Early Behavioral Inhibition and Increased Error Monitoring Predict Later Social Phobia Symptoms in Childhood

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 53; no. 4; pp. 447 - 455
• Main Authors: Lahat, Ayelet, Lamm, Connie, Chronis-Tuscano, Andrea, Pine, Daniel S., Henderson, Heather A., Fox, Nathan A.
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Elsevier Inc 01.04.2014; Elsevier; Elsevier BV
• Subjects: Adolescence; Age; Anxiety; Anxiety Disorders; Avoidance behavior; Behavior; behavioral inhibition; Biological and medical sciences; Child; Child Behavior - physiology; Child clinical studies; Child psychology; Child, Preschool; Childhood; Children; error monitoring; error-related negativity (ERN); Event-related potentials; Evoked Potentials - physiology; Fear; Fear & phobias; Female; Humans; Inhibition; Inhibition (Psychology); longitudinal; Male; Medical sciences; Pediatrics; Phobic Disorders - physiopathology; Prevention programs; Psychiatric/Mental Health; Psychology. Psychoanalysis. Psychiatry; Psychomotor Performance - physiology; Psychopathology. Psychiatry; Risk; Risk factors; Social anxiety; Social interaction; Social phobia; Symptoms; Temperament; Young Children; anxiety; error monitoring; longitudinal; error-related negativity (ERN); behavioral inhibition; Human; Behavioral inhibition; Social phobia; Central nervous system; Anxiety disorder; Electrophysiology; Cognition; Encephalon; Symptomatology; Predictive factor; Child; Event evoked potential
• ISSN: 0890-8567; 1527-5418; 1527-5418
• DOI: 10.1016/j.jaac.2013.12.019

Behavioral inhibition (BI) is an early childhood temperament characterized by fearful responses to novelty and avoidance of social interactions. During adolescence, a subset of children with stable childhood BI develop social anxiety disorder and concurrently exhibit increased error monitoring. The current study examines whether increased error monitoring in 7-year-old, behaviorally inhibited children prospectively predicts risk for symptoms of social phobia at age 9 years. A total of 291 children were characterized on BI at 24 and 36 months of age. Children were seen again at 7 years of age, when they performed a Flanker task, and event-related potential (ERP) indices of response monitoring were generated. At age 9, self- and maternal-report of social phobia symptoms were obtained. Children high in BI, compared to those low in BI, displayed increased error monitoring at age 7, as indexed by larger (i.e., more negative) error-related negativity (ERN) amplitudes. In addition, early BI was related to later childhood social phobia symptoms at age 9 among children with a large difference in amplitude between ERN and correct-response negativity (CRN) at age 7. Heightened error monitoring predicts risk for later social phobia symptoms in children with high BI. Research assessing response monitoring in children with BI may refine our understanding of the mechanisms underlying risk for later anxiety disorders and inform prevention efforts.