Maternal Over-Control Moderates the Association Between Early Childhood Behavioral Inhibition and Adolescent Social Anxiety Symptoms

Abstract

Behavioral inhibition (BI) and maternal over-control are early risk factors for later childhood internalizing problems, particularly social anxiety disorder (SAD). Consistently high BI across childhood appears to confer risk for the onset of SAD by adolescence. However, no prior studies have prospectively examined observed maternal over-control as a risk factor for adolescent social anxiety (SA) among children initially selected for BI. The present prospective longitudinal study examines the direct and indirect relations between these early risk factors and adolescent SA symptoms and SAD, using a multi-method approach. The sample consisted of 176 participants initially recruited as infants and assessed for temperamental reactivity to novel stimuli at age 4 months. BI was measured via observations and parent-report across multiple assessments between the ages of 14 months and 7 years. Maternal over-control was assessed observationally during parent-child interaction tasks at 7 years. Adolescents (ages 14-17 years) and parents provided independent reports of adolescent SA symptoms. Results indicated that higher maternal over-control at 7 years predicted higher SA symptoms and lifetime rates of SAD during adolescence. Additionally, there was a significant interaction between consistently high BI and maternal over-control, such that patterns of consistently high BI predicted higher adolescent SA symptoms in the presence of high maternal over-control. High BI across childhood was not significantly associated with adolescent SA symptoms when children experienced low maternal over-control. These findings have the potential to inform prevention and early intervention programs by identifying particularly at-risk youth and specific targets of treatment.

Early childhood behavioral inhibition, adult psychopathology and the buffering effects of adolescent social networks: a twenty‐year prospective study

“…Subjects were repeatedly assessed across the first 20 years of life (Calkins, et al, 1996; Chronis-Tuscano, et al, 2009; Fox, et al, 2001; Lewis-Morrarty, et al, 2012). For the original sample, 165 participants (50.09% female), recruited across the years 1989-1993, provided temperament data either observationally and/or via maternal report questionnaires from infancy through childhood.…”

“…Included participants did not differ from excluded participants on BI and/or adolescent social data ( ps >0.36). All participants were White, Non-Hispanic/Latino and initially from two-parent, middle-to-upper class families (Chronis-Tuscano, et al, 2009; Lewis-Morrarty, et al, 2012). Of those who provided demographic data regarding level of education at the adult time point ( n =125; 96.89%), 11.6% ( n =15) completed high school education (without college education), and 85.3% ( n =110) were in college at the time of the young adult assessment.…”

“…Importantly, the relations between BI and pathological outcomes may be influenced by the environment (Lewis-Morrarty et al, 2012; Rapee, Kennedy, Ingram, Edwards, & Sweeney, 2010). In adolescence, the peer group emerges as a particularly salient source of socialization, exerting the greatest influence during middle adolescence and gradually declining thereafter (e.g.…”

Extending Parent–Child Interaction Therapy for Early Childhood Internalizing Problems: New Advances for an Overlooked Population

“…There is evidence that children with behaviorally inhibited temperaments, characterized by social wariness and a tendency to withdrawal from unfamiliar people and situations, are at an elevated risk of developing clinical anxiety later on in development (Chronis-Tuscano et al 2009). Further, among young children with stable behavioral inhibition, those whose mothers show overcontroling behaviors are at greatest risk of subsequently developing social anxiety in adolescents (Lewis-Morrarty et al 2012), underscoring the potential utility that training parents in how to manage early behavioral inhibition without excessively accommodating symptoms may offer. Moreover, group treatment formats may offer parents of behaviorally inhibited youth critical opportunities for modeling and support.…”

Gender Differences in Child and Adolescent Social Withdrawal: A Commentary

“…This seems especially the case for those socially reticent children whose parents continue to be overly controlling (e.g., Hane et al 2008). Eventually, these anxiously withdrawn, overly controlled, peer-rejected/excluded/victimized children develop intrapersonal thoughts and feelings of loneliness, negative self-regard, social anxiety, depression, and rejection sensitivity (e.g., Gullone et al 2006; Ladd 2006; Lewis-Morrarty et al 2012). Significantly, however, the developmental stability of anxiously withdrawn, reticent behavior may be disrupted if parents begin to display supportive behaviors, the parent–child relationship becomes secure, and if close and supportive friendships are formed and maintained (Booth-LaForce et al 2012; Oh et al 2008).…”