Retrospective Self-Report Of Inhibition Research Articles

Relationship of behavioral inhibition to separation anxiety in a sample (N = 377) of adult individuals with mood and anxiety disorders

BackgroundBehavioral Inhibition (BI) is an early temperamental trait characterized by shyness, withdrawal, avoidance, uneasiness, and fear of unfamiliar situations, people, objects, and events. The DSM-5 refers to behavioral inhibition as a temperamental factor related to neurodevelopmental conditions in childhood, including attention deficit hyperactivity disorder, selective mutism, and specific phobias; and to its influence on adult anxiety disorders including social anxiety disorder, agoraphobia, and generalized anxiety disorder, but, interestingly, not separation anxiety disorder (SAD). However, there are phenomenological overlaps between BI and SAD. We aimed to explore whether there is a correlation between BI as an early temperamental trait and childhood or adult separation anxiety disorder. MethodsThe study was conducted in 377 consecutive adults (mean age 40.2±12.4 years) outpatients with anxiety and mood disorders as the principal diagnosis, grouped on the presence/absence of a DSM-5 diagnosis of childhood or adult separation anxiety disorder. Separation anxiety was assessed by the Structured Clinical Interview for Separation Anxiety (SCI-SAS) and the Adult Separation Anxiety Checklist (ASA27). Behavioral inhibition was assessed by the Retrospective Self-Report of Inhibition (RSRI). ResultsThe four comparison groups included: 1) 168 patients without childhood or adult SAD, 2) 81 with adult SAD, 3) 97 with both adult SAD and childhood SAD, and 4) 31 with childhood SAD only. The group with both adult and childhood SAD had the highest scores on RSRI total and sub-scale scores. Both groups with adult SAD had significantly higher RSRI scores than the group with only childhood SAD or without SAD. Significant bivariate correlations were found between ASA-27 scores and RSRI scores. Correlations between RSRI scores and measures of anxiety and depressive symptoms were significantly weaker than those on the ASA-27. Regression analyses showed a significant predictive value of RSRI scores on ASA-27 total score, but not of age of onset of SAD. ConclusionsBI has an onset in the very first years of life and may represent a potential developmental endophenotype for later anxiety disorders. Our findings indicate that BI and separation anxiety are connected in individuals with affective and anxiety disorders. This may have important clinical and therapeutic implications for preventive interventions.

P.3.005 - Interactions of oxytocin receptor gene variation with behavioural inhibition and adult separation anxiety in complicated grief

Complicated grief (CG) refers to the severe and prolonged (≥ 6 months) grief reaction following the loss of a beloved person that occurs in approximately 10 – 20% of bereaved individuals and is associated with an increased risk for the development of depression and anxiety disorders [1]. So far, the underlying processes contributing to the vulnerability to CG are not yet well understood but likely comprise the complex interplay of genetic, temperamental and psychological factors that interactively influence the severity and persistence of grief reactions. In light of its central role in social behavior, stress regulation and attachment, the oxytocin receptor (OXTR) gene may play a key role in the conferral of CG. Additionally, temperamental traits such as behavioral inhibition (BI) or psychological characteristics such as symptoms of separation anxiety (SA) may predispose to the development of CG. For instance, adult SA has been linked to higher symptom severity and impairment in individuals with CG [2]. Therefore, the present study for the first time aimed to address the involvement of OXTR gene variation in the emergence of CG and the potential moderating effects of BI and SA. To this end, 96 adult outpatients (70 female, 26 male; mean age ± SD = 39.96 ± 12.71 years) with DSM-IV mood and anxiety disorders were assessed for CG using the Inventory of Complicated Grief (ICG). All patients were genotyped for OXTR rs2254298 and characterized for BI using the Retrospective Self-Report of Inhibition (RSRI) and SA symptoms using the Adult Separation Anxiety Scale (ASA-27). Patients were grouped according to genotype (GG vs. AG/AA carriers). The influence of grouped OXTR genotype, RSRI and ASA-27 scores, respectively, on ICG score was investigated via hierarchical multiple regression analyses. No differences were observed with regard to age, sex, or questionnaire scores (all p ≥ 0.05). No main effects of OXTR genotype, RSRI or ASA-27 scores on CG were observed, however ICG scores differed as a function of OXTR genotype and RSRI score (OXTR x BI, p=0.031), and, on a trend-level, ASA-27 score (OXTR x ASA, p=0.064). Specifically, in patients homozygous for the OXTR G allele, increased levels of both BI and ASA were related to higher ICG scores. Of note, this pattern appears to be reversed under conditions of low BI or low ASA. In line with the ‘differential susceptibility hypothesis’ [3], the present findings suggest that while OXTR GG genotype carriers are more vulnerable to the development of CG in the presence of risk-increasing factors, they at the same time are the least likely to develop CG in the absence of these risk factors. Taken together, the present results for the first time provide evidence for an interaction of OXTR gene variation with BI and potentially also symptoms of adult SA in the moderation of clinically relevant grief reactions and may therefore inspire new insights into the development and improvement of therapeutic options in the prevention and treatment of CG.

The role of behavioral inhibition and parenting for an unfavorable emotional trauma response and PTSD.

