Behavioral Inhibition and Anxiety: The Moderating Roles of Inhibitory Control and Attention Shifting

Behavioral inhibition (BI), a temperament identified in early childhood, is associated with social reticence in childhood and an increased risk for anxiety problems in adolescence and adulthood. However, not all behaviorally inhibited children remain reticent or develop an anxiety disorder. One possible mechanism accounting for the variability in the developmental trajectories of BI is a child’s ability to successfully recruit cognitive processes involved in the regulation of negative reactivity. However, separate cognitive processes may differentially moderate the association between BI and later anxiety problems. The goal of the current study was to examine how two cognitive processes—attention shifting and inhibitory control—laboratory assessed at 48 months of age moderated the association between 24-month BI and anxiety symptoms in the preschool years. Results revealed that high levels of attention shifting decreased the risk for anxiety problems in children with high levels of BI, whereas high levels of inhibitory control increased this risk for anxiety symptoms. These findings suggest that different cognitive processes may influence relative levels of risk or adaptation depending upon a child’s temperamental reactivity.     

Childhood behavioral inhibition and the experience of social anxiety in American Indian adolescents

American Indian youth may be at increased risk for anxiety-related problems. Social anxiety is the most common form of anxiety experienced by adolescents, yet little research specific to American Indians has been conducted. Childhood temperament, especially behavioral inhibition (BI), has been identified as an important risk factor for social anxiety in other racial and ethnic groups. This study examined BI in relation to social anxiety in a cross-sectional community-based sample of 86 rural southeastern American Indian adolescents. Patterns of childhood BI suggested cultural variations in the way temperament relates to adolescent social anxiety. Specifically, nonsocially based fears in childhood were associated with social anxiety symptoms in adolescence, which is in contrast to previous findings in non American Indian samples that have suggested continuity between social inhibition in childhood and social anxiety in adolescence. It is recommended that major psychological risk factors, including temperament, be evaluated within the specific social and cultural context of the adolescent population of interest.     

Cognitive control moderates early childhood temperament in predicting social behavior in 7‐year‐old children: an ERP study

Behavioral inhibition (BI) is a temperament associated with heightened vigilance and fear of novelty in early childhood, and social reticence and increased risk for anxiety problems later in development. However, not all behaviorally inhibited children develop signs of anxiety. One mechanism that might contribute to the variability in developmental trajectories is the recruitment of cognitive‐control resources. The current study measured N2 activation, an ERP (event‐related potential) associated with cognitive control, and modeled source‐space activation (LORETA; Low Resolution Brain Electromagnetic Tomography) at 7 years of age while children performed a go/no‐go task. Activation was estimated for the entire cortex and then exported for four regions of interest: ventromedial prefrontal cortex (VMPFC), ventrolateral prefrontal cortex (VLPFC), dorsal anterior cingulate cortex (dorsal ACC), and dorsal lateral prefrontal cortex (DLPFC). BI was measured in early childhood (ages 2 and 3 years). Anxiety problems and social reticence were measured at 7 years of age to ascertain stability of temperamental style. Results revealed that BI was associated with increased performance accuracy, longer reaction times, greater (more negative) N2 activation, and higher estimated dorsal ACC and DLPFC activation. Furthermore, early BI was only associated with social reticence at age 7 at higher (more negative) levels of N2 activation or higher estimated dorsal ACC or DLPFC activation. Results are discussed in the context of overcontrolled behavior contributing to social reticence and signs of anxiety in middle childhood.     

Threat perception bias in nonreferred, socially anxious children

Investigated whether socially anxious children display a threat perception bias. A sample of 252 primary school children ages 8 to 13 years were exposed to ambiguous stories of social situations and instructed to find out as quickly as possible whether a story was scary. Furthermore, children were invited to tell how each story would end and to judge how they would feel when actually confronted with that situation. The main results can be summarized as follows. First, socially anxious children displayed lower thresholds for threat perception than control children. In other words, compared with control children, socially anxious children needed to hear fewer sentences of a story before deciding it was scary. Furthermore, socially anxious children more frequently perceived threat while listening to the stories than did control children. Finally, socially anxious children more often interpreted the stories as threatening and displayed higher levels of negative feelings and cognitions in relation to these stories compared with control children. These findings fit nicely in current information-processing theories of childhood anxiety. An additional aim of this study was to investigate the convergent validity of the social phobia scales of 2 recently developed self-report questionnaires for measuring anxiety disorder symptoms in children: the Spence Children's Anxiety Scale (Spence, 1998) and the Screen for Child Anxiety Related Emotional Disorders (Birmaher et al., 1997). Results indicated that the social phobia scale of the Spence Children's Anxiety Scale and the extended social phobia scale of the Screen for Child Anxiety Related Emotional Disorders correlated substantially with a specific measure of social anxiety, the Social Anxiety Scale for Children-Revised.     

