL-Bref (physical, psychological, environmental and social)Whether depressive symptoms at BL are associated with changes in QoL over time.Multivariate regression modelsHigher depressive symptoms at BL were associated with a decline in QoL over time (significant for physical and psychological).
Pakpour (2018) [ ]Dental anxiety at BL (MDAS); PedsQL 4.0 general hrqol and oral hrqol scale at FUWhether dental anxiety at BL predicted oral- and general-health-related QoL at FU.Structural equation modelingDental anxiety at BL was no significant direct predictor of generic QoL at FU and was significantly associated with worse oral-health-related QoL at FU.
Pyne (1997) [ ]MD-diagnosis (SCID/SADS) and depressive symptoms (HAM-D); QWBWhether group status over time (community controls, continuously non-depressed patients, incident depression patients and continuously depressed patients) is associated with changes in QoL.Repeated measure analysis (ANOVA)There was no significant interaction term between group status and time, indicating that changes in QoL did not differ between the groups. At both points in time, QoL differed significantly among all groups, except between the incident depression and continuous depression group.
Remmerswaal (2020) [ ]OCD course (SCID), Y-BOCS, BDI, BAI over time; EQ-5D over time(a) Whether OCD symptom severity and QoL over time were associated.
(b) Whether QoL over time differs between OCD course groups (chronic, intermittent and remitting) and general population norms.
(c) Whether OCD symptom severity, anxiety and depressive symptoms over time are associated with changes in QoL over time in patients with OCD.
(a) Pearson’s correlation

