Child Psychiatry & Human Development

, Volume 46, Issue 1, pp 150–157 | Cite as

Anxiety Disorders and Behavioral Inhibition in Preschool Children: A Population-Based Study

  • Frank W. Paulus
  • Aline Backes
  • Charlotte S. Sander
  • Monika Weber
  • Alexander von Gontard
Original Article


This study assessed the prevalence of anxiety disorders in preschool children and their associations with behavioral inhibition as a temperamental precursor. A representative sample of 1,342 children aged 4–7 years (M = 6;1, SD = 4.80) was examined with a standardized parental questionnaire, including items referring to anxiety disorders at the current age and behavioral inhibition at the age of 2 years. The total prevalence of anxiety disorders was 22.2 %. Separation anxiety (SAD) affected 7 %, social phobia (SOC) 10.7 %, specific phobia (PHOB) 9.8 % and depression/generalized anxiety (MDD/GAD) 3.4 % of children. The prevalence of most types of anxiety was higher in girls except for separation anxiety, which affected more boys. Behavioral inhibition in the second year of life was associated with all types of anxiety. Anxiety disorders are common but frequently overlooked in preschool children. Different subtypes can be differentiated and are often preceded by behavioral inhibition. Assessment, prevention and treatment of anxiety disorders are recommended in preschool children.


Anxiety disorders Prevalence Behavioral inhibition Preschool age Gender differences 



Behavioral inhibition


Child behavior checklist 1½–5


Child behavior checklist 4–18


Diagnostic and statistical manual-5


General anxiety disorder


Infant behavior questionnaire


International classification of diseases-10


Major depressive disorder/generalized anxiety disorder


Preschool age psychiatric assessment


Specific phobia


Retrospective infant behavioral inhibition scale


Separation anxiety disorder


Social phobia



The authors would like to thank Prof. E. Möhler for the provision of the RIBI items [46].

Conflict of interest

There is no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Frank W. Paulus
    • 1
  • Aline Backes
    • 1
  • Charlotte S. Sander
    • 1
  • Monika Weber
    • 2
  • Alexander von Gontard
    • 1
  1. 1.Department of Child and Adolescent PsychiatrySaarland University HospitalHomburgGermany
  2. 2.Institute for Community HealthSaarlouisGermany

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