Maternal Over-Control Moderates the Association Between Early Childhood Behavioral Inhibition and Adolescent Social Anxiety Symptoms

Behavioral inhibition (BI) and maternal over-control are early risk factors for later childhood internalizing problems, particularly social anxiety disorder (SAD). Consistently high BI across childhood appears to confer risk for the onset of SAD by adolescence. However, no prior studies have prospectively examined observed maternal over-control as a risk factor for adolescent social anxiety (SA) among children initially selected for BI. The present prospective longitudinal study examines the direct and indirect relations between these early risk factors and adolescent SA symptoms and SAD, using a multi-method approach. The sample consisted of 176 participants initially recruited as infants and assessed for temperamental reactivity to novel stimuli at age 4?months. BI was measured via observations and parent-report across multiple assessments between the ages of 14?months and 7?years. Maternal over-control was assessed observationally during parent–child interaction tasks at 7?years. Adolescents (ages 14–17?years) and parents provided independent reports of adolescent SA symptoms. Results indicated that higher maternal over-control at 7?years predicted higher SA symptoms and lifetime rates of SAD during adolescence. Additionally, there was a significant interaction between consistently high BI and maternal over-control, such that patterns of consistently high BI predicted higher adolescent SA symptoms in the presence of high maternal over-control. High BI across childhood was not significantly associated with adolescent SA symptoms when children experienced low maternal over-control. These findings have the potential to inform prevention and early intervention programs by indentifying particularly at-risk youth and specific targets of treatment.     

Attention Biases to Threat Link Behavioral Inhibition to Social Withdrawal over Time in Very Young Children

Behaviorally inhibited children display a temperamental profile characterized by social withdrawal and anxious behaviors. Previous research, focused largely on adolescents, suggests that attention biases to threat may sustain high levels of behavioral inhibition (BI) over time, helping link early temperament to social outcomes. However, no prior studies examine the association between attention bias and BI before adolescence. The current study examined the interrelations among BI, attention biases to threat, and social withdrawal already manifest in early childhood. Children (N = 187, 83 Male, M _age  = 61.96 months) were characterized for BI in toddlerhood (24 & 36 months). At 5 years, they completed an attention bias task and concurrent social withdrawal was measured. As expected, BI in toddlerhood predicted high levels of social withdrawal in early childhood. However, this relation was moderated by attention bias. The BI-withdrawal association was only evident for children who displayed an attention bias toward threat. The data provide further support for models associating attention with socioemotional development and the later emergence of clinical anxiety.     

Social Anxiety in Children with Anxiety Disorders: Relation with Social and Emotional Functioning

Investigated the psychometric properties of the Social Anxiety Scale for children-Revised (SASC-R) as well as relations between social anxiety and children's social and emotional functioning. Participants were a clinic sample of children, ages 6–11 with anxiety disorders (N = 154) who completed the SASC-R. For a subset of these children, parent ratings of social skills, and self-ratings of perceived competence and peer interactions were also obtained. Factor analysis of the SASC-R supported the original three-factor solution and internal consistencies were in the acceptable range. Among children with simple phobia, scores on the SASC-R differentiated those with and without a comorbid social-based anxiety disorder. Social anxiety was also associated with impairments in social and emotional functioning. Specifically, highly socially anxious children reported low levels of social acceptance and global self-esteem and more negative peer interactions. Girls with high levels of social anxiety were also rated by parents as having poor social skills, particularly in the areas of assertive and responsible social behavior.     

