گزارش اولیه مادری پایدار از پیش بینی اختلال اضطراب اجتماعی بازداری رفتاری در طول عمر در دوران نوجوانی

Abstract Objective Behavioral inhibition (bi), a temperamental style identifiable in early childhood, is considered a risk factor for the development of anxiety disorders, particularly social anxiety disorder (sad). however, few studies examining this question have evaluated the stability of bi across multiple developmental time points and followed participants into adolescence—the developmental period during which risk for SAD onset is at its peak. The current study used a prospective longitudinal design to determine whether stable early BI predicted the presence of psychiatric disorders and continuous levels of social anxiety in adolescents. It was hypothesized that stable BI would predict the presence of adolescent psychiatric diagnoses, specifically SAD.

Results Preliminary Analyses The 4-month temperament groupings were examined for significant relations to the adolescent psychopathology measures. None of the temperament groups were significantly related to adolescent diagnoses or anxiety symptoms (all p's > .25). Therefore, these groupings were not included in any further analysis. Schedule for Affective Disorders and Schizophrenia for School-Age Children The percentage of participants with current and lifetime anxiety, mood, and disruptive behavior disorders are presented in Table 1 and Table 2, respectively. Rates of disorder did not differ across sex (p's > .10). In many cases, neither the adolescent nor the parent could pinpoint the exact age of onset; however, review of parent and adolescent interviews for adolescents with anxiety diagnoses confirmed that clinically significant anxiety was present after age 7 years, the last previous temperament assessment before adolescence in all but one case (for which the precise timing of remission was unclear). This establishes the prospective nature of the associations between early BI and social anxiety examined here. Table 1. Percentage of Participants Within Each Latent Class That Met Criteria for Current DSM-IV Disorders DSM-IV Diagnosis Total, % (n = 122) “High” BI class, % (n = 15) “Low” BI Class, % (n=107) Odds Ratio (95% CI) Any disorder 41.8 (n = 51) 53.3 (n = 8) 40.2 (n = 43) 1.70 (0.57–5.04) Any anxiety disorder 24.6 (n = 30) 33.3 (n = 5) 23.4 (n = 25) 1.64 (0.51–5.25) Any mood disorder 8.2 (n = 10) 6.7 (n = 1) 8.4 (n = 9) 0.78 (0.09–6.61) Any disruptive disorder 23.8 (n = 29) 33.3 (n = 5) 22.4 (n = 24) 1.72 (0.54–5.54) Social anxiety disorder 12.3 (n = 15) 20.0 (n = 3) 11.2 (n = 12) 1.98 (0.49–8.03) Note: Odds ratio refers to odds of diagnosis given membership in the high-BI class relative to the low-BI class. BI = behavioral inhibition; CI = confidence interval. Table options Table 2. Percentage of Participants Within Each Latent Class That Met Criteria for Lifetime DSM-IV Disorders DSM-IV Diagnosis Total, % (n = 122) “High” BI class, % (n = 15) “Low” BI Class, % (n = 107) Odds Ratio (95% CI) Any disorder 54.1 (n = 66) 60.0 (n = 9) 53.3 (n = 57) 1.32 (0.44–3.96) Any anxiety disorder 31.1 (n = 38) 53.3 (n − 8) 28.0 (n = 30) 2.93 (0.98–8.80) Any mood disorder 14.8 (n = 18) 20.0 (n = 3) 14.0 (n = 15) 1.53 (0.39–6.08) Any disruptive disorder 27.0 (n = 33) 33.3 (n = 5) 26.2 (n = 28) 1.41 (0.44–4.49) Social anxiety disorder 18 (n = 22) 40.0 (n = 6) 15.0 (n = 16) 3.79 (1.18–12.12) Note: Odds ratio refers to odds of diagnosis given membership in the high-BI class relative to the low-BI class. BI = behavioral inhibition; CI = confidence interval. Table options Logistic regression analyses modeled the risk for current and lifetime diagnosis as a function of BI profile. Results are shown in Table 1 and Table 2, respectively. Stable high BI predicted a fourfold significantly increased odds of a lifetime SAD diagnosis (B = 1.33, p < .05); the association with any lifetime anxiety disorder was marginally nonsignificant (B = 1.08, p = .055). No significant findings emerged for current diagnoses; however, for most classes of disorder (except mood), there was a greater percentage of cases in the stable high BI class. Screen for Child Anxiety-Related Emotional Disorders–Revised The adolescents in the stable high-BI class had significantly higher SCARED-R Social Phobia scores than the low-BI class, according to independent reports from both adolescents (t111 = 2.09, p = .04; mean 5.54 [SD 4.12] versus mean 3.52 [SD 3.15]; d = 0.39) and parents (t110 = 3.95, p = .00; mean 7.31 [SD 4.73] versus mean 3.29 [SD 3.26]; d = 0.75). The parents of the participants in the high-BI class also reported higher total SCARED-R scores relative to the parents in the low-BI group (t110 = 2.56, p = .01; mean 17.00 [SD 12.42] versus mean 9.77 [SD 9.19]; d = 0.66).