Social versus non-social behavioral inhibition: Differential prediction from early childhood of long-term psychosocial outcomes

Behavioral inhibition (BI) is a temperamental style characterized by cautious and fearful behaviors in novel situations. The present multi-method, longitudinal study examined whether young children's observed and parent-reported BI in social versus non-social contexts predicts different long-term psychosocial outcomes. Participants (N = 279) were drawn from a longitudinal study of socioemotional development. BI in social contexts ("social BI") was measured via children's observed wariness toward unfamiliar adults and peers at 24 and 36 months and parents' reports of children's social fear/shyness at 24, 36, and 48 months. BI in non-social contexts ("non-social BI") was measured via children's observed fearful responses to masks and novel toys, and parents' reports of children's distress to non-social novelty at 9 months and non-social fear at 48 months. At 15 years, anxiety was assessed via adolescent- and parent-reports, and global internalizing and externalizing problems were assessed via parent-reports. Confirmatory factor analysis showed that a two-factor model fit the BI data significantly better than a single-factor model, providing evidence for the dissociation of BI in social versus non-social contexts. Social BI was uniquely associated with adolescent social anxiety, whereas non-social BI was specifically associated with adolescent separation anxiety. Neither social BI nor non-social BI predicted global internalizing and externalizing problems, providing evidence for the specific relations between BI and anxiety problems. Together, these results suggest that young children's inhibited responses in social versus non-social situations predict different subtypes of anxiety problems in adolescence, highlighting the multifaceted nature of BI and the divergent trajectories of different anxiety problems.

Encouraging a Peer in Need: The Impacts of Social Anxiety and Peer Familiarity

Extant research has produced conflicting findings regarding the link between social fearfulness and prosocial behavior, with some studies reporting negative relations and others reporting null effects. Furthermore, these studies have focused predominantly on toddlerhood, and few have examined prosociality between peers. The present study investigated whether the link between social anxiety and a prosocial behavior (i.e., providing encouragement) varied depending on interpersonal and situational factors (i.e., one's familiarity with a peer, the level of support sought by a peer, respectively). We tested this question using a multimethod approach, which included an ecologically valid stress inducing task and dyadic design with a sample of 9- to 10-year-olds (N = 447). Results revealed that social anxiety was related negatively to providing encouragement among familiar and unfamiliar dyads. In familiar dyads, however, this main effect was qualified by an interaction with the level of support sought by one's peer. Compared to those low in social anxiety, children high in social anxiety provided relatively less encouragement in response to higher levels of support seeking from their peers. The findings are considered in relation to theorizing regarding the effect of overarousal on children's prosocial behavior.

Effects of foster care intervention and caregiving quality on the bidirectional development of executive functions and social skills following institutional rearing

Institutional rearing negatively impacts the development of children's social skills and executive functions (EF). However, little is known about whether childhood social skills mediate the effects of the foster care intervention (FCG) and foster caregiving quality following early institutional rearing on EF and social skills in adolescence. We examined (a) whether children's social skills at 8 years mediate the impact of the FCG on the development of EF at ages 12 and 16 years, and (b) whether social skills and EF at ages 8 and 12 mediate the relation between caregiving quality in foster care at 42 months and subsequent social skills and EF at age 16. Participants included abandoned children from Romanian institutions, who were randomly assigned to a FCG (n = 68) or care as usual (n = 68), and a never-institutionalized group (n = 135). At ages 8, 12, and 16, social skills were assessed via caregiver and teacher reports and EF were assessed via the Cambridge Neuropsychological Test Automated Battery. Caregiving quality of foster caregivers was observed at 42 months. FCG predicted better social skills at 8 years, which in turn predicted better EF in adolescence. Higher caregiver quality in foster care at 42 months predicted better social skills at 8 and 12 years, and better EF at 12 years, which in turn predicted 16-year EF and social skills. These findings suggest that interventions targeting caregiving quality within foster care home environments may have long-lasting positive effects on children's social skills and EF.