Does Father Know Best? A Formal Model of the Paternal Influence on Childhood Social Anxiety

We explore paternal social anxiety as a specific risk factor for childhood social anxiety in a rational optimization model. In the course of human evolution, fathers specialized in external protection (e.g., confronting the external world) while mothers specialized in internal protection (e.g., providing comfort and food). Thus, children may instinctively be more influenced by the information signaled by paternal versus maternal behavior with respect to potential external threats. As a result, if fathers exhibit social anxiety, children interpret it as a strong negative signal about the external social world and rationally adjust their beliefs, thus becoming stressed. Under the assumption that paternal signals on social threats are more influential, a rational cognitive inference leads children of socially anxious fathers to develop social anxiety, unlike children of socially anxious mothers. We show in the model that mothers cannot easily compensate for anxious paternal behavior, but choose to increase maternal care to maintain the child’s wellbeing. We discuss research directions to test the proposed model as well as implications for the prevention and treatment of child social anxiety.     

Social anxiety in children: social skills deficit, or cognitive distortion?

BACKGROUND: Treatments for childhood social anxiety have traditionally employed social skills training, based on the assumption that effected children have social skills deficits. Recent conceptualisations of social anxiety in adults have questioned this assumption, and have suggested that socially anxious individuals merely believe that they have skill deficits. A recent study using children provided preliminary confirmation of this for younger populations, and also suggested that beliefs about appearing nervous are of particular importance. METHODS: Two groups of children, aged 10-11 years (analogue high social anxiety/low social anxiety), participated in a conversation with an unfamiliar adult. They then rated their performance in a number of domains, after which independent observers also rated their performances. RESULTS: Independent observers were unable to distinguish between the low and high social anxiety groups. However, high socially anxious children rated themselves as appearing significantly less skilled than their low socially anxious counterparts. Notably, high socially anxious children rated themselves particularly poorly in terms of how nervous they looked. CONCLUSIONS: Socially anxious children may not necessarily display social skill deficits. However, they may believe that they appear nervous during social encounters. Clinicians should consider using CBT techniques to address these concerns, rather than relying on social skill remediation.     

Paternal Child-Rearing Style and Child Social Anxiety: Investigation of Child Perceptions and Actual Father Behavior

This study examined associations among perceived and actual father behavior and child social anxiety. Forty-eight children (22 high socially anxious, 26 low socially anxious) completed self-report measures of social anxiety, general anxiety, and depression. Children also completed a measure of perceived parental style and subsequently collaborated with their fathers on a challenging task (origami). After controlling for general anxiety and depression, fathers of high socially anxious children exhibited more controlling behavior during the origami task; high and low socially anxious children, however, did not differ behaviorally from one another. Perceptions of father child-rearing style did not differ as a function of child social anxiety, nor were significant relations found between perceived parenting and specific father behaviors. Findings underscore the importance of assessing various types of internalizing symptoms (i.e., controlling for shared construct variance), obtaining children's perceptions of parental style in conjunction with conducting behavioral observations, and including fathers in psychopathology research.     

Investigating a socially anxious‐impulsive subgroup of adolescents: A prospective community study

Previous research has identified a subgroup of socially anxious adults who are both anxious and impulsive. To date, however, this subgroup has not been identified in adolescence. Therefore, in this study we aimed to identify this subgroup in a sample of adolescents. In addition, we hypothesized that this subgroup would be higher on problem behaviors, and that these processes would be moderated by gender. We used longitudinal data from 714 adolescents who were in the 7th and 8th grades at Time 1. They were followed annually for three years. Cluster analyses identified an anxious‐inhibited subgroup as well as an anxious‐impulsive subgroup in early adolescence (Time 1). The socially anxious‐impulsive adolescent boys were generally higher on both intoxication frequency and delinquency compared with all other adolescents in all clusters at each time point. Findings suggest that social anxiety subgroups may differ on problem behavior, and that early detection of an anxious‐impulsive subgroup may be important to prevent maladjustment, especially for adolescent boys.     

