Behavioural Inhibition and Childhood Anxiety: Interventions and the Role of Peer Relationships

Ooi, Jinnie (2021) Behavioural Inhibition and Childhood Anxiety: Interventions and the Role of Peer Relationships. Doctoral thesis, University of East Anglia.

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Background: Behavioural inhibition (BI), a temperament style characterised by shy, quiet, or restrained behaviours when exposed to novel situations, has consistently been identified as a key risk factor for the development of anxiety disorders. This thesis aims to examine whether psychological interventions targeting BI are efficacious in reducing BI and anxiety (symptoms and diagnosis) in preschool-aged children. It also aims to examine the longitudinal relationship between BI, peer relationship difficulties, and anxiety in a cohort of young children over an 8-year period. Method: The efficacy of interventions targeting BI in preschool-aged children was examined by conducting a systematic review and meta-analysis consisting of 10 studies (N = 1475 children, aged 3 – 7 years). The empirical study included a cohort of 202 preschool-aged children initially assessed as behaviourally inhibited (n = 102) and behaviourally uninhibited (BUI; n = 100) at baseline. Peer relationship difficulties were assessed at baseline, 2-year, 5-year and 8-year follow-ups. Anxiety symptoms and disorders were assessed at baseline and at 8-year follow-up. Results: Intervention significantly reduced behavioural inhibition when outcomes were reported by parents (SMD = -.42) and teachers (SMD = -.69), but not when assessed by observers (SMD = -.13). Additionally, intervention significantly reduced anxiety symptoms when reported by parents (SMD = -.35) but not for anxiety diagnosis (OR = .39). Results of the empirical study indicated that BI children generally exhibited higher levels of peer relationship difficulties than BUI children across time-points. Peer relationship difficulties across time-points were significantly associated with and predictive of anxiety disorders at age 12 generally. Finally, peer relationship difficulties moderated the longitudinal relationship between BI and anxiety diagnosis predominantly when the difficulties were reported by mothers. Conclusion: Intervention targeted at BI preschool-aged children may be effective in reducing BI and anxiety symptoms (but not disorder). Moreover, children’s peer relationship difficulties across development impacts on their anxiety diagnosis in early adolescence.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Jackie Webb
Date Deposited: 19 Nov 2021 12:51
Last Modified: 19 Nov 2021 12:51

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