Department of Psychiatry, Dalhousie University, Abbie J. Lane Building, 5909 Veterans' Memorial Lane, Halifax, Nova Scotia, B3H 2E2, Canada.
Nova Scotia Health Authority, Halifax, NS, Canada.
J Abnorm Child Psychol. 2020 Jan;48(1):57-66. doi: 10.1007/s10802-019-00588-5.
Behavioral inhibition (BI) is a risk factor for anxiety. However, the estimates of the strength of this association vary widely. In addition, while BI is a strong predictor of social anxiety disorder (SAD), its association with other anxiety disorders is unclear. The current study sought to establish the relationship between BI and anxiety and to quantify this association for a range of anxiety disorders. We searched PsycInfo, PubMed and Embase for articles published before May 18th, 2019 using search terms for BI, anxiety and prospective study design. We selected articles which assessed the prospective relationship between BI in childhood and anxiety. Using random-effects meta-analysis with robust variance estimation, which allowed for the inclusion of multiple follow-ups of the same sample, we established the association between BI and any anxiety. We also explored the association between BI and individual anxiety disorders. Data from 27 studies consisting of 35 follow-ups of 20 unique samples indicated that BI prospectively increases the odds of anxiety (OR = 2.80, 95% CI 2.03 to 3.86, p < 0.001). There was also a positive association between BI and all individual anxiety disorders, with effect sizes ranging from small in the case of specific phobia (OR = 1.49, 95% CI 1.03 to 2.14, p = 0.03) to large in the case of SAD (OR = 5.84, 95% CI 3.38 to 10.09, p < 0.001). BI in early childhood is a strong risk factor for anxiety. Targeting BI may help reduce the number of children who will develop anxiety disorders.
行为抑制（BI）是焦虑的一个风险因素。然而，这种关联的强度估计差异很大。此外，虽然 BI 是社交焦虑障碍（SAD）的强有力预测因子，但它与其他焦虑障碍的关系尚不清楚。本研究旨在确定 BI 与焦虑之间的关系，并量化 BI 与一系列焦虑障碍的关联。我们在 2019 年 5 月 18 日之前使用 BI、焦虑和前瞻性研究设计的搜索词在 PsycInfo、PubMed 和 Embase 上搜索了文章。我们选择了评估儿童时期 BI 与焦虑之间前瞻性关系的文章。使用随机效应荟萃分析和稳健方差估计，允许包含相同样本的多个随访，我们确定了 BI 与任何焦虑之间的关联。我们还探讨了 BI 与个体焦虑障碍之间的关联。来自 27 项研究的数据，其中包括 20 个独特样本的 35 次随访，表明 BI 前瞻性地增加了焦虑的几率（OR=2.80，95%CI 2.03 至 3.86，p<0.001）。BI 与所有个体焦虑障碍之间也存在正相关，效应大小从特定恐惧症（OR=1.49，95%CI 1.03 至 2.14，p=0.03）的小到 SAD（OR=5.84，95%CI 3.38 至 10.09，p<0.001）的大。儿童早期的 BI 是焦虑的一个强有力的风险因素。针对 BI 可能有助于减少患焦虑障碍的儿童人数。
