Full APA Citation:

Marilyn J., E., Klein, M. H., Slattery, M. J., Goldsmith, H. H., & Kahn, N. H. (2011). Early Risk
Factors and Developmental Pathways to Chronic High Inhibition and Social Anxiety
Disorder in Adolescence. American Journal Of Psychiatry, 167(1), 40-46.
doi:10.1176/appi.ajp.2009.07010051
Permanent URL:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2806488/pdf/nihms144698.pdf
Overview of Topic/Article:
The authors researched the early risk factors for chronic high inhibition, that is an increased fear
response, as well as the developmental pathways of young children with chronic high inhibition.
They also researched the association of this inhibition with social anxiety disorder (SAD) in
adolescence. According to the research, chronic high inhibition and SAD share many of the
same qualities, including fear of meeting/interacting with unfamiliar peers and adults (2011).
They identify four potential early risk factors: 1.) Child gender; 2.) Exposure to maternal stress
during the early childhood; 3.) The prevalence of behavioral inhibition in the early years, and; 4.)
Afternoon cortisol levels.
Key Points/Findings [bulleted list]:

Chronic Inhibition in early years was positively correlated with:

o Being female
o Exposure to higher levels of maternal stress
o Higher levels of behavioral inhibition
80% of those children in the Chronic High group received at least one lifetime
psychiatric diagnosis, and 50% of this group received a diagnosis of SAD

Implications to Current/Future Practitioners [bulleted list]:

The development pathway of being female indicates that girls are at a higher risk for
developing chronic high inhibition
The stress pathway indicated that greater maternal stress beginning at birth showed that
children were at a greater risk of developing chronic high inhibition
Prevention strategies for children in either of these pathways should be put in place early
o Before school-age: Work with the mother on her stress
o During school: target the social competencies of those highly inhibited children