Which Anxious Adolescents Were Most Affected by the COVID-19 Pandemic?

Although the COVID-19 pandemic caused significant stress and anxiety among many, individuals' experiences varied. We examined if specific forms of anxiety predicted distinct trajectories of anxiety, perceived stress, and COVID-related worries during three early months of the pandemic. In a longitudinal study (N = 291), adolescents' (n = 194) social and generalized anxiety levels were assessed via parent- and self-reports and clinical diagnostic interviews. In young adulthood (n = 164), anxiety, stress, and COVID-related worries were assessed thrice during the pandemic. Pre-pandemic generalized anxiety predicted higher initial levels and maintenance of anxiety, stress, and COVID-related worries during the pandemic. In contrast, pre-pandemic social anxiety predicted lower initial levels of anxiety, stress, and COVID-related worries, but this initial effect on anxiety and stress was offset over time by social anxiety's positive effect on the slope. Our results highlight the importance of understanding how pre-pandemic factors influence individuals' experiences during the pandemic.

A Developmental Pathway From Early Behavioral Inhibition to Young Adults' Anxiety During the COVID-19 Pandemic

Objective

The COVID-19 pandemic has brought unprecedented changes to young adults' lives, resulting in mental health difficulties for many; however, some individuals are particularly prone to heightened anxiety. Little is known about the early life predictors of anxiety during the pandemic. We examined a developmental pathway from behavioral inhibition (BI), a temperament characterized by fearful responses toward novelty, to changes in young adults' anxiety during the initial period of the pandemic. We hypothesized that a stable pattern of BI across early childhood would predict greater adolescent worry dysregulation, which in turn would predict increases in young adult anxiety during a stressful phase of the pandemic.

Method

Participants (N = 291; 54% female) were followed from toddlerhood to young adulthood. BI was observed at ages 2 and 3 years. Social wariness was observed at age 7 years. Participants rated their worry dysregulation in adolescence (age 15) and anxiety in young adulthood (age 18) at 2 assessments during the COVID-19 pandemic, 1 month apart.

Results

A significant moderated mediation, in which a stable pattern of BI from toddlerhood to childhood, as compared to the absence of this pattern, predicted greater worry dysregulation in adolescence. Worry dysregulation predicted elevated young adult anxiety in the second assessment during COVID-19, even after accounting for the first assessment.

Conclusion

This study identifies a developmental pathway from toddlerhood BI to young adults' elevated anxiety during the COVID-19 pandemic. Findings have implications for early identification of individuals at risk for dysregulated worry and the prevention of anxiety during stressful life events in young adulthood.Reprinted from J Am Acad Child Adolesc Psychiatry, 60, Zeytinoglu et al., A Developmental Pathway From Early Behavioral Inhibition to Young Adults' Anxiety During the COVID-19 Pandemic, pp. 1300-1308, copyright 2021, with permission from Elsevier.

Bidirectional and interactive effects of child temperament and parenting in early childhood on the trajectory of social anxiety in adolescence

INTRODUCTION

Research suggests that certain parenting behaviors are best suited to promote optimal child development, depending on a child's distinctive temperamental presentation. This multimethod, longitudinal study examines the interactive effect of parenting and temperament in early childhood on the developmental trajectory of social anxiety in adolescence.

METHODS

Longitudinal growth modeling was used to examine the developmental trajectory of child social anxiety from age 9-15 and the interactive effect of parenting and child temperament at 36 months on the developmental trajectory of child social anxiety from age 9-15.

RESULTS

The slope of social anxiety from age 9-15 suggested a decrease in social anxiety throughout early adolescence. Furthermore, 36-month behavioral inhibition (BI) predicted the trajectory of child social anxiety from age 9-15 when parents displayed low and high levels of dismissive and supportive parenting (at 36 months).

