Predicting Temperamentally Inhibited Young Children’s Clinical-Level Anxiety and Internalizing Problems from Parenting and Parent Wellbeing: a Population Study

  • Jordana K. Bayer
  • Amy Morgan
  • Luke A. Prendergast
  • Ruth Beatson
  • Tamsyn Gilbertson
  • Lesley Bretherton
  • Harriet Hiscock
  • Ronald M. Rapee


The aim of this study was to explore how some temperamentally inhibited young children and not others in the general population develop anxiety disorders and broader clinical-level internalizing (anxious/depressive) problems, with a focus on the family. A brief screening tool for inhibition was universally distributed to parents of children in their year before starting school across eight socioeconomically diverse government areas in Melbourne, Australia (307 preschool services). Screening identified 11% of all children as inhibited. We invited all parents of inhibited children to participate in a longitudinal prevention study. Participants were 545 parents of inhibited pre-schoolers (78% uptake) of whom 498 (91%) completed assessment one year later and 469 (86%) two years later. Parents completed questionnaires to assess parenting practices, parent wellbeing, and child internalizing problems. Parents also engaged in structured diagnostic interviews to assess child anxiety disorders. During the follow up period close to half of the inhibited young children had anxiety disorders and one in seven had clinical-level internalizing problems, with girls perhaps at higher risk. The family variables significantly predicted inhibited children’s anxiety disorders and broader internalizing problems. For child anxiety disorders, overinvolved/protective parenting was particularly important for girls and boys, and poorer parent wellbeing contributed. For child anxious/depressive problems, harsh discipline was a consistent predictor for girls and boys, and poorer parent wellbeing again contributed. These etiological findings support early intervention for temperamentally inhibited young children that focuses on the family environment to prevent the development of mental health problems.


Child, preschool Internalizing problems Anxiety disorders Etiology Parenting Mental health 



We thank preschool services and families in the Victorian cities of Banyule, Boroondara, Frankston, Kingston, Knox, Maroondah, Whitehorse and Wyndham who took part in this research. We also thank Alexandra Perry, Megan Mathers, Cassima Beechey, Chelsea Cornell, Kate Beasley and Tim Grant-Taylor who were research assistants during the longitudinal study period.


JB took the leading role in designing the study and writing the grant that was funded by the Australian National Health and Medical Research Council (NHMRC). RR and HH contributed to the study design and grant preparation. JB, RB, and TG were involved in the acquisition of study data. LP, JB and AM did the statistical analysis in consultation with RR. JB drafted the manuscript with critical revision from RR, LP, AM, RB, LB, HH, and TG. JB is the guarantor.


This research was supported by a National Health and Medical Research Council (NHMRC) Project Grant 607302 and by the Victorian Government’s Operational Infrastructure Support Program. JB and HH were supported by NHMRC Population Health Capacity Building Grant 436914.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jordana K. Bayer
    • 1
    • 2
    • 3
  • Amy Morgan
    • 1
  • Luke A. Prendergast
    • 4
  • Ruth Beatson
    • 1
  • Tamsyn Gilbertson
    • 2
    • 5
  • Lesley Bretherton
    • 2
    • 3
  • Harriet Hiscock
    • 2
    • 3
    • 6
  • Ronald M. Rapee
    • 7
  1. 1.School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
  2. 2.Murdoch Childrens Research InstituteParkvilleAustralia
  3. 3.Department of PaediatricsUniversity of MelbourneParkvilleAustralia
  4. 4.Department of Mathematics and StatisticsLa Trobe UniversityMelbourneAustralia
  5. 5.Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleAustralia
  6. 6.Royal Children’s Hospital MelbourneParkvilleAustralia
  7. 7.Centre for Emotional HealthMacquarie UniversitySydneyAustralia

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