(b)–(c) Linear mixed models
(a) QoL over time and OCD symptom severity were significantly correlated.
(b) The QoL of OCD patients was significantly lower compared to general population norms, except the QoL of the intermittent OCD group at FU1, where there was no significant difference compared to the general population. When comparing the OCD course groups, the chronic OCD group had a significantly lower QoL over time compared to the other groups. The remitting group had moderately improved until FU1 and a small QoL improvement between FU1 and FU2 relative to the chronic group.
(c) In those with a remitting OCD, only more severe symptoms of comorbid anxiety and depressive symptoms, but not OCD symptom severity over time, were significantly associated with a lower QoL over time.
Rhebergen (2010) [ ]MD-/dysthymia-/DD diagnosis at BL and subsequent recovery at FU (according to CIDI); comorbid anxiety at BL (CIDI); SF-36 (physical health summary score)Whether QoL trajectories over time differ between:
(a) different depression status groups who achieved remission (MDD, dysthymia and double depression) and a comparison group without mental health disorders.
(b) The different depression status groups.
(c) Whether comorbid anxiety at BL in a sample recovering from depression is associated with changes in QoL.
(a)–(c) Linear mixed models(a) There was a significant interaction between group status and time. More specifically, compared to changes in QoL over time in people without a mental health diagnosis, QoL improved over time in those with MDD and DD, but not dysthymia. All depression diagnosis groups showed a significantly lower QoL compared to the no diagnosis group at all waves.
(b) Considering the depression groups, only the interaction term between dysthymia and time until FU1 was significant. Those with dysthymia had a significantly lower QoL compared to those with MDD at FU1. This difference was not significant at FU2.
(c) Comorbid anxiety disorder at BL in people who recovered from depression over time was not associated with a significant change in QoL over time.
Rubio (2014) [ ]First episode of incident MDD (AUDADIS-IV) at FU; incident GAD, social anxiety disorder, PD, specific phobia (AUDADIS-IV); SF-12 (MCS)Whether incident MDD is associated with changes in QoL over time compared to:
(a) people without history of MDD,
(b) without history of any mental health disorder,
(c) and whether the association differed by gender.
Whether incident anxiety disorders are associated with changes in QoL over time:
(d) compared to no history of the specific anxiety disorder,
(e) compared to no history of any psychiatric disorder,
(f) and whether the association differed by gender.
Linear regression model(a) Incidence of MDD (compared to no MDD) was associated with a significant decrease in QoL until FU.
(b) Incidence of MDD (compared to no mental health disorder) was associated with a significant decrease in QoL until FU.
(c) The association did not vary by gender.
(d) Incidence of all anxiety disorders (with comorbid disorders; ref: no history of anxiety disorder) was associated with a significant decrease in QoL over time.
(e) Incident anxiety disorders were not significantly associated with QoL when only considering “pure” anxiety without any comorbidities (ref: no history of any psychiatric disorder).
(f) The association did not vary by gender.
Rubio (2013) [ ]Remission from MDD, dysthymia (AUDADIS-IV); Remission from GAD, PD, SAD, specific phobia (AUDADIS-IV); SF-12 (MCS)Whether remission from depression (MDD, dysthymia) is associated with:
(a) changes in QoL over time (compared to non-remitted cases),
(b) QoL at FU (compared to people with no history of a specific depressive disorder),
(c) QoL at FU, when only considering depressive disorders without any psychiatric comorbidity (compared to people without any lifetime psychiatric diagnosis).
Whether remission from anxiety disorders are associated with:
(d) changes in QoL over time (compared to non-remitted cases),
(e) QoL at FU (compared to people with no history of a specific anxiety disorder),
(f) QoL at FU, when only considering anxiety disorders without any psychiatric comorbidity (compared to people without any lifetime psychiatric diagnosis).
(a)–(f) Linear regression models(a) Remission from MD and dysthymia was associated with a significant positive change in QoL compared to non-remitted cases.
(b) Remission of MD and dysthymia was associated with significantly lower QoL at FU compared to people without history of a specific diagnosis.
(c) Remission of MD and dysthymia was associated with significantly lower QoL at FU compared to people without any lifetime psychiatric diagnosis.
(d) Remission from SAD and GAD was associated with significant positive changes in QoL compared to non-remitted cases.
(e) Remission of PD, SAD, specific phobia and GAD was associated with significantly lower QoL at FU compared to people without history of a specific diagnosis.
(f) Remission of “pure” PD, SAD, specific phobias and GAD was associated with significantly lower QoL at FU compared to people without any lifetime psychiatric diagnosis.
Rozario (2006) [ ]Depressive symptoms (GDS); SF-12 (MCS and PCS)Whether depressive symptom severity was associated with QoL change profiles over time (no change, declined and improved groups).Multinomial logistic regressionThere was no significant association between depressive symptom severity and QoL change score profiles at FU.
Sareen (2013) [ ]Depression trajectory groups over time (according to AUDADIS-IV); anxiety disorder trajectory groups over time (according to AUDADIS-IV); SF-12 (MCS and PCS)(a) Whether depression trajectory groups (no past year disorder/no suicide attempt at FU, remission without treatment, persistent disorder/comorbidity/suicide attempt/treatment) differed according to QoL at FU.
(b) Whether anxiety disorder trajectory groups (no past year disorder/no suicide attempt at FU, remission without treatment, persistent disorder/comorbidity/suicide attempt/treatment) differed according to QoL at FU.
(a) and (b) Multiple linear regression models(a) QoL at FU differed among the different depression trajectory groups (MCS was significant for all groups: no disorder > remitted disorder > persistent disorder; PCS: no disorder > remitted disorder; remitted disorder < persistent disorder).
(b) QoL at FU differed among the different anxiety trajectory groups (MCS was significant for all groups: no disorder > remitted disorder > persistent disorder; PCS: no disorder > persistent disorder, remitted disorder > persistent disorder).
Shigemoto (2020) [ ]PTSD symptoms (PCL-C); Q-LES-Q (psychosocial and physical)Whether previous PTSD symptoms are associated with QoL at FU.Longitudinal structural equation modelPrevious PTSD symptoms were associated with physical QoL at FU1, but not FU2 or psychosocial QoL at both FUs.
Siqveland (2015) [ ]Depressive symptoms (according to the depression scale from the GHQ-28); PTSD symptoms (PCL-S); WHOQOL-Bref (global and hrqol)(a) Whether depressive symptoms at BL are associated with QoL at FU.
(b) Whether PTSD symptoms at BL are associated with QoL at FU.
(a) and (b) Multiple mixed effects regression analyses(a) Higher depressive symptoms at BL were associated with reduced QoL at FU.
(b) PTSD levels at BL were not significantly associated with reduced QoL at FU.
Spijker (2004) [ ]Depression status (CIDI); Comorbid anxiety (CIDI); SF-36 (social, role emotional)(a) Whether depression status over time (non-depressed, recovered or depressed (including persistent, relapsing course)) is associated with QoL at FU.
Whether comorbid anxiety is associated with QoL at FU
(b) in a group with persistent depression and
(c) in a group recovered from depression.
ANOVA(a) QoL at FU was significantly reduced in depressed samples compared to the non-depressed group, and lower in the persistently depressed compared to the recovered group (significant for: role emotional and social). Among the depressed subgroups, there was no significant difference between a persistent or a relapsing course regarding QoL at FU.
(b) In the persistently depressed group, comorbid anxiety was significantly associated with reduced QoL at FU (significant for role emotional and social).
(c) In those who recovered from depression, comorbid anxiety was significantly associated with reduced QoL (significant for role emotional).
Stegenga (2012) [ ]MDD status according to CIDI (remitted, intermittent and chronic); SF-12 (PCS and MCS)Whether MDD course (remitted, intermittent and chronic) is associated with QoL over time.Random coefficient analysisWhile change in QoL over time did not differ between course groups, QoL at BL (MCS) was lower in those with a chronic course compared to those who remitted from BL.
Stegenga (2012) [ ] MDD (CIDI); anxiety syndromes (panic disorder and others, PHQ); SF-12 (PCS)(a) Whether MDD at BL predicts change in QoL over time.
(b) Whether anxiety syndrome at BL (compared to no psychiatric diagnosis) predict changes in QoL over time.
(c) Whether comorbid anxiety and MDD at BL (compared to no psychiatric diagnosis) predict changes in QoL over time.
(a)–(c) Random coefficient model(a) While changes in QoL over time did not differ significantly between those with MDD at BL and those without any psychiatric diagnosis, QoL at BL was lower in those with depression.
(b) While changes in QoL over time did not differ significantly between those with anxiety syndrome at BL and those without any psychiatric diagnosis, QoL at BL was lower in those with anxiety compared to those without any psychiatric diagnosis.
(c) While changes in QoL over time did not differ significantly between those with comorbid anxiety and MDD at BL and those without any psychiatric diagnosis, QoL at BL was lower in those with comorbid anxiety and MDD compared to those without any psychiatric diagnosis.
Stevens (2020) [ ]Posttraumatic stress symptoms (VETR-PTSD); SF-36 (MCS, PCS, physical functioning, bodily pain, general health, role physical, role emotional, mental health, vitality and social functioning) Whether PTSS at BL is associated with QoL at FU.Generalized estimating equationsHigher BL PTSS was significantly associated with lower QoL (PCS and MCS) at FU. Using a Bonferroni-corrected alpha value, only the domains of mental health, vitality and social functioning at FU were significantly associated with BL PTSS symptoms. The interaction between time and PTSS at BL was not significant, indicating that PTSS had the same effect on QoL outcomes at both FUs.
Tsai (2007) [ ]Increased post-traumatic stress symptoms (DRPST); MOS SF-36 (physical functioning, role physical, pain, general health, vitality, social functioning, role emotional, mental health, PCS and MCS)(a) Whether different PTSS trajectory groups over time (persistent PTSS, recovered, delayed and persistently healthy) differed in QoL at FU.
(b) Whether increased post-traumatic stress symptoms at BL predicted QoL at FU.
(a) ANOVA
(b) Multiple regression models
(a) At FU, those who were persistently healthy had the highest QoL scores (significantly higher compared to the persistent group in all domains; significantly higher than the recovered group for: pain, general health, vitality, mental health and MCS; significantly higher compared to delayed PTSS in all domains). In addition, those with delayed PTSS (significantly lower than the recovered group in all domains except physical functioning) and those with persistent PTSS (significantly lower than recovered group in all domains) had the lowest QoL overall.
(b) Increased PTSS at BL was not significantly associated with QoL at FU.
Vulser (2018) [ ]Depressive symptom levels (CES-D score), depression status (CES-D ≥ 19); SF-12v2 (role emotional and social)Whether depressive symptoms or depression status at BL are associated with QoL at FU.Generalized linear modelsBoth the level of depressive symptoms at BL as well as depression status at BL were associated with QoL at FU (significant for: role emotional and social).
Wang (2000) [ ] Depressive symptoms (SCL-90 subscale); anxiety symptoms (SCL-90 subscale); WHOQOL-Bref (total)(a) Whether depressive symptoms at BL were associated with QoL at FU.
(b) Whether anxiety symptoms at BL were associated with QoL at FU.
(a) and (b) Stepwise regression(a) Higher depressive symptoms at BL were associated with reduced QoL at FU.
(b) Anxiety symptoms BL were not included in the final stepwise regression model.
Wang (2017) [ ]Depressive disorder course groups (CIDI); anxiety disorder course (CIDI); SF-36 (MCS, PCS)(a) Whether QoL at FU differs between three different course groups of depressive disorders (1. no disorder at BL and no suicide attempt until FU; 2. remitted without treatment; 3. persistent disorder/treatment/developed psychiatric co-morbidity/suicide attempt until FU).
(b) Whether QoL at FU differs between three different course groups of anxiety disorders (1. no disorder at BL and no suicide attempt until FU; 2. remitted without treatment; 3. persistent disorder/treatment/developed psychiatric co-morbidity/suicide attempt until FU).
(a) and (b) Multiple linear regression(a) Those with depression at BL that remitted without treatment had lower QoL at FU (significant for MCS and PCS) than those without the disorder and higher QoL at FU (significant for MCS) than those with a persistent disorder.
(b) Those with anxiety at BL that remitted without treatment over time had lower QoL at FU than those without the disorder and higher QoL (MCS, but not PCS) than those with a persistent disorder.
Wu (2015) [ ]Depressive symptoms according to CDI; social anxiety symptoms (SASC); QOLS(a) Whether depressive symptoms at BL are associated with QoL at FU.
(b) Whether social anxiety symptoms at BL are associated with QoL at FU.
(a) and (b) Multivariate stepwise forward regression(a) Higher depressive symptoms at BL were significantly associated with reduced QoL at FU.
(b) Higher social anxiety symptoms at BL were not significantly associated with QoL at FU.