CONCLUSIONS

Results support an interactive effect of infant temperament and parenting in early childhood (at 36 months) on the developmental trajectory of child social anxiety from age 9-15. Specifically, results suggest that engaging highly inhibited children with high supportive and low dismissive parenting may help reduce social anxiety over time in adolescence. Furthermore, parenting needs may differ for children high or low in BI to impact the developmental trajectory of social anxiety in adolescence, such that children who are high BI seem to benefit from low dismissive and high supportive parenting, and children who are low in BI seem to benefit more from high dismissive parenting.

Pathways from maternal shyness to adolescent social anxiety

BACKGROUND

Social anxiety is amongst the most prevalent adolescent mental health problems; however, it is often unrecognized due to its comorbidity with other anxiety problems such as generalized anxiety. Thus, understanding the unique developmental pathways to social anxiety is critical for improving its prevention. We examined the pathway from maternal shyness, when children were 4 years old, to adolescents' social anxiety at age 15 through social wariness at age 7. We hypothesized that childhood social wariness would mediate the association between maternal shyness and social anxiety in adolescence.

METHODS

Participants (N = 291; 54% female) were followed from early childhood to adolescence. Mothers reported on their own shyness when children were 4 years old. Social wariness toward unfamiliar peers was observed in the laboratory at ages 4 and 7. Adolescent social anxiety and generalized anxiety were assessed via self-report, parent-report, and clinical diagnoses at age 15.

RESULTS

Maternal shyness was positively associated with adolescent social anxiety but not generalized anxiety at age 15. Higher levels of maternal shyness at age 4 predicted greater social wariness at age 7, which in turn predicted greater social anxiety but not generalized anxiety at age 15. Social wariness at age 7 partially mediated the association between maternal shyness and adolescent social anxiety.

CONCLUSIONS

This study identifies a unique developmental pathway from maternal shyness to adolescent social anxiety. Findings suggest that childhood social wariness connects maternal shyness to adolescent social anxiety.

A Developmental Pathway From Early Behavioral Inhibition to Young Adults' Anxiety During the COVID-19 Pandemic

OBJECTIVE

The COVID-19 pandemic has brought unprecedented changes to young adults' lives, resulting in mental health difficulties for many; however, some individuals are particularly prone to heightened anxiety. Little is known about the early life predictors of anxiety during the pandemic. We examined a developmental pathway from behavioral inhibition (BI), a temperament characterized by fearful responses toward novelty, to changes in young adults' anxiety during the initial period of the pandemic. We hypothesized that a stable pattern of BI across early childhood would predict greater adolescent worry dysregulation, which in turn would predict increases in young adult anxiety during a stressful phase of the pandemic.

METHOD

Participants (N = 291; 54% female) were followed from toddlerhood to young adulthood. BI was observed at ages 2 and 3 years. Social wariness was observed at age 7 years. Participants rated their worry dysregulation in adolescence (age 15) and anxiety in young adulthood (age 18) at 2 assessments during the COVID-19 pandemic, 1 month apart.

RESULTS

A significant moderated mediation, in which a stable pattern of BI from toddlerhood to childhood, as compared to the absence of this pattern, predicted greater worry dysregulation in adolescence. Worry dysregulation predicted elevated young adult anxiety in the second assessment during COVID-19, even after accounting for the first assessment.

CONCLUSION

This study identifies a developmental pathway from toddlerhood BI to young adults' elevated anxiety during the COVID-19 pandemic. Findings have implications for early identification of individuals at risk for dysregulated worry and the prevention of anxiety during stressful life events in young adulthood.

Neurocognitive Profiles in Adolescence Predict Subsequent Anxiety Trajectories During the COVID-19 Pandemic

Background

The COVID-19 pandemic has created increased stress and anxiety for many; however, some individuals are particularly prone to heightened anxiety. It is unclear if and how prestress neurocognitive factors moderate risk for anxiety during high-stress situations. Enhanced error monitoring and a cognitive control strategy of more instantaneous (reactive) control have both been independently related to anxiety. We examined if a specific neurocognitive profile characterized by heightened error monitoring and a more reactive cognitive control strategy in adolescence predicts young adults’ anxiety trajectories across 3 early months of the COVID-19 pandemic.

