Early Behavioral Inhibition Predicts Greater Anxiety in Adolescents With High Stress Levels

Hurricane Sandy, October 30 2012. NASA Earth Observatory image by Jesse Allen, using VIIRS Day-Night Band data from the Suomi National Polar-orbiting Partnership (Suomi NPP)
Investigators assessed the role of stress, in the form of life events and exposure to a natural disaster, in moderating the effects of behavioral inhibition in preschoolers on anxiety in early adolescence.

Children with high levels of behavioral inhibition (BI) at 3 years of age reported greater anxiety symptoms at age 12 after exposure to stressful life events and disaster-related stress, according to a study published in the Journal of Child Psychology and Psychiatry.

BI is a well-established risk factor for anxiety disorders, but to date, no studies have examined the moderating effects of stress on early childhood BI and anxiety symptoms in early adolescence.

The study investigated the role of stress, in the form of life events and exposure to a natural disaster (Hurricane Sandy in this case), in moderating the effects of BI in preschoolers on anxiety in early adolescence. A total of 392 children (184 female) and 313 mothers participated. Of the child participants, 94.9% were white, 2.3% African American, 2.6% Asian, 0.3% Native American, and 8.7% were Hispanic.

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At 3 years of age, the children completed the Laboratory Temperament Assessment Battery (Lab-TAB) as a measure of BI. The children also completed the Screen for Child Anxiety Related Emotional Disorders (SCARED) at 9 years of age, as well as the SCARED and UCLA Life Stress Interview at 12 years of age. In addition, 8 weeks after Hurricane Sandy, mothers completed a web-based questionnaire on stressors experienced during and immediately after the event.

BI at age 3 predicted greater anxiety with higher levels of independent life stress or events that were independent of the child’s behavior (eg, death of a family member and parent losing a job) (B=9.06, t(383) = 2.56, P=.01). This relationship was not the case with lower levels of stress (B= -6.56, t(383) = -1.79, P=.07). BI at age 12 years predicted significantly greater anxiety in the context of higher exposure to hurricane-related stress (B=9.56, t(304)=2.70, P<.01) but not at lower levels of hurricane-related stress (B= -4.00, t(304) = -1.14, P=.26).

“Taken together, these findings indicate that temperamental diatheses are evident early in life and confer risk for anxiety after exposure to a variety of environmental adversities, including common life events and natural disasters,” the investigators concluded. The study suggests that interventions aimed at young children with high BI may cushion the risks of later exposure to stressors and the emergence of anxiety in adolescence.


Mumper EE, Dyson MW, Finsaas MC, Olino TM, Klein DN. Life stress moderates the effects of preschool behavioral inhibition on anxiety in early adolescence [published online September 18, 2019]. J Child Psychol Psychiatry. doi: 10.1111/jcpp.13121