Abbreviations: QoL = quality of life; MD = major depression; FU = follow-up; DSM = Diagnostic and Statistical Manual of Mental Disorders; HDRS = Hamilton Depression Rating Scale; PCS = Physical Component Score; MDS = Mental Component Score; MDD = major depressive disorder; ANOVA = analysis of variance; BL = baseline; MDE = major depressive episode; CIDI = Composite International Diagnostic Interview; SF-36 = Short Form 36; AUDADIS = Alcohol Use Disorders and Associated Disabilities Interview Schedule; SF-12 = Short Form 12; PHQ = Patient Health Questionnaire; SF-12v2: Short Form 12, Version 2; HRSD = Hamilton Rating Scale for Depression; HADS = Hospital Anxiety and Depression Scale; QLDS = Quality of Life in Depression Scale; EQ-VAS = EQ Visual Analogue Scale; DIS = Diagnostic Interview Schedule; BDI = Beck Depression Inventory; SCID = Short Children’s Depression Inventory; MINI = Mini-International Neuropsychiatric Interview; PTSD = post-traumatic stress disorder; hrqol = health-related quality of life, IES-15 = Impact of Event Scale 15; Q-DIS = Quick Version of the Mental Health’s Diagnostic Interview Schedule; MADRS = Montgomery–Åsberg Depression Rating Scale; FDD-DSM-IV = Fragebogen zur Depressionsdiagnostik nach Diagnostic and Statistical Manual of Mental Disorders IV; SCAN = Schedule for Clinical Assessment in Neuropsychiatry; DASS = Depression Anxiety Stress Scales; MOS SF = Medical Outcomes Study Short Form; CES-D = Center for Epidemiological Studies Depression Scale; WHOQOL-Bref-TW = WHOQOL-Bref Taiwan Version; MHI-5 = Mental Health Inventory 5; OCD = obsessive compulsive disorder; Y-BOCS = Yale–Brown Obsessive Compulsive Scale; BAI = Beck Angst Inventar; DD = depressive disorder; PD = psychiatric disorder; SAD = social anxiety disorder; Q-LES-Q = Quality of Life Enjoyment and Satisfaction Questionnaire; GHQ-28 = General Health Questionnaire 28; PCL-S = Post-traumatic Stress Disorder Checklist Scale; VETR-PTSD = Vietnam Era Twin Registry Posttraumatic Stress Disorder; DRPST = Disaster-Related Psychological Screening Test; SCL-90 = Symptomcheckliste bei psychischen Störungen 90; SASC = SpLD Assessment Standards Committee; QOLS = Quality of Life Scale; CDI = Children’s Depression Inventory.

Depression as independent variable and QoL as outcome. One study investigated QoL at several time points during the entire course of an episode of MD .

Buist-Bouwman, Ormel, de Graaf and Vollebergh [ 46 ] analyzed an MD group from a general population setting (NEMESIS) with data on SF-36 domains in the onset, acute and recovery phase of the depressive episode. The onset of MD was associated with a significant drop in several QoL domains and recovery with a significant increase. Pre- and post-morbid QoL levels were not significantly different for most domains, and post-morbid QoL was even higher for the psychological role functioning and psychological health domains. In comparison to a group without MD, pre- and post-morbid QoL levels in the MD group were significantly lower, except for the psychological role functioning domain, where no significant differences were found. Additionally, it should be noted that 40% of the sample had lower post-morbid QoL compared to pre-morbid levels.

Two studies investigated changes in QoL for people experiencing an onset of depression relative to different comparison groups over two points in time.

One study investigated incident MD in a general population sample (NESARC; Rubio, Olfson, Perez-Fuentes, Garcia-Toro, Wang and Blanco [ 14 ]). Here, incident MD (compared to those without a history of MD as well as to a group without any mental disorder) was associated with a significant drop in QoL (SF-12 MCS). Additionally, analyzing two waves, Pyne, Patterson, Kaplan, Ho, Gillin, Golshan and Grant [ 67 ] compared the QoL (Quality of Well-Being scale) between MD patients and community controls. The patient group was further divided into those continuously not receiving an MD diagnosis, those who continuously received the diagnosis and those who only received the diagnosis at FU (onset). The authors found that changes in QoL did not differ between the groups. At both points in time, QoL scores differed significantly between the groups, except for the incident and the continuous depression group [ 67 ].

Six studies investigated different courses of depression over time in people with depression at BL with or without a healthy comparison group as reference.

Two primary care studies analyzed groups with clinical depression at BL with different FU depression statuses (remission, no remission). One study [ 51 ] analyzed changes in generic QoL measures (SF-12, WHOQOL-Bref) and the disease-specific Quality of Life in Depression Scale. In this study, remission was associated with an improvement in all QoL domains, whereas QoL did not change significantly over time for the non-remitted group. Another study [ 60 ] investigated SF-12 MCS and PCS scores and reported a significant increase in MCS over time in the remitting group. MCS scores in the continuously depressed group and PCS scores in both groups improved, albeit not significantly.

Another study [ 47 ] investigated whether chronic MD in a general population sample (NESARC) was associated with domain-specific reduced QoL (SF-12). They found that chronic MD was a significant risk factor for persistently reduced QoL in all domains and for the onset of reduced QoL at FU in all domains except for physical role.

Two population-based studies further differentiated between the depressive disorders. Analyzing MCS scores (NESARC), Rubio, Olfson, Villegas, Perez-Fuentes, Wang and Blanco [ 15 ] reported a significant increase in QoL for those who remitted from MD and from dysthymia relative to those who had a persistent disorder. Rhebergen, Beekman, de Graaf, Nolen, Spijker, Hoogendijk and Penninx [ 69 ] differentiated between people with MD, double depression or dysthymia at BL who remitted until FU relative to a group without a mental health diagnosis (NEMESIS). Physical health (SF-36) was lowest at BL for double depression, dysthymia and then the MD group. Over time, the MD and double depression groups improved significantly in their physical health, while the dysthymia group did not improve significantly. QoL was significantly lower relative to healthy comparisons for all depression groups at all waves. There were no significant differences regarding physical health trajectories over time among the depressive disorder groups.

Stegenga, Kamphuis, King, Nazareth and Geerlings [ 75 ] investigated more than two MD course groups over time (remitted, intermittent and chronic MD) in association with SF-12 MCS and PCS over time in a primary care-recruited sample with BL MD (Predict study). MCS increased over time in all groups, while changes in PCS were small. Compared to those who remitted, MCS at BL was significantly lower for the chronic course group. While the intermittent group also displayed a lower mean MCS at BL, the coefficient was not significant.

Three studies investigated changes in depressive symptom levels as the independent variable and changes in QoL as outcomes in adults.

One study found no significant association between an initial change in depressive symptoms and subsequent change in QoL (EQ-VAS) in older adults recruited in primary care [ 21 ]. The two other studies analyzed changes in depressive symptoms in samples with MD at BL [ 50 , 51 ]. Chung, Tso, Yeung and Li [ 50 ] found that changes in depressive symptom levels was associated with changes in several QoL domains (SF-36: general health, vitality, social functioning, mental health and MCS). Diehr, Derleth, McKenna, Martin, Bushnell, Simon and Patrick [ 51 ] investigated whether quartiles of change in depressive symptoms were associated with changes in QoL (SF-12, QLDS and WHOQOL-Bref). Those without any change in depressive symptoms generally showed no change in QoL. For all QoL domains and scores except for SF-12 PCS, improvement in depressive symptoms over time was associated with a significant increase in QoL, while a reduction in depressive symptoms was associated with a significant reduction in QoL. Those who had the largest reduction in depressive symptoms also had the largest improvement in QoL measures.

Anxiety as an independent variable and QoL as an outcome. Two publications used a general population sample (NESARC) to investigate incident anxiety disorders [ 14 ] and the remission of anxiety disorders [ 15 ] in association with SF-12 MCS. Both studies separated generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder (PD) and social phobia (SP). All incident disorders were associated with a significant reduction in QoL compared to people without a history of the specific disorders. When the analysis was restricted to incident cases without comorbidities, QoL levels were not significantly different compared to people without a history of any psychiatric disorder [ 14 ]. Those who remitted from SAD showed a significant increase in QoL compared to persistent cases. While QoL improved for all remitting anxiety disorders, change scores for PD and SP were not significant [ 15 ].

Another study investigated different courses (intermittent, chronic or remitting) of obsessive compulsive disorder (OCD) and course in QoL (EQ-5D) as well as a comparison group from the general population [ 68 ]. They found that the OCD groups mostly reported a lower QoL compared to the general population. Moreover, the course groups differed regarding their QoL over time, with remitters reporting small to moderate improvements compared to the chronic group.

One study investigated changes in anxiety symptoms in association with changes in all SF-36 domains and both summary scores over time in a sample with MD at BL [ 50 ]. Changes in anxiety symptoms were significantly associated with changes in bodily pain, general health and the mental health domain.