Methods

As part of a longitudinal study (N = 291), data were acquired in adolescence (13 years) on error monitoring (n = 124) and cognitive control strategy (n = 119). In young adulthood (18 years), anxiety was assessed three times during the COVID-19 pandemic (n = 162).

Results

On average, participants experienced greater anxiety in the first COVID-19 pandemic assessment, then anxiety decreased in the following months. Error monitoring and cognitive control strategy interacted to predict anxiety trajectories, such that among adolescents with an increased reliance on reactive control, error monitoring predicted greater anxiety in the first assessment but greater decreases the following months as stay-at-home orders were lifted and families adapted to the restrictions.

Conclusions

Results suggest that neurocognitive profiles in adolescence predict young adults’ anxiety responses during a highly stressful period, such as the initial months of the COVID-19 pandemic. Our findings have implications for the early identification of individuals at greater risk for anxiety.

Transactional Associations Between Parent and Late Adolescent Internalizing Symptoms During the COVID-19 Pandemic: The Moderating Role of Avoidant Coping

Extensive research has demonstrated the transactional nature of parent-child psychopathology, with limited studies examining these effects during late adolescence and none, to our knowledge, longitudinally during the COVID-19 pandemic. The current study examined the cross-lagged effects of parent and adolescent internalizing symptoms during the COVID-19 pandemic and the moderating role of avoidant coping. A sample of 291 adolescents (Age_mean = 18.27; 53% female; 61% White) and their parents rated their own anxiety and depressive symptoms and coping during the first two months following stay-at-home orders during the COVID-19 pandemic. Parent internalizing symptoms at the first assessment predicted adolescent internalizing symptoms at the second assessment. Adolescent avoidant coping style moderated this effect of parent internalizing symptoms on adolescent internalizing symptoms in the subsequent month, such that parent internalizing symptoms predicted child internalizing symptoms only among adolescents with moderate to high rates of avoidant coping. Follow-up analyses indicated different patterns when examining depressive and anxiety symptoms separately. The results highlight complex family dynamics between adolescents and their parents and begin to differentiate how individual characteristics impact the response to a significant life event such as the COVID-19 pandemic.

Caregiving Disruptions Affect Growth and Pubertal Development in Early Adolescence in Institutionalized and Fostered Romanian Children: A Randomized Clinical Trial

OBJECTIVES

To determine the effects of foster care vs institutional care, as well as disruptions in the caregiving environment on physical development through early adolescence.

STUDY DESIGN

This was a randomized controlled trial of 114 institutionalized, though otherwise healthy, children from 6 orphanages and 51 never institutionalized control children living in birth families (family care group) in Bucharest, Romania. Children were followed from baseline (21 months, range 5-31) through age 12 years for caregiving disruptions and growth trajectories and through age 14 years for pubertal development.

RESULTS

Children randomized to the foster care group showed greater rates of growth in height, weight, and body mass index (BMI) through age 12 years than institutionalized group. Tanner development was delayed in institutionalized group boys compared with foster care group and family care group boys at 12 but not 14 years. There were no differences in Tanner development and age of menarche among foster care group, institutionalized group, and family care group girls at ages 12 and 14 years. More disruptions in caregiving between 30 months and 12 years moderated decreases in growth rates of height in foster care group and weight in foster care group and institutionalized group across age. institutionalized group boys with ≥2 disruptions showed lower Tanner scores at age 12 vs institutionalized group and foster care group boys with <2 disruptions. foster care group girls with ≥2 disruptions had higher Tanner scores at age 14 vs foster care group girls with <2 disruptions. Age of menarche was not affected by caregiving disruptions.

CONCLUSIONS

For children who experienced early institutionalization, stable placement within family care is essential to ensuring the best outcomes for physical developmental.

