A Developmental Pathway From Early Behavioral Inhibition to Young Adults' Anxiety During the COVID-19 Pandemic

Selin Zeytinoglu, Santiago Morales, Nicole E Lorenzo, Andrea Chronis-Tuscano, Kathryn A Degnan, Alisa N Almas, Heather Henderson, Daniel S Pine, Nathan A Fox, Selin Zeytinoglu, Santiago Morales, Nicole E Lorenzo, Andrea Chronis-Tuscano, Kathryn A Degnan, Alisa N Almas, Heather Henderson, Daniel S Pine, Nathan A Fox

Abstract

Objective: The COVID-19 pandemic has brought unprecedented changes to young adults' lives, resulting in mental health difficulties for many; however, some individuals are particularly prone to heightened anxiety. Little is known about the early life predictors of anxiety during the pandemic. We examined a developmental pathway from behavioral inhibition (BI), a temperament characterized by fearful responses toward novelty, to changes in young adults' anxiety during the initial period of the pandemic. We hypothesized that a stable pattern of BI across early childhood would predict greater adolescent worry dysregulation, which in turn would predict increases in young adult anxiety during a stressful phase of the pandemic.

Method: Participants (N = 291; 54% female) were followed from toddlerhood to young adulthood. BI was observed at ages 2 and 3 years. Social wariness was observed at age 7 years. Participants rated their worry dysregulation in adolescence (age 15) and anxiety in young adulthood (age 18) at 2 assessments during the COVID-19 pandemic, 1 month apart.

Results: A significant moderated mediation, in which a stable pattern of BI from toddlerhood to childhood, as compared to the absence of this pattern, predicted greater worry dysregulation in adolescence. Worry dysregulation predicted elevated young adult anxiety in the second assessment during COVID-19, even after accounting for the first assessment.

Conclusion: This study identifies a developmental pathway from toddlerhood BI to young adults' elevated anxiety during the COVID-19 pandemic. Findings have implications for early identification of individuals at risk for dysregulated worry and the prevention of anxiety during stressful life events in young adulthood.

Keywords: COVID-19 pandemic; anxiety; behavioral inhibition; temperament; worry.

Copyright © 2021 American Academy of Child and Adolescent Psychiatry. All rights reserved.

Figures

Figure 1
Figure 1
Conceptual Diagram Illustrating the Moderated Mediation Model Tested in the Current Study Note:Anxiety month 1 and anxiety month 2 represent the first and second anxiety assessments during the COVID-19 pandemic, respectively.
Figure 2
Figure 2
Simple Slopes for the Interaction Between Behavioral Inhibition and Social Wariness Predicting Worry Dysregulation at Age 15 Years Note:Low social wariness was defined as −1 standard deviation and high social wariness was defined as +1 standard deviation from the mean. SW = social wariness.

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