A Longitudinal Investigation of Predictors of the Association Between Age 3 and Age 6 Behavioural Inhibition

Validation of the Italian Version of the Behavioral Inhibition Questionnaire (BIQ) for Preschool Children

Behavioral Inhibition (BI) is a temperamental trait characterized by fear and wariness in reaction to new and unfamiliar stimuli, both social and non-social. BI has been recognized as possible forerunner of anxiety disorders, especially social anxiety and phobia; therefore, its assessment is clinically relevant. The present study aimed to examine the psychometric properties of the Italian adaptation of the Behavioral Inhibition Questionnaire (BIQ), which measures BI in preschool children. The BIQ was completed by 417 Italian parents (230 mothers, 187 fathers) of 270 preschoolers aged 3-5. Confirmatory factor analysis showed a good internal validity: the factorial structure was corresponding to the original six-factor version. Results showed excellent internal consistency, significant item-total correlations, good inter-rater reliability, convergent validity (by correlating the BIQ with the Italian Questionnaires of Temperament-QUIT, the Anxiety-Shy Conner's Scale and the Laboratory Temperament Assessment Battery) and discriminant validity (i.e., no correlation with Conners' ADHD scale). Significant correlations emerged between BI indexes and total BIQ scores of parents and maternal (but not paternal) versions of the questionnaire. Altogether, the results are promising and consistent with previous validation studies, suggesting the BIQ as a reliable and valid measure for evaluating parents' perception of BI in Italian preschoolers.

Observational measures of early irritability predict children's psychopathology risk

Irritability is a transdiagnostic feature of diverse forms of psychopathology and a rapidly growing literature implicates the construct in child maladaptation. However, most irritability measures currently used are drawn from parent-report questionnaires not designed to measure irritability per se; furthermore, parent report methods have several important limitations. We therefore examined the utility of observational ratings of children's irritability in predicting later psychopathology symptoms. Four-hundred and nine 3-year-old children (208 girls) completed observational tasks tapping temperamental emotionality and parents completed questionnaires assessing child irritability and anger. Parent-reported child psychopathology symptoms were assessed concurrently to the irritability assessment and when children were 5 and 8 years old. Children's irritability observed during tasks that did not typically elicit anger predicted their later depressive and hyperactivity symptoms, above and beyond parent-reported irritability and context-appropriate observed anger. Our findings support the use of observational indices of irritability and have implications for the development of observational paradigms designed to assess this construct in childhood.

Toddler dysregulated fear predicts continued risk for social anxiety symptoms in early adolescence

Identifying early risk factors for the development of social anxiety symptoms has important translational implications. Accurately identifying which children are at the highest risk is of critical importance, especially if we can identify risk early in development. We examined continued risk for social anxiety symptoms at the transition to adolescence in a community sample of children (n = 112) that had been observed for high fearfulness at age 2 and tracked for social anxiety symptoms from preschool through age 6. In our previous studies, we found that a pattern of dysregulated fear (DF), characterized by high fear in low threat contexts, predicted social anxiety symptoms at ages 3, 4, 5, and 6 years across two samples. In the current study, we re-evaluated these children at 11-13 years of age by using parent and child reports of social anxiety symptoms, parental monitoring, and peer relationship quality. The scores for DF uniquely predicted adolescents' social anxiety symptoms beyond the prediction that was made by more proximal measures of behavioral (e.g., kindergarten social withdrawal) and concurrent environmental risk factors (e.g., parental monitoring, peer relationships). Implications for early detection, prevention, and intervention are discussed.

