Biederman J, Rosenbaum J F, Bolduc-Murphy E A, Faraone S V, Chaloff J, Hirshfeld D R, Kagan J
Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114-3139.
J Am Acad Child Adolesc Psychiatry. 1993 Jul;32(4):814-21. doi: 10.1097/00004583-199307000-00016.
Previous work suggested that children of parents with panic disorder and agoraphobia were likely to be classified as behaviorally inhibited and that behaviorally inhibited children were likely to develop anxiety disorders. Although these findings suggested that "behavioral inhibition to the unfamiliar" may be associated with risk for anxiety disorders in children, longitudinal data were needed to confirm the initial impressions.
Using DSM-III structured interviews, the authors examined psychiatric disorders at 3-year follow-up in children of two independently ascertained, previously described, and preexisting samples of children. One sample was cross sectional and clinically derived (Massachusetts General Hospital at-risk sample), and the other was epidemiologically derived and longitudinal (Kagan et al. Longitudinal Cohort).
Analyses of follow-up findings revealed significant differences between inhibited and not inhibited children in the rates of multiple > or = 4 psychiatric disorders, multiple > or = 2 anxiety disorders, avoidant disorder, separation anxiety disorder, and agoraphobia. Among inhibited children, the rates of anxiety disorders increased markedly from baseline to follow-up assessments, attaining statistical significance for multiple > or = 2 anxiety disorders and avoidant disorder. Our findings also show there were significant differences between inhibited and not inhibited children in the emergence of multiple > or = 2 anxiety disorders, avoidant disorder, and separation anxiety disorder in children who did not have these diagnoses at baseline.
These findings indicate that inhibited children are at high risk for developing childhood-onset anxiety disorders and provide additional support for the hypothesis that behavioral inhibition is a predictor of later anxiety disorder.
先前的研究表明，患有惊恐障碍和广场恐惧症的父母的孩子很可能被归类为行为抑制型，而行为抑制型儿童很可能会患上焦虑症。尽管这些研究结果表明，“对不熟悉事物的行为抑制”可能与儿童患焦虑症的风险有关，但仍需要纵向数据来证实最初的印象。
作者使用《精神疾病诊断与统计手册》第三版（DSM-III）的结构化访谈，对两个独立确定、先前描述且已存在的儿童样本中的儿童进行了3年随访，以检查精神疾病。一个样本是横断面的且来自临床（麻省总医院高危样本），另一个样本是基于流行病学的且为纵向样本（卡根等人的纵向队列）。
对随访结果的分析显示，在患有多种≥4种精神疾病、多种≥2种焦虑症、回避型障碍、分离焦虑症和广场恐惧症的发生率方面，行为抑制型儿童和非行为抑制型儿童之间存在显著差异。在行为抑制型儿童中，焦虑症的发生率从基线评估到随访评估显著增加，对于多种≥2种焦虑症和回避型障碍达到了统计学显著性。我们的研究结果还表明，在基线时没有这些诊断的儿童中，行为抑制型儿童和非行为抑制型儿童在出现多种≥2种焦虑症、回避型障碍和分离焦虑症方面存在显著差异。
这些研究结果表明，行为抑制型儿童患儿童期起病的焦虑症的风险很高，并为行为抑制是后期焦虑症的预测因素这一假设提供了额外支持。