3.4. Overview of Studies on the Association between QoL as Independent Variable and Anxiety/Depression as Outcomes

Additionally, we identified publications operationalizing QoL as the independent variable and anxiety/depression as outcomes with details on all studies reported in Table 3 . Only one study reported on change in QoL over time and change/trajectories in mental health outcomes over time. This study operationalized change in QoL as a predictor of future change in depressive symptoms over time and reported that an initial improvement in EQ-VAS was associated with a future reduction in depressive symptoms in older adults [ 21 ].

Studies on QoL as the independent variable and depression/anxiety as outcome.

First Author (Year)Disorder or Symptoms Analyzed; QoL Domains AnalyzedResearch QuestionMethodsResults
Chou (2011) [ ]Depressive sympt oms (CES-D-20 score); WHOQOL-Bref (total)Whether QoL at BL is associated with depressive symptoms at FU.Multiple regressionLower QoL at BL was associated with higher depressive symptoms at FU.
De Almeida Fleck (2005) [ ]Depression status (remission vs. no complete remission, CIDI and CES-D-20 cutoff >16); QLDS, WHOQOL-Bref (physical, psychological, social and environment), SF-12 (PCS, MCS)Whether QoL at BL is associated with course of depression (complete remission vs. non-complete remission) in a depressed sample.Stepwise multiple logistic regressionDisease-specific QoL measure at BL significantly predicted the remission of depression at FU (significant for QLDS).
Hajek (2015) [ ]Depressive symptoms (GDS); EQ-VASWhether an initial change in QoL is associated with subsequent changes in depressive symptoms. Vector autoregressive modelInitial changes in QoL were associated with a subsequent reduction in depression score (significant for total sample and women).
Hoertel (2017) [ ]MD (according to AUDADIS-IV): SF-12v2 (PCS and MCS)Whether QoL at BL predicted recurrence (vs. remission) or persistence (vs. remission) of MD over time.Structural equation modelLower QoL at BL was a predictor of risk of persistence (PCS and MCS) and recurrence of MDE over time.
Johansen (2007) [ ]PTSD symptoms according to IES-15; WHOQOL-Bref (total)Whether QoL predicted PTSD symptoms at FU.Structural equation modelQoL did not significantly predict PTSD symptoms at FU.
Kuehner (2009) [ ]Depressive symptoms (MADRS); WHOQOL (overall, physical, psychological, social and environmental)Whether the lag of levels of QoL predicts future levels of depressive symptoms and whether the association differs by group (formerly depressed inpatients vs. community controls)Time-lagged linear modelsLower levels of QoL were associated with higher future depressive symptoms (significant for physical, psychological, environmental and overall). The association was not moderated by group status.
Stegenga (2012) [ ]MDD (CIDI); anxiety syndromes (panic disorder and others, PHQ); SF-12 (PCS)(a) Whether “dysfunction” (i.e., reduced QoL) at BL (mildly reduced, moderately reduced or severely reduced; compared to no reduced QoL) predicts MDD onset over time.
(b) Whether “dysfunction” (i.e., reduced QoL) at BL (mildly reduced, moderately reduced or severely reduced; compared to no reduced QoL) predicts anxiety syndrome onset over time.
(c) Whether “dysfunction” (i.e., reduced QoL) at BL (mildly reduced, moderately reduced or severely reduced; compared to no reduced QoL) predicts onset of comorbid anxiety and MDD over time.
(a)–(c) Multinomial logistic regressions(a) Dysfunction (i.e., reduced QoL) at BL was associated with higher odds of onset of MDD over time in the sample of people without a diagnosis at BL (significant for severely reduced QoL).
(b) Dysfunction (i.e., reduced QoL) at BL was associated with higher odds of onset of anxiety syndrome over time in the sample of people without a diagnosis at BL (significant for moderately and severely reduced QoL).
(c) Dysfunction (i.e., reduced QoL) at BL was associated with higher odds of onset of comorbid anxiety and depression over time in the sample of people without a diagnosis at BL (significant for mild, moderately and severely reduced QoL).
Wu (2016) [ ] Elevated social anxiety symptoms (SASC cutoff 9); QOLSWhether QoL is associated with changes in elevated social anxiety symptoms over time.Generalized Estimating EquationHigher QoL was associated with a decreased risk for developing elevated social anxiety symptoms over time.
Wu (2017) [ ] Elevated depressive symptoms (according to CDI ≥19); QOLSWhether QoL at BL is associated with elevated depressive symptoms at FU.Multiple stepwise logistic regressionQoL at BL was not significantly related to depressive symptoms at FU.

Abbreviations: CES-D-20 = Center for Epidemiological Studies Depression Scale 20; BL = baseline; FU = follow-up; QoL = quality of life; CIDI = Composite International Diagnostic Interview; QLDS = Quality of Life in Depression Scale; SF-12 = Short Form 12; PCS = Physical Component Score; MCS = Mental Component Score; GDS = Geriatric Depression Scale; EQ-VAS = EQ Visual Analogue Scale; MD = mental disorder; AUDADIS-IV = Alcohol Use Disorders and Associated Disabilities Interview Schedule; SF-12v2 = Short Form 12 Version 2; PTSD = post-traumatic stress disorder; IES-15 = Impact of Event Scale 15; MADRS = Montgomery–Åsberg Depression Rating Scale; MDD = major depressive disorder; PHQ = Patient Health Questionnaire; SASC = SpLD Assessment Standards Committee; QOLS = Quality of Life Scale; CDI = Children’s Depression Inventory.

3.5. Meta-Analyses on Anxiety, Depression and SF Summary Scores

In total, eight studies on adults were included in a supplementary meta-analyses of several research questions on SF PCS and MCS in association with anxiety and depressive disorders. Forest plots for the analyses are provided in the supplementary materials (Figures S1–S10) .

Differences in SF summary scores at FU among adults with and without depressive disorders at BL. Based on a pooling of four studies [ 45 , 49 , 52 , 54 ], those with depression at BL showed lower MCS scores at FU compared to a group without depression at BL with a large effect size (SMD = −0.96, 95% CI: −1.04 to −0.88, p < 0.001, I 2 = 0.0%). PCS scores at FU were lower for the depression group compared to the non-depression group with a medium effect size (SMD = −0.68, 95% CI: −1.06 to −0.30, p < 0.001, I 2 = 94.6%). Excluding the study rated “poor” in the quality/risk of bias assessment from the pooling did not substantially affect the results (MCS: SMD = −0.96, 95% CI: −1.03 to −0.88, p < 0.001, I 2 = 0.01%; PCS: SMD = −0.63, 95% CI: −1.08 to −0.19, p < 0.01, I 2 = 96.8%).

BL differences in SF summary scores among adults with MD at BL with and without remitting courses over time. Based on a pooling of two studies [ 19 , 84 ] of samples with MD at BL, those with persistent MD at FU had significantly lower MCS at BL (SMD = −0.25, 95% CI: −0.41 to −0.10, p = 0.001, I 2 = 74.95) and PCS scores at BL (SMD = −0.24, 95% CI: −0.39 to −0.09, p = 0.002, I 2 = 73.14) compared to those who achieved remission until FU. Effect sizes were small for both summary scores.

FU differences in SF summary scores among adults with depressive and anxiety disorders at BL with and without remitting courses . Based on the pooling of two studies [ 71 , 81 ] of samples with MD and/or dysthymia, the group where the disorder had persisted/a co-morbid condition was present/had a suicide attempt until FU had significantly lower MCS scores at FU compared to the group where the disorder had remitted without treatment until FU, with a medium effect size for depressive disorders (SMD = −0.59, 95% CI: −0.75 to −0.42, p < 0.001, I 2 = 37.72) and a small effect size for anxiety disorders (SMD = −0.44, 95% CI: −0.58 to −0.30, p < 0.001, I 2 = 58.87). The SMD for PCS scores at FU was negligible in terms of effect size for both disorder groups (depressive disorders: SMD = 0.02, 95% CI: −0.24 to 0.27, p = 0.90, I 2 = 73.65; anxiety disorders: SMD = −0.09, 95% CI: −0.17 to −0.01, p = 0.03, I 2 = 0.01).