Cognitive specificity and affective confounding in social anxiety and dysphoria in children

Cognitive features of social anxiety and dysphoria were examined with a design that allowed for evaluation of each state alone and in combination. From a community sample of 211 8 to 12 year olds, four groups of children were defined based on previous researcher's criteria: mixed (high socially anxious-dysphoric;n= 14), socially anxious (high socially anxiousnondysphoric;n= 14), dysphoric (non-socially anxious-dysphoric;n= 13), and control (non-socially anxious-nondysphoric;n= 14). The negative cognitive triad and negative cognitions pertaining to the self were associated with both dysphoria and social anxiety. Both dysphoric and socially anxious groups reported significantly more cognitive distortions than the control group, yet cognitive distortions of overgeneralizing and personalizing were specific to social anxiety and not dysphoria. Both dysphoric and socially anxious groups reported significantly more depressive cognitions than the control group, and evidence of cognitive content-specificity emerged only for anxiety, although there was some evidence for depressive content-specificity in the mother's ratings. The mixed group was the most dysfunctional on all of the cognitive measures. This study provided some evidence of cognitive-specificity as well as the confounding between the affective states of dysphoria and social anxiety. Methodological, theoretical, and treatment implications are highlighted.     

Interpretation and Expectation in Childhood Anxiety Disorders: Age Effects and Social Specificity

Theory and treatment for childhood anxiety disorders typically implicates children’s negative cognitions, yet little is known about the characteristics of thinking styles of clinically anxious children. In particular, it is unclear whether differences in thinking styles between children with anxiety disorders and non-anxious children vary as a function of child age, whether particular cognitive distortions are associated with childhood anxiety disorders at different child ages, and whether cognitive content is disorder-specific. The current study addressed these questions among 120 7–12 year old children (53% female) who met diagnostic criteria for social anxiety disorder, other anxiety disorder, or who were not currently anxious. Contrary to expectations, threat interpretation was not inflated amongst anxious compared to non-anxious children at any age, although older (10–12 year old) anxious children did differ from non-anxious children on measures of perceived coping. The notion of cognitive-content specificity was not supported across the age-range. The findings challenge current treatment models of childhood anxiety, and suggest that a focus on changing anxious children’s cognitions is not warranted in mid-childhood, and in late childhood cognitive approaches may be better focussed on promoting children’s perceptions of control rather than challenging threat interpretations.     

The Stability of Temperament from Early Childhood to Early Adolescence:A Multi‐method,Multi‐informant Examination

Temperament is a core aspect of children's psychological functioning and is assumed to be at least somewhat stable across childhood. However, little research has assessed the stability of temperament from early childhood to early adolescence. Moreover, few studies have examined the influence of measurement and analytic methods on the stability of early temperament over periods of more than a few years. We obtained laboratory observations and mother and father reports of temperamental negative and positive emotionality and effortful control from 559 three‐year‐olds. Approximately nine years later, children and both parents completed questionnaire measures of similar temperament constructs. Zero‐order correlations revealed greater within‐informant than cross‐informant stability. In addition, compared with parent reports, early childhood laboratory measures showed greater convergent and divergent validity with child, mother, and father reports at age 12. Finally, latent temperament variables at age 3 composed of laboratory and parent‐report measures and latent variables at age 12 composed of parent and child reports showed moderate stability. There was also a weak but significant association of early effortful control with later negative and positive emotionality. Results have implications for assessing temperament and knowledge of the stability of temperament across childhood. Copyright © 2018 European Association of Personality Psychology     

When the heat is on: romantic partner responses influence distress in socially anxious women

This study provided a preliminary test of whether socially anxious women and their partners would show more negative social support behavior, especially among those with low relationship satisfaction, and whether this would increase the distress of the socially anxious women. Women with (n=22) and without (n=23) heightened social anxiety were observed interacting with their partners under a social-evaluative threat and support behaviors were coded. Unexpectedly, no differences were found between socially and non-socially anxious women and their partners. Although relationship satisfaction influenced this process, it was the more satisfied women who showed more negative behavior. Additionally, the more positive behaviors the partner exhibited, the greater was the distress reported by socially anxious women, particularly among women whose partners reported high relationship satisfaction. Implications for how these findings might expand theories on interpersonal processes in social anxiety are discussed.     