Emerging Evidence for Putative Neural Networks and Antecedents of Pediatric Anxiety in the Fetal, Neonatal, and Infant Periods

Anxiety disorders are the most prevalent psychiatric disorders in youth and are associated with profound individual impairment and public health costs. Research shows that clinically significant anxiety symptoms manifest in preschool-aged children, and correlates of anxiety symptoms are observable in infancy. Yet, predicting who is at risk for developing anxiety remains an enduring challenge. Predictive biomarkers of anxiety are needed before school age when anxiety symptoms typically consolidate into diagnostic profiles. Increasing evidence indicates that early neural measures implicated in anxiety and anxious temperament may be incorporated with traditional measures of behavioral risk (i.e., behavioral inhibition) to provide more robust classification of pediatric anxiety problems. This review examines the phenomenology of anxiety disorders in early life, highlighting developmental research that interrogates the putative neurocircuitry of pediatric anxiety. First, we discuss enduring challenges in identifying and predicting risk for pediatric anxiety. Second, we summarize emerging evidence for putative neural antecedents and networks underlying risk for pediatric anxiety in the fetal, neonatal, and infant periods that represent novel potential avenues for risk identification and prediction. We focus on evidence examining the importance of early amygdala and extended amygdala circuitry development to the emergence of anxiety. Finally, we discuss the utility of integrating developmental psychopathology and neuroscience to facilitate future research and clinical work.

Behavioral Inhibition in Childhood: European Portuguese Adaptation of an Observational Measure (Lab-TAB)

The assessment of behaviorally inhibited children is typically based on parent or teacher reports, but this approach has received criticisms, mainly for being prone to bias. Several researchers proposed the additional use of observational methods because they provide a direct and more objective description of the child's functioning in different contexts. The lack of a laboratory assessment of temperament for Portuguese children justifies the adaptation of some episodes of the Laboratory Temperament Assessment Battery (Lab-TAB) as an observational measure for behavioral inhibition. Method: In our study, we included 124 children aged between 3 and 9 years and their parents. The evaluation of child behavioral inhibition was made by parent report (Behavioral Inhibition Questionnaire) and through Lab-TAB episodes. Parental variables with potential influence on parents’ reports were also collected using the Social Interaction and Performance Anxiety and Avoidance Scale (SIPAAS) and the Parental Overprotection Measure (POM). Results and Discussion: The psychometric analyses provided evidence that Lab-TAB is a reliable instrument and can be incorporated in a multi-method approach to assess behavioral inhibition in studies involving Portuguese-speaking children. Moderate convergence between observational and parent report measures of behavioral inhibition was obtained. Mothers’ characteristics, as well as child age, seem to significantly affect differences between measures, being potential sources of bias in the assessment of child temperament.

Prenatal maternal psychological distress and fetal developmental trajectories: associations with infant temperament

Associations between prenatal maternal psychological distress and offspring developmental outcomes are well documented, yet relatively little research has examined links between maternal distress and development in utero, prior to postpartum influences. Fetal heart rate (FHR) parameters are established indices of central and autonomic nervous system maturation and function which demonstrate continuity with postnatal outcomes. This prospective, longitudinal study of 149 maternal-fetal pairs evaluated associations between prenatal maternal distress, FHR parameters, and dimensions of infant temperament. Women reported their symptoms of psychological distress at five prenatal visits, and FHR monitoring was conducted at the last three visits. Maternal report of infant temperament was collected at 3 and 6 months of age. Exposure to elevated prenatal maternal psychological distress was associated with higher late-gestation resting mean FHR (FHRM) among female but not male fetuses. Higher late-gestation FHRM was associated with lower infant orienting/regulation and with higher infant negative affectivity, and these associations did not differ by infant sex. A path analysis identified higher FHRM as one pathway by which elevated prenatal maternal distress was associated with lower orienting/regulation among female infants. Findings suggest that, for females, elevated maternal distress alters fetal development, with implications for postnatal function. Results also support the notion that, for both sexes, individual differences in regulation emerge prenatally and are maintained into infancy. Collectively, these findings underscore the utility of direct assessment of development in utero when examining if prenatal experiences are carried forward into postnatal life.