4. Discussion

4.1. main results.

This review adds to the present literature by providing an overview of longitudinal observational studies investigating the association between depression, anxiety and QoL in samples without other specific illnesses or specific treatments. Additional meta-analyses investigated group differences according to SF MCS and PCS.

While a concise synthesis of all the identified studies is challenging due to heterogeneity, the following picture emerges from studies investigating change–change associations: before the onset of disorders, QoL is already lower in disorder groups in comparison to healthy comparisons. The onset of the disorders further reduces the QoL. Remission is associated with an increase in QoL, mostly to pre-morbid levels. Additionally, some studies show that remission patterns are relevant for QoL outcomes as well. Moreover, a bi-directional effect was reported, whereby QoL is also predictive of mental health outcomes.

Evidence for a bi-directional association as well as studies showing lower QoL across the entire course of the disorders (before onset, during disorder, after disorder) relative to a healthy comparison group seem to suggest that impairments in QoL may result from a certain pre-disorder vulnerability in these groups. Longitudinal studies using general population data have investigated different hypotheses on (QoL) impairments after remission of anxiety disorders and MD [ 87 , 88 ]. One hypothesis suggests that impairments after the illness episode reflect a pre-disorder vulnerability (vulnerability or trait hypothesis), while the another states that impairments develop during the mental health episode and remain as a residual after recovery (scar hypothesis). Generally, both studies favored the vulnerability hypothesis [ 87 , 88 ]. For subgroups with recurrent anxiety disorders, scarring effects were also found for mental functioning [ 88 ]. Yet, it has to be noted that it was not the aim of our review to gather evidence for these hypotheses using QoL as an indicator, which represents an opportunity for future research.

To be able to investigate possible domain-specific differences across studies, we aimed to conduct a meta-analysis on all studies on the same research question which reported on QoL subdomains (e.g., using WHOQOL and SF). However, as described in the Methods section above, only eight studies reported comparable information on different research questions and could be included in meta-analyses. Due to the limited number of studies included in each meta-analysis, the focus on SF MCS and PCS scores, and most studies reporting on depression, the results of the meta-analyses should be viewed with caution. Keeping this in mind, our results indicate that both mental and physical QoL are significantly impacted by anxiety and depressive disorders and that the course of the disorder is also relevant for QoL outcomes. Not surprisingly, effect sizes for MCS were larger compared to PCS for most research questions. A pooling of two studies on different courses of anxiety and depressive disorders found that effect sizes for MCS at FU were of moderate size for depressive (SMD = −0.59) and of small size for anxiety disorders (SMD = −0.44), while SMDs for PCS at FU were negligible in size.

Overall, effect sizes from meta-analyses ranged from negligible to large, and heterogeneity varied considerably (I 2 between 0% and 95%). Because of the small number of studies, possible influential study-level factors (e.g., setting, operationalization of the variables, length of FU) could not be investigated in further detail by means of a meta-regression, which remains a question for future research.

4.2. Implications for Future Research

Based on the results described and study heterogeneity discussed above, we provide recommendations for future research.

First recommendation: future research should differentiate between individual disorders and focus on anxiety disorders. The majority of the studies investigated depressive disorders or symptoms. On the level of individual disorders, most focused on MD, while two studies additionally reported on dysthymia [ 15 , 69 ]. One of these investigated double depression [ 69 ]. On the level of anxiety disorders, three publications differentiated between individual anxiety disorders within the same study [ 14 , 15 , 63 ]. While it was not possible to conduct a meta-analysis comparing different anxiety disorders in our case, individual studies suggest possible disorder-specific differences when analyzing changes in QoL over time: Rubio, Olfson, Villegas, Perez-Fuentes, Wang and Blanco [ 15 ] suggest that QoL significantly improved for those remitting from GAD and SAD (compared to non-remission). QoL improved for PD and SP as well, but differences in change scores were smaller and did not reach statistical significance. The incidences of all of these disorders were associated with a significant drop in QoL [ 14 ]. In summary, future longitudinal studies should focus on anxiety disorders and generally differentiate between individual disorders to investigate possible disorder-specific differences.

Second recommendation: future research should consider trajectories of disorders/change in symptoms and changes in QoL over time. We would have liked to include a meta-analysis of disorder trajectories and change scores in QoL over time. Because of the small, diverse number of studies on this association in general and the number of assumptions that would have had to have been made for a meta-analysis, we refrained from pooling effects for this research question. In total, 17 studies investigated changes in independent variables associated with changes in outcomes. This approach has several advantages. On the one hand, different disorder or symptom trajectories can be identified. Several studies reported that QoL outcomes differ according to disorder course and the degree of change in symptoms. The focus on the change in characteristics over time in future research could additionally reduce the problem of unobserved time-constant heterogeneity in observational studies when appropriate methods are applied [ 26 ].

Third recommendation: future research should investigate individual QoL domains. Several systematic reviews on cross-sectional studies found that effect sizes differed by QoL domains [ 32 , 89 ]. For example, Olatunji, Cisler and Tolin [ 89 ] reported that health and social functioning were most impaired for anxiety disorders (compared to non-clinical controls). Comparing individuals with diabetes and depressive symptoms to those with diabetes only, Schram, Baan and Pouwer [ 32 ] reported that while SF pain scores were mild to moderately impaired, role and social functioning displayed moderate to severe impairments in those with comorbid depressive symptoms. The other scores were moderately impaired. As described above in detail, a meta-analysis using all subdomains was not feasible in this review. Further research differentiating between QoL domains would thus allow future meta-analyses to investigate whether the observed domain-specific differences reported in previous reviews of cross-sectional data can be observed in longitudinal studies as well.

Fourth recommendation: future research should consider bi-directional effects. While investigating QoL as the outcome measure and anxiety/depression as independent variables seems relatively straightforward, ten studies investigated QoL as the independent variable and anxiety/depression as outcomes. In light of possible bi-directional effects and pre-existing vulnerability suggested by individual studies, future research considering QoL as an independent variable could inform a deeper understanding of this complex association.

4.3. Strengths and Limitations

A strength of this work is the transparent methodological process: the review was prospectively registered with PROSPERO and a study protocol was published [ 34 ]. Two reviewers were included in screening, data extraction and quality assessment processes. There were no limitations regarding the time or location of the publications. Moreover, all versions of the ICD/DSM and validated questionnaires were considered eligible to identify anxiety or depression. Another strength is the thorough literature search that enabled us to identify all relevant studies. Additionally, we did not limit the age range and were therefore able to shed light on studies investigating children/adolescents. Moreover, some studies could be pooled using random-effects meta-analyses, which allows for stronger conclusions regarding effect sizes compared to individual studies. Besides the content analysis, this review emphasizes difficulties in meta-analysis from observational, longitudinal studies. We hope that our work can facilitate discussion on this topic.

The study has some limitations. We did not limit our search to specific research questions, which led to the inclusion of heterogeneous studies. Heterogeneity particularly stemmed from the operationalization of the variables of interest. Due to this, a concise narrative synthesis of all results was not feasible. The positive aspect of this broad focus is that it allowed us to provide an overview of studies and research questions analyzed and to formulate more nuanced recommendations for future research. We have to acknowledge that there is an abundance of QoL assessments used in medicine and health sciences [ 37 ]. The list applied in this work was derived with respect to previous relevant reviews on QoL research. It was not designed to be fully comprehensive or exhaustive. Rather, it provided us with a working definition for this review and helped to enhance the transparency of our selection processes. Additionally, because we included validated QoL measures frequently used in research, we assume that exclusion would particularly have been the case for novel or study-specific measures. Finally, the focus on peer-reviewed literature means that studies in other languages and gray literature were not considered. Nonetheless, this focus on literature published in peer-reviewed journals should ensure a certain scientific quality.

