The influence of behavioural inhibition and parental expression on childhood anxiety.

Abstract

Childhood anxiety disorders are one of the most prevalent and detrimental mental health conditions within young people worldwide. Understanding the risk factors and mechanisms that lead to the development of anxiety in young people can serve to inform practice and help with prevention. Some reviews and meta-analyses have explored the associations between the temperamental style of behavioural inhibition (BI) and anxiety, however had not yet explored the association when dependent of the conceptualisation of BI and anxiety or the type of study design used. We explored this in the first chapter of this thesis. Additionally, experimental, and observational studies had started to explore the mechanisms behind the development of anxiety in children, however the underlying mechanism by which children learn to be anxious remained unclear. The second chapter of this thesis encapsulates a pilot study examining the role of maternal gaze in a social referencing task on the anxious behaviours of infants aged 12-14 months. The first chapter examines the association between BI and presentations of childhood anxiety. BI has been characterised by a categorical construct and is described as a temperamental style of sensitivity to novel and unfamiliar stimuli, accompanied by fear and wariness. More recent explorations of BI have used continuous measures to assess for temperament and the categorical characterisation has been contested. This systematic review and meta-analysis examined 70 studies that reported a quantitative outcome for the association between BI and childhood anxiety. We found no significant moderating effects of sex or age but did find significant effects for the type of assessment used for BI, anxiety and time delay between assessments of BI and anxiety. We provide novel findings in relation to the strength of association depending on the conceptualisation of both BI and anxiety as categories or on continuums and the type of study design used. We found a larger significant effect when anxiety was categorical, rather than assessed continuously, and found the opposite with BI, a larger significant effect when BI was measured continuously, rather than operationalised categorically. Finally, we also found a larger significant effect when using cross-sectional designs. We make recommendations for future research and ways further research could address limitations with this meta-analysis. The second chapter presents an empirical study examining whether maternal gaze (gaze or no gaze) while behaving anxiously in a social referencing task affects the anxious behaviours of 12–14-month-old infants. We also examined the moderating effect of BI on anxious behaviours across both conditions (gaze or no gaze). We know that those who are behaviourally inhibited are more likely to be anxious and that infants can learn through both vicarious learning and social referencing. Although research highlighted the effect of gaze on threat communication, we were unclear on the role of eye gaze on infant responses during a social referencing task. Method: Thirteen mother-infant dyads completed two experimental conditions whereby they met with a stranger. In both tasks, mothers acted anxiously while interacting with a stranger, however in one task mothers did not look at their infant at all and in the other, they gazed directly at their infant in 10 second intervals. The stranger then approached the infant for 60 seconds. Both tasks were video recorded, and infants’ behaviours were coded for fearfulness and avoidance. Results: We did not find any significant results. Looking behaviour was greater in the condition infants were exposed to first. We also found gaze did not have an impact on infants expressed fear or avoidance. We did, however find a large effect of fear between conditions, showing greater fear in the no-gaze condition. We also found a medium effect size in the interaction between condition and BI on fear and a large effect size in the interaction between condition and BI on avoidance. Conclusions: we have identified possible preliminary findings into the role of maternal direct (gaze) and indirect (no gaze) expressions of anxiety on infants expressed emotion in a social referencing task. We have established feasibility of the study and identified pitfalls of the study design in this pilot phase.

More information

Identifiers

ORCID for Ruth Mary Webster: orcid.org/0000-0002-0897-5983

ORCID for Jana Kreppner: orcid.org/0000-0003-3527-9083

ORCID for Peter Lawrence: orcid.org/0000-0001-6181-433X

Catalogue record

Export record