Targeting social wariness in childhood may prevent anxiety disorders in young adults

Behavioural inhibition is a childhood temperament characterised by high levels of cautious, fearful, and avoidant responses to unfamiliar people, objects, and situations. Studies have established that children who display this behaviour are at increased risk of developing anxiety disorders later in life. A recent study by researchers at the National Institute of Mental Health (NIMH) Section on Development and Affective Neuroscience, US, suggests this display also puts them at greater risk for heightened anxiety during stressful events, such as the COVID-19 pandemic.

NIMH researchers hypothesised children who demonstrated a stable pattern of behavioural inhibition may find it difficult to manage worry and would display inappropriate expressions of worry in adolescence. For the study, the researchers measured behavioural inhibition using children’s responses to novel toys and interaction with unfamiliar adults at ages 2 to 7; while worry dysregulation was assessed at age 15 through a self-report survey.

The researchers studied data from 291 participants who had been followed from toddlerhood to young adulthood – participants were given a final assessment for anxiety at the average age of 18, twice during the early months of the COVID-19 pandemic after stay-at-home orders had been issued (first between April 20 and May 15 and approximately a month later).

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At the first assessment, 20% of the participants reported moderate levels of anxiety symptoms considered to be in the clinical range. At the second assessment, 18.3% of participants reported clinical levels of anxiety. As expected, the researchers found that individuals with high behavioural inhibition in toddlerhood who continued to display high levels of social wariness in childhood reported experiencing dysregulated worry in adolescence, and this ultimately predicted increased anxiety in young adulthood during a critical stage of the pandemic.

However, this developmental pathway was not significant for children who showed behavioural inhibition in toddlerhood but displayed low levels of social wariness later in childhood.

The findings suggest that targeting social wariness in childhood and worry dysregulation in adolescence may be a viable strategy for the prevention of anxiety disorders during stressful life events and preventing heightened anxiety.

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