5. Conclusions and Relevance for Clinical Practice

Overall, the results indicate that QoL is lower before the onset of anxiety and depressive disorders, further reduces upon onset of the disorders and generally improves with remission to pre-morbid levels. Moreover, disorder course (e.g., remitted, intermittent, chronic) seems to play an important role; however, only a few studies analyzed this. Changes in anxiety and depressive symptoms were also associated with changes in QoL over time. Meta-analyses found that effect sizes were larger for MCS relative to PCS, highlighting the relevance of differentiation between QoL domains. While our review identified some gaps in the current literature and made recommendations for future research, the following should be noted for clinical practice. On the one hand, an improvement in mental health is associated with better QoL, which emphasizes the relevance of support during the disorders. This is also shown by meta-analyses, which show that cognitive behavioral therapy additionally improves QoL [ 90 , 91 ]. Moreover, the results indicate reduced QoL even before disorder onset, highlighting the relevance of early preventive measures in vulnerable groups. In line with this, studies on school-based prevention programs show a significant reduction in anxiety and depressive symptoms [ 92 , 93 ], and psychosocial prevention programs may additionally improve QoL [ 94 ].

During the COVID-19 pandemic, it is of high relevance to tackle the arising challenges associated with this pandemic. For example, it is important to face the high prevalence rates of both depression and anxiety with appropriate measures.

Acknowledgments

The authors would like to thank Elzbieta Kuzma for her consultation (Albertinen-Haus Centre for Geriatrics and Gerontology, University of Hamburg, Hamburg, Germany; University of Exeter Medical School, Exeter, UK).

Supplementary Materials

The following are available online at https://www.mdpi.com/article/10.3390/ijerph182212022/s1 , Table S1: detailed descriptive information for included studies ( n = 47); Figure S1: forest plot for differences in SF MCS at FU among adults with and without depressive disorders at BL; Figure S2: forest plot for differences in SF PCS at FU among adults with and without depressive disorders at BL; Figure S3: forest plot for differences in SF MCS at FU among adults with and without depressive disorders at BL (sensitivity analysis); Figure S4: forest plot for differences in SF PCS at FU among adults with and without depressive disorders at BL (sensitivity analysis); Figure S5: forest plot for BL differences in SF MCS among adults with MD at BL with and without remitting courses over time; Figure S6: forest plot for BL differences in SF PCS among adults with MD at BL with and without remitting courses over time; Figure S7: forest plot for FU differences in SF MCS among adults with depressive disorders at BL with and without remitting courses; Figure S8: forest plot for FU differences in SF PCS among adults with depressive disorders at BL with and without remitting courses; Figure S9: forest plot for FU differences in SF MCS among adults with anxiety disorders at BL with and without remitting courses; Figure S10: forest plot for FU differences in SF PCS among adults with anxiety disorders at BL with and without remitting courses.

Author Contributions

J.K.H.: conceptualization of research question; development of search strategy; study screening and selection; risk of bias/quality assessment; study synthesis; writing—original draft, review and editing; H.-H.K.: conceptualization of research question; writing—review and editing; E.Q.: study screening and selection; risk of bias/quality assessment; writing—review and editing; A.H.: conceptualization of research question; development of search strategy; study screening and selection (third party); study synthesis; writing—review and editing. All authors have read and agreed to the published version of the manuscript.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Institutional Review Board Statement

Data availability statement, conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Anxiety and Depression Among College Students Essay

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Introduction

Methods section.

Education is expected to have appositive importance on the student’s life by enhancing their capability to think and improving their competency. However, it often acts as a source of stress that affects students’ mental health adversely. This causation of academic stress often emanates from the need to have high grades, the requirement to change attitude for success, and even pressures put by various school assignments.

These pressures introduced by education can make the student undergo a series of anxiety, depression, and stress trying to conform to the forces. The causes of academic stress are well-researched but there is still no explanation why the rate of strain increases despite some measures being implemented to curb student stress. This research explores this niche by using 100 participants who study at my college.

Nowadays there are many reasons that cause stress among growing number of students who might not know they are going through the condition most of the time. Hence, undiscovered discouragement or uneasiness can cause understudies to feel that they are continually passing up unique open doors. It prompts substance misuse; self-destruction is the second most typical reason for death among undergrads. The main hypothesis of this article is that college and university students have higher depression rates.

Problem Statement

This proposal undercovers how the problem of anxiety and depression is progressing if not addressed. With such countless youngsters experiencing undiscovered tension, it may be challenging for them to appreciate school. Understudies’ emotional well-being is risked when pressure and trouble go unnoticed, which can prompt social and educational issues (Nelson & Liebel, 2018). Educators might battle to perceive uneasiness since these circumstances manifest themselves contrastingly in different people.

Anxiety and depression are complicated disorders with numerous elements that impact people differently. Teachers and staff must be well trained to deal with these unforeseen events. Understudies coming to college come from various financial foundations, which can prompt an assortment of psychological wellness chances (Li et al., 2021). Additionally, current works will be evaluated to differentiate the risk factors associated with stress among university undergraduates worldwide.

There are various reasons which might cause the onset of anxiety and depression. It can be absence of rest, terrible dietary patterns, and lack of activity add to the gloom in undergrads (Ghrouz et al., 2019). Scholarly pressure, which incorporates monetary worries, strain to track down a decent profession after graduation, and bombed connections, is sufficient to drive a few understudies to exit school or more awful.

Numerous parts of school life add to despondency risk factors. For example, understudies today are owing debtors while having fewer work prospects than prior. Discouraged kids are bound to foster the problems like substance misuse (Lattie et al., 2019). For adaptation to close-to-home trouble, discouraged understudies are more inclined than their non-discouraged companions to knock back the firewater, drink pot, and participate in unsafe sexual practices.

Hypothesis on the Topic

The central hypothesis for this study is that college students have a higher rate of anxiety and depression. The study will integrate various methodologies to prove the hypothesis of nullifying it. High rates of anxiety and depression can lead to substance misuse, behavioral challenges, and suicide (Lipson et al., 2018). Anxiety is one of the most critical indicators of academic success, it shows how students’ attitudes change, reflecting on their overall performance.

Participants

The study will use college students who are joining and those already in college. The research period is planned to last six months; college students are between the ages of 18 and 21 and life is changing rapidly at this age (Spillebout et al., 2019). This demography will come from the college where I study. The participants will be chosen randomly, the total number will be 100, both female and male, and from all races.

Apparatus/ Materials/ Instruments

Some of the materials to be used in the study will include pencils, papers, and tests. Paper and pencils are typical supplies that students are familiar with, so using them will not cause additional stress. It will be used during the interview with the students and throughout the study will be in effect (Huang et al., 2018). These have been applied in various studies before, and, hence, they will be instrumental in this study.

The study will follow a step-wise procedure to get the required results. First, the students’ pre-depression testing results would be researched and recorded. Second, the students would undergo standardized testing in the same groups. Scholarly accomplishment is impacted by past intellectual performance and standardized testing (Chang et al., 2020). Third, the students’ levels of depression and anxiety would be monitored along with their test results.

The study will use a descriptive, cross-sectional design with categorical and continuous data. The sample demographic characteristics were described using descriptive statistics. Pearson’s proportion of skewness values and common mistakes of skewness was utilized to test the ordinariness of the persistent factors. The distinctions in mean scores between sociodemographic variables and stress will be examined using Tests (Lipson et al., 2018). The independent variable will be essential because it will provide the basis of measurement.

