Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA.
Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Psychol Med. 2020 Jan;50(1):96-106. doi: 10.1017/S0033291718003999. Epub 2019 Jan 8.
Anxiety symptoms gradually emerge during childhood and adolescence. Individual differences in behavioral inhibition (BI), an early-childhood temperament, may shape developmental paths through which these symptoms arise. Cross-sectional research suggests that level of early-childhood BI moderates associations between later anxiety symptoms and threat-related amygdala-prefrontal cortex (PFC) circuitry function. However, no study has characterized these associations longitudinally. Here, we tested whether level of early-childhood BI predicts distinct evolving associations between amygdala-PFC function and anxiety symptoms across development.
Eighty-seven children previously assessed for BI level in early childhood provided data at ages 10 and/or 13 years, consisting of assessments of anxiety and an fMRI-based dot-probe task (including threat, happy, and neutral stimuli). Using linear-mixed-effects models, we investigated longitudinal changes in associations between anxiety symptoms and threat-related amygdala-PFC connectivity, as a function of early-childhood BI.
In children with a history of high early-childhood BI, anxiety symptoms became, with age, more negatively associated with right amygdala-left dorsolateral-PFC connectivity when attention was to be maintained on threat. In contrast, with age, low-BI children showed an increasingly positive anxiety-connectivity association during the same task condition. Behaviorally, at age 10, anxiety symptoms did not relate to fluctuations in attention bias (attention bias variability, ABV) in either group; by age 13, low-BI children showed a negative anxiety-ABV association, whereas high-BI children showed a positive anxiety-ABV association.
Early-childhood BI levels predict distinct neurodevelopmental pathways to pediatric anxiety symptoms. These pathways involve distinct relations among brain function, behavior, and anxiety symptoms, which may inform diagnosis and treatment.
焦虑症状在儿童和青少年时期逐渐出现。行为抑制（BI）作为一种早期的儿童气质，个体差异可能会影响这些症状出现的发展轨迹。横断面研究表明，早期 BI 水平调节了后期焦虑症状与威胁相关的杏仁核-前额叶皮层（PFC）回路功能之间的关联。然而，尚无研究从纵向角度描述这些关联。在这里，我们测试了早期 BI 水平是否可以预测儿童焦虑症状与杏仁核-PFC 功能之间在整个发展过程中不同的、不断演变的关联。
87 名儿童在幼儿期接受过 BI 水平评估，在 10 岁和/或 13 岁时提供数据，包括焦虑评估和基于 fMRI 的点探测任务（包括威胁、快乐和中性刺激）。使用线性混合效应模型，我们研究了焦虑症状与威胁相关的杏仁核-PFC 连接之间的纵向变化，作为早期 BI 的函数。
在早期 BI 水平较高的儿童中，随着年龄的增长，当注意力需要集中在威胁上时，焦虑症状与右杏仁核-左背外侧前额叶皮层的连接变得更加负相关。相比之下，在低 BI 儿童中，随着年龄的增长，在相同的任务条件下，连接呈现出越来越正的焦虑相关性。在行为上，在 10 岁时，焦虑症状与注意力偏差（注意力偏差可变性，ABV）在两组中均无相关性；到 13 岁时，低 BI 儿童表现出负性的焦虑-ABV 相关性，而高 BI 儿童表现出正性的焦虑-ABV 相关性。
早期 BI 水平预测了儿童焦虑症状的不同神经发育途径。这些途径涉及大脑功能、行为和焦虑症状之间的不同关系，这可能为诊断和治疗提供信息。
