a Department of Psychology , University of Maryland, College Park.
b Department of Human Development and Quantitative Methodology , University of Maryland, College Park.
J Clin Child Adolesc Psychol. 2018 Jul-Aug;47(4):655-667. doi: 10.1080/15374416.2018.1426006. Epub 2018 Feb 6.
Anxiety disorders are common among young children, with earlier onset typically associated with greater severity and persistence. A stable behaviorally inhibited (BI) temperament and subsequent shyness and social withdrawal (SW) place children at increased risk of developing anxiety disorders, particularly social anxiety. In this Future Directions article, we briefly review developmental and clinical research and theory that point to parenting and peer interactions as key moderators of both the stability of BI/SW and risk for later anxiety, and we describe existing interventions that address early BI/SW and/or anxiety disorders in young children. We recommend that future research on early intervention to disrupt the trajectory of anxiety in children at risk (a) be informed by both developmental science and clinical research, (b) incorporate multiple levels of analysis (including both individual and contextual factors), (c) examine mediators that move us closer to understanding how and why treatments work, (d) be developed with the end goal of dissemination, (e) examine moderators of outcome toward the goal of treatment efficiency, (f) consider transdiagnostic or modular approaches, (g) integrate technology, and (h) consider cultural norms regarding BI/SW/anxiety and parenting.
焦虑障碍在幼儿中很常见,发病较早通常与更严重和持续时间较长有关。稳定的行为抑制(BI)气质以及随后的害羞和社交退缩(SW)使儿童更容易患上焦虑障碍,尤其是社交焦虑症。在这篇未来方向的文章中,我们简要回顾了发展和临床研究和理论,这些研究和理论指出,父母和同伴互动是 BI/SW 稳定性和日后焦虑风险的关键调节因素,我们还描述了现有的干预措施,这些干预措施针对幼儿的早期 BI/SW 和/或焦虑障碍。我们建议,未来针对有风险的儿童进行早期干预以阻断焦虑轨迹的研究(a)应同时参考发展科学和临床研究,(b)纳入多个分析层面(包括个体和环境因素),(c)研究中介因素,以更深入地了解治疗方法的作用机制和原因,(d)以推广为最终目标进行开发,(e)研究结局的调节因素,以提高治疗效率,(f)考虑跨诊断或模块化方法,(g)整合技术,以及(h)考虑有关 BI/SW/焦虑症和养育方式的文化规范。