Behavioral inhibition in childhood predicts social anxiety in adolescence, study finds

A 7-year study of twins found that behavioral inhibition in childhood is associated with social anxiety in adolescence. Behavioral inhibition was mainly assessed by shyness. Parental stress and a number of other factors have been found to influence the strength of this association. The study was published in Development and psychopathology.

Behavioral inhibition is a property of one’s temperament that makes a person prone to withdrawal or reluctance in the face of novelty or threat. It’s a bit like shyness. However, shyness refers to feelings of discomfort in social situations while behavioral inhibition affects behavior in social and non-social situations.

Behavioral inhibition has long attracted research interests in the field of mental health, as it is considered a “trait that biases responses to subsequent stressors in a way that can lead to maladaptive behavioral patterns”. Behavioral inhibition in childhood has also been reported to predict social anxiety in later years. This association is important because anxiety disorders are among the leading causes of disability worldwide. They mainly affect 15-34 year olds, 8.6% of adolescents and 13% of adults meeting the diagnostic criteria for social anxiety disorder.

To study the links between behavioral inhibition and social anxiety in adolescence and to explore the factors that affect the strength of this relationship, including genetic factors, study author H. Hill Goldsmith and his colleagues conducted a 7-year longitudinal study of 1,735 children from 868 families. Data was collected from them at three points in time – when they were 8, 13 and 15 years old. The average number of participants at each time was 700 pairs of twins + parents. All participants collected data from them at least once.

At all three time points, the researchers assessed behavioral inhibition and social anxiety. Behavioral inhibition was assessed using a combination of observational methods (Laboratory Temperament Assessment Battery, Lab-TAB, and Investigator Assessment) and based on parent reports (Children’s Behavior Questionnaire , CBQ and Early Adolescence Temperament Questionnaire-revised, EATQ-R) to assess shyness.

Ratings of social anxiety were obtained from parents’ ratings (MacArthur Health and Behavior Questionnaire, HBQ, Social Anxiety Scales) and children’s self-reports (Multidimensional Anxiety Scale for Children , MASC). These ratings were combined to create unified measures of behavioral inhibition and social anxiety.

In addition to this, the researchers assessed overprotective parenting (Child-Rearing Practices Report, CRPR), parental internalization of psychopathology (Composite International Diagnostic Interview, CIDI and the Multidimensional Personality Questionnaire, MPQ), parenting stress (Parenting Stress Index, PSI), socioeconomic status (education and profession of parents), victimization by peers (7 items of the HBQ) and pubertal development at 13 and 15 years.

The results showed that behavioral inhibition and social anxiety were relatively stable over time. Behavioral inhibition predicts social anxiety, but this relationship likely goes both ways because social anxiety also predicts behavioral inhibition. Factors such as parental stress, socioeconomic status, peer victimization, and internalizing psychopathology have been shown to influence the strength of the association between behavioral inhibition and social anxiety.

Moreover, “both behavioral inhibition and social anxiety are moderately inherited, behavioral inhibition more so than social anxiety. Genetic influences on behavioral inhibition also impact differences in social anxiety, as do unshared environmental effects, to a much lower degree,” the study authors report.

Due to its longitudinal nature and comprehensive set of assessments used, this study sheds important light on the relationship between behavioral inhibition and social anxiety during puberty. However, it should be noted that the behavioral inhibition ratings used in the study primarily captured shyness, that the associations between behavioral inhibition and social anxiety likely run in both directions.

“Childhood Inhibition Predicts Adolescent Social Anxiety: Findings from a Longitudinal Twin Study” was authored by H. Hill Goldsmith, Emily C. Hilton, Jenny M. Phan, Katherine L Sarkisian, Ian C. Carroll, Kathryn Lemery-Chalfant, and Elizabeth M. Planalp.