Are fearful boys at higher risk for anxiety? Person-centered profiles of toddler fearful behavior predict anxious behaviors at age 6

Abstract

Dysregulated fear (DF), the presence of fearful behaviors in both low-threat and high-threat contexts, is associated with child anxiety symptoms during early childhood (e.g., Buss et al., 2013). However, not all children with DF go on to develop an anxiety disorder (Buss and McDoniel, 2016). This study leveraged the data from two longitudinal cohorts (N = 261) to (1) use person-centered methods to identify profiles of fearful temperament, (2) replicate the findings linking DF to anxiety behaviors in kindergarten, (3) test if child sex moderates associations between DF and anxiety behaviors, and (4) examine the consistency of findings across multiple informants of child anxiety behaviors. We identified a normative fear profile (low fear in low-threat contexts; high fear in high-threat contexts), a low fear profile (low fear across both low- and high-threat contexts) and a DF profile (high fear across both low- and high-threat contexts). Results showed that probability of DF profile membership was significantly associated with child self-reported overanxiousness, but not with parent-reported overanxiousness. Associations between DF profile membership and overanxiousness was moderated by child sex such that these associations were significant for boys only. Additionally, results showed that probability of DF profile membership was associated with both parent-reported social withdrawal and observations of social reticence, but there were no significant associations with child self-report of social withdrawal. Results highlight the importance of considering person-centered profiles of fearful temperament across different emotion-eliciting contexts, and the importance of using multiple informants to understand associations with temperamental risk for child anxiety.

Keywords: anxiety; early childhood; fear; latent profile analysis; temperament.

FIGURE 1

Bar chart showing average proportion of fear for each event by profile, with significant differences between profiles indicated. *p < 0.05.

FIGURE 2

Line graph depicting associations between the probability of dysregulated fear (DF) profile membership and child self-report of overanxiousness on the BPI, with child sex as a moderator. The symbol * indicates a significant slope (p < 0.05).

FIGURE 3

Line graph depicting associations between the probability of dysregulated fear (DF) profile membership and parental report of social withdrawal symptoms on the Health and Behavior Questionnaire (HBQ), with child sex as a moderator. Other multiple regressions with probability of profile membership, child sex, and their interaction as predictors of maternal report of child social withdrawal on the Health and Behavior Questionnaire (HBQ), with cohort as a covariate were not significant (R² = 0.01, f² = 0.01). The symbol * indicates a significant slope (p < 0.05).

FIGURE 4

Line graph depicting associations between the probability of dysregulated fear (DF) profile membership and proportion of reticence behaviors during a peer play task, with child sex as a moderator. The symbol * indicates a significant slope (p < 0.05).