TRIAL REGISTRATION

clinicaltrials.gov: NCT00747396.

The Impact of Caregiving Disruptions of Previously Institutionalized Children on Multiple Outcomes in Late Childhood

This study examined disruptions in caregiving, as well as the association of these disruptions, with cognitive, behavioral, and social outcomes at age 12 in a sample of 136 Romanian children who were abandoned to institutions as infants and who experienced a range of subsequent types of care. Children were found to experience significantly more caregiving disruptions (CGD) earlier in life than later in childhood. More frequent CGD predicted increases in externalizing and internalizing behavior problems at age 12. Results are discussed in terms of the association between CGD and the long-term development of children who have experienced institutional rearing.

IQ at age 12 following a history of institutional care: Findings from the Bucharest Early Intervention Project

Young children removed from institutions and placed into foster care or adoptive homes have been shown to experience significant gains in IQ relative to children who remain in institutions. Less is known about the long-term impact of severe early deprivation on development in late childhood. Data are presented from a follow-up of children at 12 years of age in the Bucharest Early Intervention Project, a randomized clinical trial of foster care for institutionally reared children. Of the original 136 children in the study, 107 were tested with the Wechsler Intelligence Scale for Children-IV. Results revealed continued benefit from the intervention through age 12, with 12-year-old children placed in foster care scoring significantly higher on full-scale IQ compared to their peers who received prolonged institutional care. Longitudinal IQ data revealed 2 IQ profiles from early to late childhood. Attachment security emerged as a significant predictor of a profile of stable, typical IQ scores over time. We demonstrate the continued importance of foster care intervention and the negative effects of severe, early psychosocial deprivation on IQ into late childhood. (PsycINFO Database Record

Longitudinal trajectories of social reticence with unfamiliar peers across early childhood

Behavioral inhibition is a temperament assessed in the toddler period via children's responses to novel contexts, objects, and unfamiliar adults. Social reticence is observed as onlooking, unoccupied behavior in the presence of unfamiliar peers and is linked to earlier behavioral inhibition. In the current study, we assessed behavioral inhibition in a sample of 262 children at ages 2 and 3, and then assessed social reticence in these same children as they interacted with an unfamiliar, same-age, same-sex peer at 2, 3, 4, and 5 years of age. As expected, early behavioral inhibition was related to social reticence at each age. However, multiple trajectories of social reticence were observed including High-Stable, High-Decreasing, and Low-Increasing, with the High-Stable and High-Decreasing trajectories associated with greater behavioral inhibition compared to the Low-Increasing trajectory. In addition, children in the High-Stable social reticence trajectory were rated higher than all others on 60-month Internalizing problems. Children in the Low-Increasing trajectory were rated higher on 60-month Externalizing problems than children in the High-Decreasing trajectory. These results illustrate the multiple developmental pathways for behaviorally inhibited toddlers and suggest patterns across early childhood associated with heightened risk for psychopathology.

The Effects of Early Institutionalization and Foster Care Intervention on Children's Social Behaviors at Age 8

The present study compared the social behaviors of 8-year-old previously institutionalized Romanian children from the Bucharest Early Intervention Project (BEIP) in two groups: 1) children randomized to foster care homes (FCG), and 2) children randomized to care as usual (remaining in institutions) (CAUG). Children were observed interacting with an age and gender-matched unfamiliar, non-institutionalized peer from the community (NIG) during six interactive tasks, and their behavior was coded for speech reticence, social engagement, task orientation, social withdrawal, and conversational competence. Group comparisons revealed that FCG children were rated as significantly less reticent during a speech task than CAUG children. For CAUG children, longer time spent in institutional care was related to greater speech reticence and lower social engagement. Using an Actor-Partner Interdependence Model, CAUG children's behaviors, but not FCG, were found to influence the behavior of unfamiliar peers. These findings are the first to characterize institutionalized children's observed social behaviors towards new peers during middle childhood and highlight the positive effects of foster care intervention in the social domain.

