Consequences of Not Planning Ahead: Reduced Proactive Control Moderates Longitudinal Relations Between Behavioral Inhibition and Anxiety

Abstract

Children with the temperament of behavioral inhibition (BI) face increased risk for developing an anxiety disorder later in life. However, not all children with BI manifest anxiety symptoms, and use of a cognitive control strategy could moderate the pathway between BI and anxiety. Individuals vary widely in the strategy used to instantiate control. The present study examined whether a more planful style of cognitive control (ie, proactive control) or a more impulsive strategy of control (ie, reactive control) would moderate the association between early BI and later anxiety symptoms. Participants were part of a longitudinal study examining the relations between BI (measured at 2-3 years of age) and later anxiety symptoms (measured at 13 years). Use of a cognitive control strategy was assessed at 13 years using the AX variant of the continuous performance task. BI in toddlerhood significantly predicted increased use of a more reactive cognitive control style in adolescence. In addition, cognitive control strategy moderated the relation between BI and anxious symptoms, such that reliance on a more reactive strategy predicted higher levels of anxiety for children high in BI. The present study is the first to identify the specific control strategy that increases risk for anxiety. Thus, it is not cognitive control per se, but the specific control strategy children adopt that could increase risk for anxiety later in life. These findings have important implications for future evidence-based interventions because they suggest that an emphasis on decreasing reactive cognitive control and increasing proactive cognitive control might decrease anxious cognition.