Behavioral Inhibition as a Risk Factor for the Development of Childhood Anxiety Disorders: A Longitudinal Study

Abstract

This longitudinal study examined the additive and interactive effects of behavioral inhibition and a wide range of other vulnerability factors in the development of anxiety problems in youths. A sample of 261 children, aged 5 to 8 years, 124 behaviorally inhibited and 137 control children, were followed during a 3-year period. Assessments took place on three occasions to measure children's level of behavioral inhibition, anxiety disorder symptoms, other psychopathological symptoms, and a number of other vulnerability factors such as insecure attachment, negative parenting styles, adverse life events, and parental anxiety. Results obtained with Structural Equation Modeling indicated that behavioral inhibition primarily acted as a specific risk factor for the development of social anxiety symptoms. Furthermore, the longitudinal model showed additive as well as interactive effects for various vulnerability factors on the development of anxiety symptoms. That is, main effects of anxious rearing and parental trait anxiety were found, whereas behavioral inhibition and attachment had an interactive effect on anxiety symptomatology. Moreover, behavioral inhibition itself was also influenced by some of the vulnerability factors. These results provide support for dynamic, multifactorial models for the etiology of child anxiety problems.

Fig. 1

Results of the path analysis examining the specificity of behavioral inhibition in predicting symptoms of anxiety disorders and in particular social anxiety as well as other psychopathological symptoms from occasion I to II. Note. Path coefficients represent standardized beta estimates. * p < 0.05 level. Comparative Fit Index (CFI) = 0.89 and SRMR = 0.10

Fig. 2

Results of the path analysis examining the influence of behavioral inhibition, life events, and their interaction on the development of social anxiety, other anxiety disorder symptoms, and depression in children during a 1-year period (i.e., from occasion I to II). Note. No moderating effect of ‘life events’ on the relation between behavioral inhibition and anxiety and depression symptoms was found. Path coefficients represent standardized beta estimates. * p < 0.05 level. Comparative Fit Index (CFI) = 0.90 and SRMR = 0.07

Fig. 3

Results of the path analysis testing direct and moderating paths of various risk factors on the development of social anxiety and other anxiety disorder symptoms in children during the 3-year follow-up period. Note. Path coefficients represent standardized beta estimates. All of the path coefficients are significant beyond the p < 0.05 level. Comparative Fit Index (CFI) = 0.89 and SRMR = 0.06