Annual Research Review: Developmental pathways linking early behavioral inhibition to later anxiety

Abstract

Behavioral Inhibition is a temperament identified in the first years of life that enhances the risk for development of anxiety during late childhood and adolescence. Amongst children characterized with this temperament, only around 40 percent go on to develop anxiety disorders, meaning that more than half of these children do not. Over the past 20 years, research has documented within-child and socio-contextual factors that support differing developmental pathways. This review provides a historical perspective on the research documenting the origins of this temperament, its biological correlates, and the factors that enhance or mitigate risk for development of anxiety. We review as well, research findings from two longitudinal cohorts that have identified moderators of behavioral inhibition in understanding pathways to anxiety. Research on these moderators has led us to develop the Detection and Dual Control (DDC) framework to understand differing developmental trajectories among behaviorally inhibited children. In this review, we use this framework to explain why and how specific cognitive and socio-contextual factors influence differential pathways to anxiety versus resilience.

Keywords: Temperament; anxiety; child development; developmental psychopathology; electroencephalography.

Figure 1

The grouping of attentional and control processes in the current model. Bullets provide an example of a task used in the study of each process, with specific indices from each task presented in parentheses. Note that this list of examples is noncomprehensive. Within the leftmost box, labeled ‘Detection’, processes range continuously from more stimulus-driven at the bottom to more goal-driven. The inclusion of this continuum reflects the heterogeneity of these processes along this dimension, with their unification in a single box reflecting the equivalency in their relationships to behavioral inhibition in the current model. ABT, attention bias to threat; AX-CPT, AX-continuous performance task; DCCS, dimensional change card sort; ERN, error-related negativity; MID, monetary incentive delay

Figure 2

Hypothetical attentional behavior of (A) a child high in behavioral inhibition (BI) at low risk of developing anxiety and (B) a child with high BI at higher risk of developing anxiety. After a salient event occurs, planful control supports the recovery of attention back to goal-relevant information. However, automatic control may instead maintain attention on the salient event and away from goal-relevant information

Figure 3

The Detection and Dual Control (DDC) framework and hypothesized links to caregiving