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

Child Psychiatry & Human Development volume 46, pages 150–157 (2015)Cite this article

Abstract

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.

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Abbreviations

BI:

Behavioral inhibition

CBCL/1½–5:

Child behavior checklist 1½–5

CBCL/4–18:

Child behavior checklist 4–18

DSM-5:

Diagnostic and statistical manual-5

GAD:

General anxiety disorder

IBQ-R:

Infant behavior questionnaire

ICD-10:

International classification of diseases-10

MDD/GAD:

Major depressive disorder/generalized anxiety disorder

PAPA:

Preschool age psychiatric assessment

PHOB:

Specific phobia

RIBI:

Retrospective infant behavioral inhibition scale

SAD:

Separation anxiety disorder

SOC:

Social phobia

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Acknowledgments

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.

Author information

Affiliations

  1. Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421, Homburg, Germany

    Frank W. Paulus, Aline Backes, Charlotte S. Sander & Alexander von Gontard

  2. Institute for Community Health, 66740, Saarlouis, Germany

    Monika Weber

Authors
  1. Frank W. Paulus
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  2. Aline Backes
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  3. Charlotte S. Sander
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  4. Monika Weber
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  5. Alexander von Gontard
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Correspondence to Frank W. Paulus.

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Paulus, F.W., Backes, A., Sander, C.S. et al. Anxiety Disorders and Behavioral Inhibition in Preschool Children: A Population-Based Study. Child Psychiatry Hum Dev 46, 150–157 (2015). https://doi.org/10.1007/s10578-014-0460-8

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  • DOI: https://doi.org/10.1007/s10578-014-0460-8

Keywords

  • Anxiety disorders
  • Prevalence
  • Behavioral inhibition
  • Preschool age
  • Gender differences