Temperament and Family Environment in the Development of Anxiety Disorder: Two-Year Follow-up
Abstract
Objective Behavioral inhibition (BI) in early childhood is associated with increased risk for anxiety. The present research examines BI alongside family environment factors, specifically maternal negativity and overinvolvement, maternal anxiety, and mother-child attachment, with a view to providing a broader understanding of the development of child anxiety.Method Participants were 202 children classified at age 4 years as either behaviorally inhibited (N = 102) or behaviorally uninhibited (N = 100). Family environment, BI and child anxiety were assessed at baseline and child anxiety and BI were assessed again 2 years later when participants were 6 years of age.Results After controlling for baseline anxiety, BI participants were significantly more likely to meet criteria for a diagnosis of social phobia and generalized anxiety disorder at follow-up. Path analysis suggested that maternal anxiety significantly affected child anxiety over time, even after controlling for the effects of BI and baseline anxiety. No significant paths from parenting or attachment to child anxiety were found. Maternal overinvolvement was significantly associated with BI at follow-up.Conclusions At age 4 years, BI, child anxiety, maternal anxiety, and maternal overinvolvement represent risk factors for anxiety at age 6 years. Furthermore, overinvolved parenting increases risk for BI at age 6, which may then lead to the development of anxiety in later childhood.
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Parenting a more sensitive and inhibited toddler may influence parenting whereby parents become more over-involved to support their child's anxious behaviours.
“Alternatively, parenting a more sensitive and inhibited toddler may in fl uence parenting whereby parents become more over-involved to support their child ' s anxious behaviours (Hudson et al., 2009, 2011).”
From Specific Phobia in Young Children: Associations between the Origins of Fear and Clinical Expression of Phobia Symptoms. (2025) · cites this paper as Hudson et al., 2011
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Kagan, J. (2014) · Elsevier eBooks · doi:10.1016/b978-0-12-394427-6.00014-5 · Cited by 6 · see citing works
Wise, S., Huang‐Pollock, C. L., & Pérez‐Edgar, K. E. (2021) · Psychological Research · doi:10.1007/s00426-021-01532-3 · Cited by 6 · see citing works
“BI is commonly measured via parent report of temperament (Chronis-Tuscano et al., 2009; Hudson et al., 2011) or labbased behavioral measures of approach (e.”
BackgroundInhibición Conductual y su Relación con los Trastornos de Ansiedad Infantil
Ordóñez-Ortega, A., Fernández, L. E., López, L. J. G., & Muela-Martínez, J. A. (2013) · Terapia psicológica · doi:10.4067/s0718-48082013000300010 · Cited by 6 · see citing works
“En este sentido, Hudson et al. (2011) señalan que los niños inhibidos de 4 años son significativamente más propensos a ser diagnosticados, a los 6 años, con fobia social y trastorno de ansiedad generalizada frente a los no inhibidos.”
BackgroundCostantini, I., Paul, E., Caldwell, D. M., López-López, J. A., & Pearson, R. M. (2020) · Systematic Reviews · doi:10.1186/s13643-020-01500-9 · Cited by 6 · see citing works
Cowie, J., Palmer, C. A., Hussain, H., & Alfano, C. A. (2015) · Child Psychiatry & Human Development · doi:10.1007/s10578-015-0597-0 · Cited by 6 · see citing works
Understanding children with Behavioral Inhibition
Fernández, L. E., López, L. J. G., Martínez, J. A. M., & Ordóñez-Ortega, A. (2020) · Psychologica · doi:10.14195/1647-8606_63-2_1 · Cited by 5 · see citing works
“For instance, studies link BI to anxiety disorders (Claus & Blackford, 2012; Chronis-Tuscano et al., 2009; Essex et al., 2010; HirshfeldBecker et al., 2007; Hudson et al., 2011; Muris et al., 2011; Ordóñez-Ortega et al., 2013; Orgiles et al., 2012; Papachristou et al., 2018; Paulus et al., 2015; Rapee, 2014).”
BackgroundInness, B. E., McCabe, R. E., & Green, S. M. (2022) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12410 · Cited by 5 · see citing works
The Role of BIS Sensitivity in the Relationship Between Family Enmeshment and Child Anxiety
Rowsell, M., Doyle, S., & Francis, S. E. B. (2016) · Journal of Child and Family Studies · doi:10.1007/s10826-016-0415-8 · Cited by 5 · see citing works
“In the context of studies associating parental control (Festa and Ginsburg 2011; Ollendick and Horsch 2007) and over protection (Hudson et al. 2011; Rork and Morris 2009) with child anxiety, results of our study indicate that family enmeshment might be an additional variable that”
BackgroundResultInfluentialNeonatal and temperament variables predict behavior problems of preterm children at toddlerhood
Gracioli, S. M. A., & Linhares, M. B. M. (2019) · Journal of Human Growth and Development · doi:10.7322/jhgd.v29.9527 · Cited by 5 · see citing works
“This questionnaire assesses the socioeconomic level of Brazilian families according to the following seven-level ordinal scale where higher scores indicate a higher socioeconomic level: A1 (30-34), A2 (25-29), B1 (21-24), B2 (17-20), C (11-16), D (6-10), and E (zero-5).”
