Trajectories of Social Anxiety in Children: Influence of Child Cortisol Reactivity and Parental Social Anxiety
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Few studies have examined the interactive effect of intra- and extra-individual vulnerability factors on the trajectory of social anxiety in children. In this study, we examined the joint influence of familial vulnerability (i.e., parental social anxiety) and child biological stress vulnerability (i.e., cortisol reactivity) on trajectories of social anxiety. Children (N = 112 (57 males), M age = 8.14 years, S.D. = 2.25) were followed over three visits spanning approximately three years. Parental social anxiety was assessed using the Social Phobia and Anxiety Inventory, children’s behavior and salivary cortisol reactivity were measured in response to a speech task, and children’s social anxiety was assessed at all three visits using the Screen for Child Related Emotional Disorders (SCARED; Parent-report). A growth curve analysis was used to examine trajectories of child social anxiety as predicted by children’s cortisol reactivity and parental social anxiety, adjusting for covariates. We found a significant interaction between parental social anxiety and child cortisol reactivity in predicting child social anxiety across time. Having a socially anxious parent coupled with heightened cortisol reactivity predicted the highest levels of child social anxiety, with scores that remained above clinically significant levels for social anxiety across all visits. Children with familial risk for social anxiety and who also exhibit high stress-reactivity appear to be at risk for persistent, clinically significant social anxiety. This highlights the importance of considering the interaction between both biological and contextual factors when considering the development, maintenance, and treatment of social anxiety in children across time.
KeywordsDevelopmental psychopathology Anxiety Longitudinal studies Shyness Phobias
This research was supported by an Ontario Graduate Scholarship (OGS) and a Canadian Institutes of Health Research (CIHR) Doctoral Award awarded to KLP, and operating grants from the Ontario Mental Health Foundation (OMHF) Grant awarded to CEC and from the Natural Sciences and Engineering Research Council of Canada (NSERC) and the Social Sciences and Humanities Research Council of Canada (SSHRC) awarded to LAS. CEC’s participation was supported by the Jack Laidlaw Chair in Patient-Centred Health Care. We would like to thank the many children and their primary caregivers for their participation in the study. We would also like to thank Lindsay Bennett, Diana Carbone, Sue McKee, Renee Nossal, and Matilda Nowakowski for their help with data collection and coordinating the visits, and Alexander Greenberg, Annie Mills, Jhanahan Sriranjan, and Anna Swain for their assistance with video coding.
Compliance with Ethical Standards
Conflict of Interest
Dr. Charles Cunningham developed the Brief Child and Family Phone Interview (BCFPI) used in the present study.
All procedures were approved by the Hamilton Integrated Research Ethics Board.
Parental consent and child assent were received from all participants.
- Beidel, D. C., & Turner, S. M. (2007). Clinical presentation of social anxiety disorder in children and adolescents. In D. C. Beidel & S. M. Turner (Eds.), Shy children, phobic adults: Nature and treatment of social anxiety disorders (2nd ed., pp. 47–80). Washington, DC: American Psychological Association.Google Scholar
- Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., et al. (1997). The screen for child anxiety related emotional disorders (SCARED): Scale construction and psycho- metric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 545–553.CrossRefPubMedGoogle Scholar
- Buckner, J. D., & Turner, R. J. (2009). Social anxiety disorder as a risk factor for alcohol use disorders: a prospective examination of parental and peer influences. Drug and Alcohol Dependence, 100, 128–137.Google Scholar
- Buckner, J. D., Timpano, K. R., Zvolensky, M. J., Sachs‐Ericsson, N., & Schmidt, N. B. (2008). Implications of comorbid alcohol dependence among individuals with social anxiety disorder. Depression and Anxiety, 25, 1028–1037.Google Scholar
- Chronis-Tuscano, A., Degnan, K. A., Pine, D. S., Perez-Edgar, K., Henderson, H. A., Diaz, Y., et al. (2009). Stable early maternal report of behavioral inhibition predicts lifetime social anxiety disorder in adolescence. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 928–935.CrossRefGoogle Scholar
- Cicchetti, D. (1989). Developmental psychopathology: Past, present, and future. In D. Cicchetti (Ed.), The Emergence of a Discipline: The Rochester Symposium on Developmental Psychopathology (Vol. 1, pp. 1–12). Hillsdale: Lawrence Erlbaum Associates.Google Scholar
- Cunningham, C. E., Boyle, M. H., Hong, S., Pettingill, P., & Bohaychuck, D. (2009). The brief child and family phone interview (BCFPI): 1. Rationale, development, and description of a computerized children’s mental health intake and outcome assessment tool. Journal of Child Psychology and Psychiatry, 50, 416–523.CrossRefPubMedGoogle Scholar
- Fox, N. A., Rubin, K. H., Calkins, S. D., Marshall, T. R., Coplan, R. J., Porges, S. W., & Long, J. (1995). Frontal activation asymmetry and social competence at four years of age: Left frontal hyper and hypo activation as correlates of social behavior in preschool children. Child Development, 66, 1770–1786.CrossRefPubMedGoogle Scholar
- Goldsmith, H.H., Reilly, J., Lemery, K.S., Longley, L., Prescott, A. (1993). The Laboratory Temperament Assessment Battery. (Technical Manual) University of Wisconsin: Madison.Google Scholar
- Gunnar, M. R., & Talge, N. M. (2008). Neuroendocrine measures in developmental research. In L. A. Schmidt & S. J. Segalowitz (Eds.), Developmental psychophysiology: Theory, systems, & applications (pp. 343–364). New York: Cambridge University Press.Google Scholar
- Gunnar, M. R., Wewerka, S., Frenn, K., Long, J. D., & Griggs, C. (2009b). Developmental changes in hypothalamus-pituitary-adrenal activity over the transition to adolescence: Normative changes and association with puberty. Development and Psychopathology, 21, 69–85.CrossRefPubMedPubMedCentralGoogle Scholar
- Hale, W. W., Raaijmakers, Q. A., García-López, L. J., Espinosa-Fernández, L., Muela, J. A., & del Mar Díaz-Castela, M. (2013). Psychometric properties of the screen for child anxiety related emotional disorders for socially anxious and healthy Spanish adolescents. The Spanish Journal of Psychology, 16, 1–7.CrossRefGoogle Scholar
- Mancini, C., Van Ameringen, M., Szatmari, P., Fugere, C., & Boyle, M. (1996). A high-risk pilot study of the children of adults with social phobia. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 1511–1517.Google Scholar
- Marmorstein, N. R., White, H., Chung, T., Hipwell, A., Stouthamer-Loeber, M., & Loeber, R. (2010). Associations between first use of substances and change in internalizing symptoms among girls: Differences by symptom trajectory and substance use type. Journal of Clinical Child & Adolescent Psychology, 39, 545–558.CrossRefGoogle Scholar
- Murray, L., De Rosnay, M., Pearson, J., Bergeron, C., Schofield, E., Royal‐Lawson, M., & Cooper, P. J. (2008). Intergenerational transmission of social anxiety: the role of social referencing processes in infancy. Child Development, 79, 1049–1064.Google Scholar
- Turner, S. M., Beidel, D. C., & Dancu, C. V. (1996). Social phobia and anxiety inventory manual. Toronto: Multi-Health Systems Inc.Google Scholar
- Walker, R. F. (1984). Salivary cortisol determinations in the assessment of adrenal activity. In D. B. Ferguson (Ed.), Steroid hormones in saliva (pp. 33–50). Basel: Karger.Google Scholar