Effects of early intervention and the moderating effects of brain activity on institutionalized children's social skills at age 8

The present study examined the social skills of previously institutionalized, 8-y-old Romanian children from the Bucharest Early Intervention Project and the influence of attachment security and brain electrical activity (alpha power) on these skills. Participants included children randomized to an intervention involving foster care [Foster Care Group (FCG)], children randomized to remain in institutions [Care As Usual Group (CAUG)], and never-institutionalized children living with their families in the Bucharest community [Never-Institutionalized Group (NIG)]. A continuous rating of children's attachment security to their primary caregiver was assessed at 42 mo of age. When children were 8 y old, teachers rated their social skills, and the children's resting electroencephalogram alpha power was recorded. Teachers rated social skills of FCG children who were placed into foster care before 20 mo of age as no different from NIG children, and both of these groups were higher than CAUG children and FCG children placed after 20 mo. Electroencephalogram alpha power at age 8 significantly moderated the relations between attachment security and social skills. These findings characterize institutionalized children's social skills in middle childhood within the context of a randomized intervention while highlighting the roles of both relational and biological factors in these developmental trajectories.

The effects of severe psychosocial deprivation and foster care intervention on cognitive development at 8 years of age: findings from the Bucharest Early Intervention Project

BACKGROUND

Previous reports from the Bucharest Early Intervention Project suggested that children removed from institutions and placed into intervention displayed gains in IQ relative to children randomized to remain in institutional care.

METHOD

The current report presents data from the 8-year follow-up of these children. One hundred and three of the original 136 children in the study were tested with the WISC IV.

RESULTS

Results reveal continued benefit from the intervention even though many of the children in both the intervention and control groups were no longer residing in their initial placements. Gains in IQ were particularly evident for those children who remained with their intervention family. There were also modest timing effects such that children placed earlier displayed higher scores on the WISC processing speed subscale. Early placement was also a significant predictor of a profile of stable, typical IQ scores over time.

CONCLUSION

These data suggest the continued importance of early intervention and the negative effects of severe psychosocial deprivation on the development of IQ scores across early childhood.

The Relations between Infant Negative Reactivity, Non-Maternal Childcare, and Children's Interactions with Familiar and Unfamiliar Peers

The present study examined the influence of children's experiences during non-maternal childcare on their behavior towards unfamiliar peers. Participants included children classified as negatively reactive at 4 months of age (n = 52) and children not negatively reactive (n = 61), who were further divided into those who experienced non-maternal care and those who did not. Children were observed during childcare at 24 months of age and in the laboratory with an unfamiliar peer at 24 and 36 months of age, where their wariness, dysregulation and social engagement were assessed. Within the negatively reactive childcare group, children's positive interactions with peers during childcare at 24 months predicted lower levels of wariness towards an unfamiliar peer at 36 months. This relation was not significant for children not classified as negatively reactive. The findings suggest that the influence of non-maternal childcare is dependent on a child's temperament and the nature of peer interactions during care.

Temperament and the environment in the etiology of childhood anxiety

Anxiety disorders are prevalent throughout childhood and adolescence. As such, identifying the factors and mechanisms that precede, maintain, or exacerbate anxiety disorders is essential for the development of empirically based prevention and intervention programs. The current review focuses on child temperament (i.e., behavioral inhibition) and the child's environment, including parenting, childcare, and peer relationships, as these factors have been linked to internalizing problems and anxiety diagnoses. Research programs are needed that examine the associations between the environment and anxiety in temperamentally at-risk populations. In order to be successful, early intervention and prevention programs require a more detailed analysis of the interplay between various environmental contexts, both distal and proximal to the child, and the child's temperamental reactivity to novelty and threat. Furthermore, conducting these investigations across multiple levels of analysis in large-scale, longitudinal samples would be an important addition to the literature on the developmental psychopathology of anxiety.