Priyanshi Patel ’22

Social anxiety disorder (SAD) is one of the most prevalent and disabling anxiety disorders with an onset age of 13 years. SAD is a chronic disorder with adverse psychiatric, social, and educational outcomes, which is why it is important to prevent it by understanding its risk factors. One known risk factor is behavioral inhibition (BI), the withdrawal from unfamiliar situations, environments, and individuals. Another risk for SAD is the presence of a subtype parental anxiety disorder, known as generalized anxiety disorder (GAD). SAD is a recurrent anxious response to social situations, whereas GAD is chronic and uncontrollable anxiety about day-to-day issues. No study has assessed whether maternal behaviors during the child’s infancy predict child SAD, regardless of whether the mother has an anxiety disorder. This study, led by Peter Lawrence and colleagues, hypothesized that the prevalence of SAD in children will be positively associated with the presence of BI in infancy, maternal SAD, and less frequent maternal encouragement, and that these maternal behaviors will be stronger in infancy than childhood. 

The longitudinal study began with prenatal check-ins and follow-ups at 4, 10, 14, and 58 months postnatally. Mothers were tested for anxiety disorders before giving birth and assigned to one of three groups: SAD, GAD, and non-anxious controls. Infant temperamental inhibition (BI) was examined at 4 and 14 months, maternal parental behaviors at 10 and 58 months, and child anxiety disorders and associated symptoms at 58 months. The results of the study indicated that child SAD was predicted by prenatal maternal SAD, but not by prenatal maternal GAD, stable temperamental inhibition, or maternal behaviors. Maternal SAD and intrusiveness specifically predicted child anxiety symptoms at 58 months. The study concluded that child SAD and anxiety symptoms were likely due to maternal SAD, rather than maternal GAD. A lack of maternal encouragement was associated with childhood anxiety symptoms. 

The findings of this study have clinical implications for the targeted prevention of SAD in early childhood. It was noted that childhood anxiety symptoms likely arose from a lack of maternal encouragement behavior in infancy. The results of this study can be applied to future therapies targeting maternal SAD, infants with stable temperamental inhibition, and maternal encouragement. An early prevention effort in childhood would be to target maternal intrusive behaviors. Future studies would benefit from the inclusion of both parents to examine the familial risk factors for child anxiety. 

Works Cited: 

1. P. Lawrence, et al., The role of maternal anxiety disorder subtype, parenting and infant stable temperamental inhibition in child anxiety: A prospective longitudinal study. Journal of Child Psychology and Psychiatry 61:7, 779-788 (2020). doi: 10.1111/jcpp.13187 
2. Image retrieved from: https://www.gettyimages.com/detail/photo/mother-and-daughter-holding-hands-royalty-free-image/1041987624?adppopup=true

Tags: #childpsychology #psychology #anxiety #disorder #prevention