The 100 participants had different anxiety levels, as seen from the Test taken and the various evaluations. Forty-five of the participants had high levels, 23 had medium levels, while the remaining 32 had low levels (Lipson et al., 2018). The correlation and ANOVA, which had a degree of era margin of 0.05, were allowed (Lipson et al., 2018). This finding aligns intending to have clear and comprehensive outcomes.

Significance of the Study

If the results would be not significant, it means that students are not subjected to more pressure on average. If the study results in significant outcomes, this would mean that there is much that needs to be done to reduce student’s anxiety. The idea that scholarly accomplishment is indispensable to progress is built up in higher instructive conditions (Nelson & Liebel, 2018). Many colleges devote money to tutoring, extra instruction, and other support services to help students succeed.

APA Ethical Guidelines

The study will have to follow the APA ethical guidelines because it involves experimenting with humans. Some of the policies include having consent from the participant, debriefing the participant on the study’s nature, and getting IRB permission (Nelson & Liebel, 2018). Ethical guidelines should comply with proficient, institutional, and government rules. They habitually administer understudies whom they likewise instruct to give some examples of obligations.

Limitations

The study also had some limitations, making it hard to get the desired outcomes. It was not easy to detect the population-level connections, but not causality. This case hardened the aspect of confounding and getting the relevant random assignment needed for the study had to access (Nelson & Liebel, 2018). For the right individuals for the investigation to be identified, the sampling was not easy.

This study would be essential as it will create a platform for future studies. The result that was gotten shows that many college students are undergoing the problem of anxiety and depression without knowing that it is happening. Educators will have an awareness on what aspects of academics they need to modify to ensure their students are not experiencing mental health challenges. Hence, it makes it possible for future researchers to conduct studies to provide possible solutions.

Chang, J., Yuan, Y., & Wang, D. (2020). Mental health status and its influencing factors among college students during the epidemic of COVID-19. Journal of Southern Medical University , 40(2), 171-176.

Ghrouz, A. K., Noohu, M. M., Manzar, D., Warren Spence, D., BaHammam, A. S., & Pandi-Perumal, S. R. (2019). Physical activity and sleep quality in relation to mental health among college students. Sleep and Breathing Journal , 23(2), 627-634.

Huang, J., Nigatu, Y. T., Smail-Crevier, R., Zhang, X., & Wang, J. (2018). Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials. Journal of Psychiatric Research , 107, 1-10.

Lattie, E. G., Adkins, E. C., Winquist, N., Stiles-Shields, C., Wafford, Q. E., & Graham, A. K. (2019). Digital mental health interventions for depression, anxiety, and enhancement of psychological well-being among college students: A systematic review. Journal of Medical Internet Research , 21(7), e12869.

Li, Y., Zhao, J., Ma, Z., McReynolds, L. S., Lin, D., Chen, Z.,… & Liu, X. (2021). Mental health among college students during the COVID-19 pandemic in China: A 2-wave longitudinal survey. Journal of Affective Disorders , 281, 597-604.

Lipson, S. K., Kern, A., Eisenberg, D., & Breland-Noble, A. M. (2018). Mental health disparities among college students of color. Journal of Adolescent Health , 63(3), 348-356.

Nelson, J. M., & Liebel, S. W. (2018). Anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD): Cross-informant, sex, and subtype differences. Journal of American College Health , 66(2), 123-132.

Spillebout, A., Dechelotte, P., Ladner, J., & Tavolacci, M. P. (2019). Mental health among university students with eating disorders and irritable bowel syndrome in France. Journal of Affective Disorders , 67(5), 295-301.

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Cause And Effect Essay Writing

Cathy A.

How to Write Cause and Effect Essays in Simple Steps

11 min read

Published on: Mar 13, 2020

Last updated on: Mar 25, 2024

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Are you struggling to wrap your head around cause and effect essays? Don’t worry; you’re not alone. 

These essays might seem complex at first glance, but with the right approach, they can become easier to write.

In this comprehensive guide, we'll look into what cause and effect essays are, how to structure them, and provide valuable tips and examples to help you understand this type of writing.

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What is a Cause and Effect Essay?

A cause and effect essay is a type of essay writing that explores the relationship between events, actions, or phenomena (causes) and their outcomes or consequences (effects) . 

In this type of essay, the writer analyzes how one event leads to another, providing insights into the underlying causes and the resulting effects. Cause and effect essays aim to explain the connections between various occurrences and explain the reasons behind certain outcomes. 

They often require critical thinking, careful analysis, and the use of evidence and examples to support arguments.

You may confuse cause-and-effect essays with compare and contrast essays . While cause and effect essays focus on analyzing the relationship between events, compare and contrast essays examine similarities and differences between two or more subjects or ideas.

How to Structure a Cause and Effect Essay

There are two main structural types commonly used to write a cause and effect essay: the block structure and the chain structure.

Block Structure

In the block structure, the writer first discusses all the causes of the event in one section, followed by a separate section dedicated to discussing all the effects.

This cause and effect essay format allows for a clear separation between the causes and effects, making it easier for the reader to understand the relationships between them.

Use the block structure when:

  • There are multiple causes and effects to discuss, and you want to provide a comprehensive overview of each.
  • You prefer a clear separation between causes and effects for easier understanding.

Chain Structure

In the chain structure, each cause is followed immediately by its corresponding effect(s), creating a chain-like sequence of events.

This structure emphasizes the direct relationship between each cause and its effect, providing a more immediate and interconnected narrative.

Use the chain structure when:

  • You want to emphasize the direct relationship between each cause and its effect.
  • You're discussing a series of events that occur in a linear or chronological order.

Cause and Effect Essay Outline

Creating an outline is essential for organizing your thoughts and structuring your cause and effect essay effectively. 

Here's a basic outline to guide you through the writing process:

Start with an attention-grabbing statement or question to engage the reader. Provide context and background information on the topic. Clearly state the main causes and effects you will discuss in your essay.

Introduction to Causes

Introduce the first cause you will discuss. Provide an explanation of the cause and its significance. Support your explanation with relevant examples or evidence.

Introduce the effects resulting from the first cause. Discuss the consequences or outcomes of the cause. Provide examples or evidence to illustrate the effects.

Repeat the above structure for each additional cause and its corresponding effects.

Summarize the main causes and effects discussed in the essay. Highlight the connections between the causes and effects. End with a thought-provoking statement or suggestion for further exploration of the topic.

Need a detailed outline guide? Be sure to check out our blog on " Cause and Effect Essay Outline " for a comprehensive breakdown of how to organize your essay.

How to Write a Cause and Effect Essay

Writing a cause and effect essay involves examining the reasons (causes) and outcomes (effects) of a particular event, phenomenon, or situation. Here's a step-by-step guide to help you craft an effective cause and effect essay:

Step 1: Choose a Topic

Start by selecting a topic that interests you and has clear cause-and-effect relationships. It could be a social issue, scientific phenomenon, historical event, or any other subject with identifiable causes and effects. 

For example, "The Effects of Climate Change on Wildlife Populations" or "Causes of Obesity in Developed Countries."

Step 2: Conduct Research

Gather relevant information and evidence to support your thesis statement . Look for credible sources such as academic journals, books, government reports, and reputable websites. 

Ensure you have a thorough understanding of both the causes and effects related to your chosen topic.

Step 4: Develop a Thesis Statement

Craft a clear and concise thesis statement that outlines the main causes and effects you will discuss in your essay. Your thesis should provide a roadmap for the reader and clearly state your position on the topic. 

For instance, "The rise in carbon emissions from human activities is leading to severe consequences for global ecosystems."

Step 5: Outline your Essay

Create a structured outline that organizes your ideas and arguments logically. Divide your essay into introduction , body paragraphs (each discussing a specific cause or effect), and conclusion . 

Each body paragraph should focus on one cause or effect and provide supporting details and evidence.

