New research
Early Behavioral Inhibition and Increased Error Monitoring Predict Later Social Phobia Symptoms in Childhood

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Objective

Behavioral inhibition (BI) is an early childhood temperament characterized by fearful responses to novelty and avoidance of social interactions. During adolescence, a subset of children with stable childhood BI develop social anxiety disorder and concurrently exhibit increased error monitoring. The current study examines whether increased error monitoring in 7-year-old, behaviorally inhibited children prospectively predicts risk for symptoms of social phobia at age 9 years.

Method

A total of 291 children were characterized on BI at 24 and 36 months of age. Children were seen again at 7 years of age, when they performed a Flanker task, and event-related potential (ERP) indices of response monitoring were generated. At age 9, self- and maternal-report of social phobia symptoms were obtained.

Results

Children high in BI, compared to those low in BI, displayed increased error monitoring at age 7, as indexed by larger (i.e., more negative) error-related negativity (ERN) amplitudes. In addition, early BI was related to later childhood social phobia symptoms at age 9 among children with a large difference in amplitude between ERN and correct-response negativity (CRN) at age 7.

Conclusions

Heightened error monitoring predicts risk for later social phobia symptoms in children with high BI. Research assessing response monitoring in children with BI may refine our understanding of the mechanisms underlying risk for later anxiety disorders and inform prevention efforts.

Section snippets

Participants and Procedure

Infants (N = 779) were seen at 4 months of age, during which positive and negative affect and motor reactivity to novel stimuli were assessed (a complete description is provided by Hane et al.34). Of this sample, 291 infants (135 male and 156 female) representing the full range of reactivity were selected for a longitudinal study, with 64% white, 14% African American, and 22% from other backgrounds. When children were 24 and 36 months of age, observations were conducted on 268 participants, and

Results

To maintain consistency with prior research,1, 48, 49 high- and low-BI groups were created via median split (Table 1). The two BI groups did not differ on age [t (111) = 0.43, p = .67], sex [χ2 (1, n = 113) = 0.19, p = .66], ethnicity [χ2 (11, n = 113) = 11.25, p = .42], CBCL anxiety [t (100.47) = −1.53, p = .13], or social phobia symptoms [t (76) = −0.50, p = .62].

Discussion

In this prospective study, 7-year-old children, characterized with BI at ages 2 and 3 years, participated in a Flanker task. When these children were 9 years old, self- and maternal-report measures of social phobia symptoms were obtained. Two main findings emerged. First, high behaviorally inhibited children exhibited increased ERN amplitudes, as compared to low behaviorally inhibited children. Second, the ERN–CRN difference in amplitude moderated the relations between early BI, as quantified 4

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    This project was supported by a grant from NIMH (U01MH093349; N.A.F.), by the NIMH Intramural Research Program, and by a Lawson Foundation Post-Doctoral Fellowship (A.L.).

    Disclosures: Drs. Lahat, Lamm, Chronis-Tuscano, Pine, Henderson, and Fox report no biomedical financial interests or potential conflicts of interest.

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