Pursuit of Harmony: Relational and Individual Predictors of Sexual Passion Expression

Harmonious, obsessive, and inhibited sexual passion comprise the Triadic Model of Sexual Passion. Research has shown that together they play an important role in sexual and relationship satisfaction. Little is known, however, about the factors that predict the likelihood of having these types of passion expression. Using a Mechanical Turk sample of 1414 individuals, we estimated structural equation models to evaluate how relationship factors (i.e., relationship length, sexual desire, sexual drive) and individual factors (i.e., attachment style, childhood abuse, personality) predict the three constructs from the Triadic Model of Sexual Passion. In general, those with higher sexual desire, secure attachment, no childhood abuse, and low impulsivity and shyness were most likely to report optimal sexual passion (higher harmonious, lower inhibited, and lower obsessive sexual passion). By better understanding how these factors predict sexual passion expression, couples may have an increased likelihood of experiencing harmonious sexual passion in their sexual relationships.

Early Childhood Predictors of Anxiety in Early Adolescence

This longitudinal study examined a multitude of early childhood predictors of anxiety symptoms and disorders over an 8-year period. The purpose of the study was to identify early life predictors of anxiety across childhood and early adolescence in a sample of at-risk children. The sample included 202 preschool children initially identified as behaviorally inhibited or uninhibited between the ages of 3 years 2 months and 4 years 5 months. Temperament and familial environment variables were assessed using observation and parent report at baseline. Anxiety symptoms and disorders were assessed using questionnaires and diagnostic interviews at baseline (age 4), and at age 6, 9 and 12 years. In line with our hypotheses, the findings showed that preschool children were more likely to experience anxiety symptoms and disorders over time i) when the child was inhibited, ii) when there was a history of maternal anxiety disorders or iii) when mothers displayed high levels of overinvolvement. Further, the study identified a significant interaction effect between temperament and maternal overvinvolvement such that behaviorally inhibited preschoolers had higher anxiety symptoms at age 12, only in the presence of maternal overinvolvement at age 4. The increased risk of anxiety in inhibited children was mitigated when mothers demonstrated low levels of overinvolvement at age 4. This study provides evidence of both additive and interactive effects of temperament and family environment on the development of anxiety and provides important information for the identification of families who will most likely benefit from targeted early intervention.

Stability of child temperament: Multiple moderation by child and mother characteristics

This 3-wave longitudinal study focuses on stability of child temperament from 3 to 6 years and considers child age, gender, birth order, and term status as well as mother age, education, anxiety, and depression as moderators of stability. Mothers of approximately 10,000 children participating in the Avon Longitudinal Study of Parents and Children rated child temperament. Stability coefficients for child temperament scales were medium to large, and stability was generally robust across moderators except child gender and birth order and mother age and education, which had small moderating effects on reports of stability of child temperament. Statement of contribution What is already known on this subject? Some is known about the stability of temperament in infancy in small samples, but much less is known about the stability of temperament in early childhood or its moderation. What does this study add? This study uses a large sample (˜10,000) to trace the stability of temperament from 3 to 6 years in three waves and considers child age, gender, birth order, and term status as well as mother age, education, anxiety, and depression as moderators of stability.

The BDNF gene val66met polymorphism and behavioral inhibition in early childhood

Stably elevated behavioural inhibition (BI) is an established risk factor for internalizing disorders. This stability may be related to genetic factors, including a valine-to-methionine substitution on codon 66 (val66met) of the brain-derived neurotrophic factor (BDNF) gene. Past work on the BDNF met variant has inconsistently linked it to vulnerability to internalizing problems; some of this inconsistency may stem from the failure to consider gene-trait interactions in shaping the course of early BI. Toward elucidating early pathways to anxiety vulnerability, we examined gene-by-trait interactions in predicting the course of BI over time in 476 children, assessed for BI using standardized laboratory methods. We found that children with the met allele showed lower stability of BI between ages 3 and 6 than those without this allele. While the mechanisms that underlie this effect are unclear, our findings are consistent with the notion that the met variant, in the context of early BI, influences the stability of this trait in early development.