Step 6: Write the Introduction

Begin with an engaging introduction that provides background information on the topic and introduces your thesis statement. 

Hook the reader's attention with an interesting fact, statistic, or anecdote related to your topic. Clearly state the purpose of your essay and preview the main points you will discuss.

In recent years, the proliferation of social media platforms has revolutionized the way people communicate, connect, and consume information. While these platforms offer numerous benefits such as instant communication and global networking, they have also been associated with various negative effects on mental health. This essay explores the causes behind the rise of social media and its detrimental effects on individuals' mental well-being.

Step 7: Body Paragraphs

In the body paragraphs, explore the causes or effects of the topic in detail. Start each paragraph with a topic sentence that introduces the cause or effect you will be discussing. 

Then, provide evidence and examples to support your claim. Use data, statistics, expert opinions, and real-life examples to strengthen your arguments. Make sure to explain the causal relationship between the factors you're discussing.

One of the primary causes behind the surge in social media usage is the widespread availability of smartphones and internet access. With the advent of affordable smartphones and widespread internet connectivity, people have constant access to social media platforms, leading to increased usage. Additionally, the addictive nature of social media interfaces, characterized by endless scrolling and notifications, further fuels this phenomenon. As individuals spend more time on social media, they become increasingly dependent on these platforms for social validation, entertainment, and information.

The excessive use of social media has been linked to various detrimental effects on mental health, including increased feelings of anxiety, depression, and loneliness. Constant exposure to carefully curated images and lifestyles on social media can create unrealistic expectations and foster feelings of inadequacy among users. Moreover, the prevalence of cyberbullying and online harassment on these platforms can exacerbate existing mental health issues and lead to social withdrawal. Studies have shown a correlation between heavy social media usage and poor sleep quality, as individuals often sacrifice sleep to engage with online content, further compromising their mental well-being.

Step 8: Transition Between Paragraphs

Use transition words and sentences to smoothly transition between paragraphs and maintain coherence throughout your essay. 

These transitions help guide the reader through your arguments and ensure a logical flow of ideas.

Step 9: Write the Conclusion

Summarize the main points of your essay in the conclusion and restate your thesis statement. Reflect on the significance of your findings and emphasize the importance of understanding the causes and effects of the topic. 

Avoid introducing new information in the conclusion; instead, offer insights or suggestions for further research or action.

In conclusion, the rise of social media has had profound implications for individuals' mental health, driven by factors such as increased smartphone usage and the addictive nature of social media platforms. While social media offers unparalleled opportunities for communication and connection, its negative effects on mental well-being cannot be ignored. It is essential for individuals to strike a balance between online and offline interactions and practice mindfulness while using social media to mitigate its adverse effects on mental health. Additionally, further research and awareness efforts are needed to address the underlying causes and consequences of excessive social media usage in society.

Step 10: Revise and Edit

Review your essay for clarity, coherence, and grammatical accuracy. Make sure each paragraph contributes to the overall argument and that your ideas are well-supported by evidence.

Once you've made revisions and edits, finalize your essay by formatting it according to the guidelines provided by your instructor or publication. 

Double-check citations and references to ensure they are accurate and properly formatted according to the required citation style (e.g., APA, MLA).

Cause and Effect Essay Examples

When writing a cause and effect essay for the first time, it is recommended to go through a few examples. It will help you understand the structure and how to use a method effectively.

The following are some of the great cause and effect examples free to use.

Cause and Effect Essay

Cause and Effect Essay Sample

Climate Change Cause and Effect Essay

Poverty Cause and Effect Essay

Air Pollution Cause and Effect Essay

Cause and Effect Essay Topics

Here are some cause and effect essay topics:

  • The Impact of Climate Change on Extreme Weather Events
  • The Rise of Mental Health Disorders Among Adolescents
  • The Effects of Social Media on Political Polarization
  • The Consequences of Deforestation on Biodiversity Loss
  • The Relationship Between Income Inequality and Social Mobility
  • The Impact of Technology on Human Relationships
  • The Causes and Effects of the Global Obesity Epidemic
  • The Effects of Air Pollution on Public Health
  • The Impact of Artificial Intelligence on Employment
  • The Causes and Consequences of Refugee Crises

These topics reflect current societal concerns and offer opportunities for in-depth analysis of cause-and-effect relationships. If you need more such ideas check out our cause and effect essay topics  blog!

Tips for Writing a Cause and Effect Essay

Here are additional tips for writing a cause and effect essay:

  • Establish Clear Connections: Clearly establish the causal relationships between different factors to help readers understand the cause-and-effect dynamics of the topic.
  • Avoid Oversimplification: Recognize that most events have multiple causes and effects, so avoid oversimplifying complex phenomena by considering various factors and their interactions.
  • Consider Chronology: When discussing historical events, consider the chronological sequence of causes and effects to provide a clear narrative structure.
  • Focus on Significance: Highlight the significance of your findings by discussing the broader implications of the causes and effects you've identified.
  • Reflect and Synthesize: In the conclusion, reflect on the insights gained from analyzing the causes and effects and synthesize your findings to provide a cohesive understanding of the topic.

To conclude, writing a cause and effect essay can be a rewarding experience that allows you to look into complex issues. By following the guidelines outlined in this guide and applying your critical thinking skills, you can create compelling essays that inform and engage your audience. 

But if you are in a time crunch do not hesitate to take professional help. CollegeEssay.org provides a top cause and effect essay writing service for those students who are having a hard time meeting deadlines. We'll help you with your cause and effects essays for the best grades. 

Reach out to avail amazing discounts and get our custom essay writing help in no time. As a plus, you can use our AI writing tool if you need a quick fix to beat the deadline stress!

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Cause and Effect Essay - English - 30 Multiple Choice, Answers - 8th grades, 11 pages

Cause and Effect Essay - English - 30 Multiple Choice, Answers - 8th grades, 11 pages

Subject: English

Age range: 11-14

Resource type: Worksheet/Activity

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Last updated

29 August 2024

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cause and effect of anxiety essay

Welcome, 8th graders and higher grades, to an exciting journey into the world of writing! In this activity, we’ll explore the art of crafting a “Cause and Effect Essay” , which is a type of writing that allows you to investigate and explain the reasons behind events or actions and their subsequent consequences.

Why do certain things happen, and what happens because of them? That’s what this 11 page activity is all about—discovering the connections and patterns in our world in one hour.

During this 30 Multiple Choice activity, you will learn the essential elements of a Cause and Effect Essay, how to structure it effectively, and how to use transitional words to guide your readers through the causal relationships. You’ll also explore common mistakes to avoid and techniques to make your essay compelling and insightful thanks to the Answers included.

By the end of this English activity, you’ll be well-equipped to write your own Cause and Effect Essays and impress your teachers with your writing skills. Let’s dive in!

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COMMENTS

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  11. 8 Cause and Effect Essay Examples to Help You Get Started

    Research and Gather Evidence: Gather relevant data, statistics, examples, and expert opinions to support your arguments. Strong evidence enhances the credibility of your essay. Outline Your Essay: Create a structured outline that outlines the introduction, body paragraphs, and conclusion. This will provide a clear roadmap for your essay and ...

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  13. A Guide to Writing a Cause and Effect Essay

    A cause and effect essay is a type of expository essay that explores its topic by discussing the issue's causes and consequences. For example, a cause and effect essay about deforestation's role in climate change might discuss a few of deforestation's specific causes, like a demand for wood and the clearing of land for grazing pastures ...

  14. Cause And Effect Essay On Social Anxiety

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  24. Cause and Effect Essay

    Welcome, 8th graders and higher grades, to an exciting journey into the world of writing! In this activity, we'll explore the art of crafting a "Cause and Effect Essay", which is a type of writing that allows you to investigate and explain the reasons behind events or actions and their subsequent consequences.. Why do certain things happen, and what happens because of them?