Familial correlates of social anxiety in children and adolescents

Retrospective studies suggest a relationship between parental rearing practices and social phobia. The present study investigated whether socially anxious children perceive their current parental rearing as rejecting, overprotective, and lacking emotional warmth, and as emphasizing the importance of other's opinion, and de-emphasizing social initiatives and family sociability. Furthermore, we examined whether parents of socially anxious children report to rely on such rearing practices, and suffer themselves from social fears. A regression analysis as well as extreme group comparisons were applied. Little support was found for the presumed role of the assessed family rearing aspects in the development of social anxiety in children. Solely family sociability (children's and mothers' report) and children's perception of overprotection of the mother predicted social anxiety in the regression analysis. Given the influence of the mentioned rearing practices, social anxiety of the mother still significantly predicted social anxiety of the child. In the extreme group comparisons, differences in the expected direction were found between socially anxious and normal children on parental rejection, emotional warmth, and family sociability. However, the lack of differences between socially anxious and clinical control children suggests that these variables do not form a specific pathway to social fears.     

Social competence in children of alcoholic parents over time

In the current study, the authors tested the hypothesis that children of alcoholic parents (COAs) show deficits in social competence that begin in early childhood and escalate through middle adolescence. Teachers, parents, and children reported on the social competence of COAs and matched controls in a community sample assessed from ages 6 to 15. Hierarchical linear growth models revealed different patterns of change in social competence across development as a function of the reporter of various indicators of competence. Moreover, female COAs showed deficits in social competence in early childhood that receded in adolescence and that varied across subtypes of parent alcoholism. Implications of these findings for understanding the development of social competence in children, and at-risk children in particular, are discussed.     

Social anxiety as a basis for friendship selection and socialization in adolescents' social networks

Socially anxious children and adolescents have previously been found to have friends with similarly socially anxious, withdrawn behavioral characteristics. How peers might socialize social anxiety over time has, however, not been thoroughly investigated. We examined this in a sample of 834 youths (339 girls and 495 boys; M=14.29), followed for 3 years. We used the social network analysis software SIENA to analyze the data. The results showed that youths who were socially anxious were less popular and chose fewer friends in the network. They also tended to choose friends who were socially anxious, and over time they influenced each other into becoming more socially anxious--over and above other effects. Finally, girls' social anxiety was more influenced than boys' by their friends' social anxiety levels. The results showed the significance of looking at socially anxious youths' friendships over time and embedded in social networks.     

Anxious Solitude and Clinical Disorder in Middle Childhood: Bridging Developmental and Clinical Approaches to Childhood Social Anxiety

It was hypothesized that children identified by their peers at school as anxious solitary would report more symptoms of social anxiety disorder on a self report questionnaire and, on the basis of child and parent clinical interviews, receive more diagnoses of social anxiety disorder and additional anxiety and mood disorders. Participants were 192 children drawn from a community sample of 688 children attending public elementary schools. Half of these children were selected because they were identified as anxious solitary by peers and the other half were demographically-matched controls. 192 children provided self reports of social anxiety disorder symptoms on a questionnaire, and 76 of these children and their parent participated in clinical interviews. Results indicate that children identified by their peers as anxious solitary in the fall of 4th grade, compared to control children, were significantly more likely to receive diagnoses of social anxiety disorder, specific phobia, and selective mutism based on parent clinical interviews. Additionally, there was a tendency for these children to be diagnosed with generalized anxiety disorder and post traumatic stress disorder based on parent clinical interviews. Furthermore, children who had been identified as anxious solitary at any time in the 3rd or 4th grades were more likely than control children to report symptoms of social anxiety disorder that fell in the clinical range and to receive diagnoses of social anxiety disorder and dysthymia (both trends) and major depression (a significant effect) according to parental clinical interview.     

Relationship between Social Cognition and Temperament in Preschool‐aged Children

The purpose of this research was to investigate the relationship between temperament and social cognition, including theory of mind and emotion understanding, in 34 preschool‐aged children (aged 3–4 years). Theory of mind was measured with a belief–desire reasoning assessment, and emotion understanding was measured with an affective perspective‐taking task. Child temperament was provided by online parent report. Consistent with previous research, theory of mind correlated with shy and socially observant temperament. In contrast, emotion understanding was associated with attention focusing and low intensity pleasure (enjoyment of low arousal activities). Both theory of mind and emotion understanding were positively related to inhibitory control and negatively related to activity level. In sum, theory of mind and emotion understanding, while both associated with executive functioning, correlate with distinct social preference temperament dimensions. Copyright © 2016 John Wiley & Sons, Ltd.