BackgroundBehavioral Inhibition: A Discrete Precursor to Social Anxiety Disorder?
Hirshfeld‐Becker, D. R., Micco, J. A., Wang, C. H., & Henin, A. (2014) · Wiley eBooks · doi:10.1002/9781118653920.ch7 · Cited by 7 · see citing works
Your Fear is My Fear: The Relationship Between Parental and Offspring Anxieties
Adolph, D., Margraf, J., & Schneider, S. (2020) · Child Psychiatry and Human Development · doi:10.1007/s10578-020-01060-y · Cited by 3 · see citing works
Kan, J. M., & Richardson, R. (2018) · Developmental Psychobiology · doi:10.1002/dev.21609 · Cited by 4 · see citing works
Tercier, D., Vandeleur, C. L., Jeanprêtre, N., Rothen, S., Vidal, S. I., Halfon, O., & Preisig, M. (2011) · Family Science · doi:10.1080/19424620.2012.689492 · Cited by 4 · see citing works
Variations in the Influence of Parental Socialization of Anxiety among Clinic Referred Children
Holly, L. E., & Piña, A. (2014) · Child Psychiatry & Human Development · doi:10.1007/s10578-014-0487-x · Cited by 5 · see citing works
“Typically, parental warmth and responsiveness are conceptually linked to lower levels of child anxiety [11, 12], while parental rejection, criticism, and control are linked to elevated anxiety in children [12–15].”
BackgroundIs There a Difference in Parental Attitudes and Attachment for ADHD-Social Phobia Comorbidity?
Ünal, D., & Çelebi, F. (2022) · Turkish Journal of Psychiatry · doi:10.5080/u26580 · Cited by 3 · see citing works
Zhou, A. M., Trainer, A., Vallorani, A., Fu, X., & Buss, K. A. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.911913 · Cited by 4 · see citing works
“Prior studies of fearful temperament and BI have demonstrated associations with the maternal report of generalized anxiety symptoms at age 6 (Hudson et al., 2011).”
BackgroundHealth Anxiety (Hypochondriasis): an Emotional Disorder in An Alternative Taxonomy
Longley, S. L., Calamari, J. E., Noyes, R., Meyers, K., & McDowell, E. (2014) · Current Psychiatry Reviews · doi:10.2174/1573400509666131119010129 · Cited by 3 · see citing works
“Parental modeling, reinforcement, and overprotection generally contribute to the core pathological behaviors for those with the emotional disorders [107-113].”
BackgroundIn‐Albon, T. (2018) · Springer eBooks · doi:10.1007/978-3-662-57369-3_33 · Cited by 2 · see citing works
Takahashi, T., Ishikawa, S., Aiboshi, T., & Miyauchi, M. (2023) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045231194104 · Cited by 3 · see citing works
“…may have profound value for research and practice; speci fi cally, early childhood behavioural inhibition is one of the most consistently demonstrated risk factors for mental health problems later in life, including anxiety disorders (Clauss & Blackford, 2012; Hudson et al., 2011; Rapee, 2014).”
BackgroundAaron, E. M., Caley, E., & Kiel, E. J. (2024) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-024-00492-5 · Cited by 2 · see citing works
“…assessed parenting when children were infants and toddlers (at 1 and 2.5 years old; Majdandžić et al., 2018), and five samples (Hudson & Dodd, 2012; Hudson et al., 2011, 2019; Lewis-Morrarty et al., 2012; Lorenzo et al., 2022; Murray et al., 2014; Vreeke et al., 2013) T h e t e r m s s e x a nd…”
BackgroundMethodResultInfluentialAsbrand, J., Lerach, T., & Tuschen‐Caffier, B. (2015) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026/1616-3443/a000329 · Cited by 2 · see citing works
Anxiety Disorders in Young Children
Monga, S., & Benoit, D. (2018) · Springer eBooks · doi:10.1007/978-3-030-04939-3_1 · Cited by 2 · see citing works
Trimarchi, L., Waters, A. M., Simcock, G., & Farrell, L. J. (2025) · Journal of Child and Family Studies · doi:10.1007/s10826-025-03040-z · Cited by 1 · see citing works
“Alternatively, parenting a more sensitive and inhibited toddler may in fl uence parenting whereby parents become more over-involved to support their child ’ s anxious behaviours (Hudson et al., 2009, 2011).”
