CoChat
Sign Up
Cited by 203Child and Adolescent Psychosocial and Emotional DevelopmentAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMaternal Mental Health During Pregnancy and Postpartum

Early risk factors and developmental pathways to chronic high inhibition and social anxiety disorder in adolescence

Open access
Essex, Marilyn J., Klein, Marjorie H., Slattery, Marcia J., Goldsmith, H. Hill, Kalin, Ned H.·2010·American Journal of Psychiatry
DOI 10.1176/appi.ajp.2009.07010051PMC PMC2806488
Open this paper in CoChat — free account

Abstract

OBJECTIVE: Evidence suggests that chronic high levels of behavioral inhibition are a precursor of social anxiety disorder. The authors sought to identify early risk factors for, and developmental pathways to, chronic high inhibition among school-age children and the association of chronic high inhibition with social anxiety disorder by adolescence. METHOD: A community sample of 238 children was followed from birth to grade 9. Mothers, teachers, and children reported on the children's behavioral inhibition from grades 1 to 9. Lifetime history of psychiatric disorders was available for the subset of 60 (25%) children who participated in an intensive laboratory assessment at grade 9. Four early risk factors were assessed: female gender; exposure to maternal stress during infancy and the preschool period; and at age 4.5 years, early manifestation of behavioral inhibition and elevated afternoon salivary cortisol levels. RESULTS: All four risk factors predicted greater and more chronic inhibition from grades 1 to 9, and together they defined two developmental pathways. The first pathway, in girls, was partially mediated by early evidence of behavioral inhibition and elevated cortisol levels at age 4.5 years. The second pathway began with exposure to early maternal stress and was also partially mediated by childhood cortisol levels. By grade 9, chronic high inhibition was associated with a lifetime history of social anxiety disorder. CONCLUSIONS: Chronic high levels of behavioral inhibition are associated with social anxiety disorder by adolescence. The identification of two developmental pathways suggests the potential importance of considering both sets of risk factors in developing preventive interventions for social anxiety disorder.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1176/appi.ajp.2009.07010051

Cites

42 of 42 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Stronger associations between early BI and later social anxiety problems have been observed in females, children with insecure attachment styles, high parental trait anxiety, domineering parenting style and high maternal intrusive control, and significant exposure to maternal stress.

    “Stronger associations have been observed in females (Essex et al., 2010), children with insecure attachment styles (Muris et al., 2011, Nachmias et al., 1996), high parental trait anxiety (Muris et al., 2011), domineering parenting style and high maternal intrusive control (Rubin et al., 2002, Williams et al., 2009), and significant exposure to maternal stress (Essex et al., 2010).”

    From Gaining insight into adolescent vulnerability for social anxiety from developmental cognitive neuroscience (2014) · cites this paper as Essex et al., 2010

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Essex, M. J., Klein, M. H., Slattery, M. J., Goldsmith, H. H., & Kalin, N. H.
Affiliations
University of Wisconsin–Madison (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2010-01-01
Volume
167
Issue
1
Pages
40-46
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.2009.07010051
PMC
PMC2806488
OpenAlex
W2116296032
Cited by
202
References
41
Citations by year
2026: 7 · 2025: 2 · 2024: 2 · 2023: 8 · 2022: 9 · 2021: 5 · 2020: 12 · 2019: 22 · 2018: 8 · 2017: 6 · 2016: 14 · 2015: 17 · 2014: 31 · 2013: 14 · 2012: 15
FWCI
15.95
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • John D. and Catherine T. MacArthur Foundation
  • National Institute of Mental Health (R01MH44340, P50-MH 52354, P50MH052354, P50MH069315, R01MH044340, P50MH084051, P50-MH69315, R01MH059785)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD003352)
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, social anxiety disorder, developmental pathways, early risk factors, maternal stress, salivary cortisol, sex differences, childhood anxiety, adolescence, preventive interventions
MeSH terms
Adolescent, Adult, Age Factors, Child, Child Behavior, Child, Preschool, Chronic Disease, Circadian Rhythm, Depressive Disorder, Female, Humans, Hydrocortisone, Inhibition, Psychological, Longitudinal Studies, Male, Phobic Disorders, Psychiatric Status Rating Scales, Risk Factors, Saliva, Shyness, Temperament, Child of Impaired Parents, Diagnostic and Statistical Manual of Mental Disorders

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review