홍민지, & 이소연 (2018) · The Korea Journal of Youth Counseling · doi:10.35151/kyci.2018.26.2.001 · Cited by 1 · see citing works
Aloisio, C., Taraban, L., Mowatt, K., Santosa, H., Huppert, T. J., Silk, J. S., Pérez‐Edgar, K. E., & Morgan, J. K. (2025) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2025.101565 · Cited by 1 · see citing works
“The PAS is a widely used measure of anxiety symptoms in preschoolers and has demonstrated high reliability and validity in past research (Broeren and Muris, 2008; Hudson et al., 2011; Spence et al., 2001; Zhou et al., 2024).”
Etiological Factors: Temperament and Personality
Torgersen, S. O. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-813004-9.00005-0 · Cited by 1 · see citing works
Fear and Anxiety in Young Children and Their Assessment
Broeren, S., Hudson, J. L., & Rapee, R. M. (2019) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199837182.013.17 · Cited by 1 · see citing works
Self-citationToyoshima, K., Inoue, T., Masuya, J., Fujimura, Y., Higashi, S., & Kusumi, I. (2020) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2020.100056 · Cited by 1 · see citing works
Vreeke, L. J. (2011) · RePub (Erasmus University Rotterdam) · Cited by 1 · see citing works
Faucher, J. (2016) · uO Research (University of Ottawa) · doi:10.20381/ruor-4933
“…& Hudson, 2014; Chronis-Tuscano et al., 2009; Clauss & Blackford, 2012; Essex et al., 2010; Gladstone, Parker, Mitchell, Wilhelm, & Malhi, 2005; Hudson et al., 2011; Hudson et al., 2011; Lahat, Hong, & Fox, 2011; Muris, van Brakel, Arntz, & Schouten, 2011; Rapee, 2014; Schwartz, Snidman, &…”
InfluentialTemperament and Family Environment in the Development of Anxiety Disorder: Two-Year Follow-Up
Mack, A. H. (2012) · Yearbook of Psychiatry and Applied Mental Health · doi:10.1016/j.ypsy.2012.07.044
Greenman, P. S., Farmanova, E., Annous, R., Chomienne, M., & Grenier, J.-Y. (2015)
Madison, K. (2016) · Lincoln (University of Nebraska)
Ordóñez-Ortega, A. (2016) · RUJA. Institutional Repository of Scientific Production of the University of Jaén (University of Jaén)
Assessment of Anxiety Disorders, PTSD, OCD, and Depression in Young Children
Garro, A. (2016) · Springer eBooks · doi:10.1007/978-1-4939-6349-2_11
Rapee, R. M., Edwards, S. L., Mabood, S., & Freeman, J. Y. A. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01801-3
“Empirical evidence has broadly supported the association between overprotective caregiver behaviour and offspring anxiousness [6, 7], although evidence has not always been consistent [8].”
Parent-Focused Interventions for Child Anxiety
Kenworthy, C., Walia, A., Kramer, L., & Francis, S. E. B. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-29009-1.00111-6
Lorenzo, N. E., Bui, H. N. T., Zeytinoglu, S., Degnan, K. A., Henderson, H. A., Pine, D. S., Fox, N. A., & Chronis-Tuscano, A. M. (2026) · Clinical Psychological Science · doi:10.1177/21677026251315150
“…et al., 2020) and other mental-health outcomes across childhood, adolescence, or adulthood, only a handful of studies have used observed early temperament measures and rigorous diagnostic interviews (Caspi et al., 1996; Dougherty et al., 2011; Hirshfeld-Becker et al., 2007; Hudson et al., 2011).”
- Authors
- Hudson, J. L., Dodd, H. F., Lyneham, H. J., & Bovopoulous, N.
- Affiliations
- Macquarie University (AU)
- Corresponding author
- Hudson, Jennifer L.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2011-12
- Volume
- 50
- Issue
- 12
- Pages
- 1255-1264.e1
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2018928735
- Cited by
- 98
- References
- 31
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 6 · 2020: 10 · 2019: 8 · 2018: 9 · 2017: 6 · 2016: 11 · 2015: 10 · 2014: 7 · 2013: 7 · 2012: 6
- FWCI
- 7.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- CentAUR (University of Reading) (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Funders
- Australian Research Council (DP0342793)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- behavioral inhibition, childhood anxiety, maternal negativity, maternal anxiety, maternal attachment, parenting, social anxiety disorder, generalized anxiety disorder, early childhood temperament, risk factors
- MeSH terms
- Anxiety Disorders, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Inhibition, Psychological, Male, Maternal Behavior, New South Wales, Object Attachment, Personality Assessment, Risk Factors, Social Environment, Temperament, Child of Impaired Parents, Parenting, Expressed Emotion, Family Conflict
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