The role of behavioral inhibition (BI) and parenting for an unfavorable emotional trauma response (DSM-IV criterion A2) and post-traumatic stress disorder (PTSD) development is unclear. A community sample of adolescents and young adults (aged 14-24) was followed up over 10 years (N=2378). Traumatic events, criterion A2, and PTSD (according to DSM-IV-TR) were assessed using the M-CIDI. BI and parenting were assessed using the Retrospective Self-Report of Inhibition and the Questionnaire of Recalled Parenting Rearing Behavior. Multiple logistic regressions adjusted for sex, age, and number of traumata were used to examine associations of BI as well as maternal and paternal overprotection, rejection, and reduced emotional warmth with (i) criterion A2 in those with trauma (N=1794) and (ii) subsequent PTSD in those with criterion A2 (N=1160). Behavioral inhibition (BI; odds ratio, OR=1.32) and paternal overprotection (OR=1.27) predicted criterion A2 in those with trauma, while only BI (OR=1.53) predicted subsequent PTSD. BI and paternal emotional warmth interacted on subsequent PTSD (OR=1.32), that is, BI only predicted PTSD in those with low paternal emotional warmth. Our findings suggest that BI and adverse parenting increase the risk of an unfavorable emotional trauma response and subsequent PTSD. Paternal emotional warmth buffers the association between BI and PTSD development.

Facilitated acquisition of eyeblink conditioning in those vulnerable to anxiety disorders

Behavioral inhibition (BI) increases vulnerability to develop anxiety disorders and is typified by avoidance and withdrawal from novel objects, people, and situations. The present study considered the relationship between BI and temperamental risk factors, such as trait anxiety and acquisition rate of a classically conditioned eyeblink response. One-hundred seventy-four healthy undergraduate students (mean age 20.3 years, 71.8% female) were given the State-Trait Anxiety Inventory and a battery of self-report measures of BI consisting of the Adult and Retrospective Measures of Behavioral Inhibition (AMBI/RMBI) and the Concurrent and Retrospective Self Report of Inhibition (CSRI/RSRI). Participants then underwent standard delay classical eyeblink conditioning consisting of 45 trials with a 500-ms CS overlapping and co-terminating with a 10-ms airpuff US. Individuals with higher scores on the AMBI and Trait Anxiety Inventory, but not the other measures, showed faster acquisition of a conditioned eyeblink response than individuals with lower scores. Results support a relationship between facilitated acquisition of inter-stimulus relationships and risk for anxiety, and suggest that some measures assessing anxiety vulnerability better capture this relationship than others.

Clinical differences between early‐ and late‐onset social anxiety disorders

The aim of this study was to elucidate the clinical differences between early- and late-onset social anxiety disorder (SAD) in the Korean population. Three hundred and eighty-seven outpatients diagnosed with SAD participated in this study. Confirmation of SAD diagnosis was based on the Mini International Neuropsychiatric Interview. All subjects completed the Liebowitz Social Anxiety Scale and anxiety-trait-related scales such as the Anxiety Sensitivity Index, Retrospective Self-Report of Inhibition, Trait Form of the State-Trait Anxiety Inventory, and Beck Depression Inventory. The early-onset group (n = 209) consisted of subjects aged up to 18 years at the time of onset, whereas the late-onset group (n = 178) consisted of subjects older than 18 years at the time of onset. Early-onset SAD patients were more likely to have the generalized subtype and to visit clinics with chief complaints other than social anxiety symptoms. They exhibited more severe symptoms and higher behavioural inhibitions. After adjusting for age and symptom severity, behavioural inhibition was the only significant difference between the two groups. The degree of behavioural inhibitions was associated with earlier onset age. Symptom severity and behavioural inhibitions, especially in social/school situations, were clinical characteristics that differentiated between early- and late-onset SAD.

Lack of Association between Brain-Derived Neurotrophic Factor Gene Val66Met Polymorphisms and Generalized Social Anxiety Disorder in Korean Population

ObjectiveSeveral lines of evidence suggest that brain-derived neurotrophic factor (BDNF) plays a role in the pathophysiology of anxiety. We analyzed the association of the BDNF gene polymorphism, G196A (val66met), in the coding region of exon XIIIA in chromosome 11p13, and generalized social anxiety disorder (GSAD).MethodsPatients with GSAD (n=73) and age-matched control subjects (n=152) were tested for the BDNF (val66met) polymorphism. A clinical interview and a Mini-International Neuropsychiatric Interview were conducted by trained psychiatrists in order to diagnose GSAD. The symptomatic characteristics of the GSAD patients were assessed with the Hamilton Anxiety Rating Scale, the Beck Anxiety Inventory, the Retrospective Self Report of Inhibition, the Spielberger State-Trait Anxiety Inventory, and the Liebowitz Social Anxiety Scale.ResultsThere were no significant differences in the frequencies of the genotypes (χ2=0.961, degree of freedom [df]=2, p=0.619), alleles (χ2=0.415, df=1, p=0.519), or allele (methionine) carriers (χ2=0.019, df=1, p=0.889) between the patients and controls. In addition, when we compared the severity of social anxiety symptom as determined by the clinical scales with the genotypes of the BDNF gene, we could not find any significant differences between the genotypes or allele carriers.ConclusionThese results do not support the hypothesis that the BDNF gene might be a candidate gene for susceptibility or severity of GSAD in the Korean population in this study.

Comparison of Anxiety-Related Traits Between Generalized and Nongeneralized Subtypes of Social Anxiety Disorder

This study aimed to investigate the possible difference in anxiety-related traits between the generalized and nongeneralized subtypes of social anxiety disorder (SAD). Two hundred seventy-three SAD Korean outpatients completed the Anxiety Sensitivity Index (ASI), the Trait Form of the State-Trait Anxiety Inventory (STAI-T), Retrospective Self-Report of Inhibition (RSRI), and the Liebowitz Social Anxiety Scale (LSAS) as part of their assessments. The unadjusted total scores of the ASI, STAI-T, RSRI, and LSAS differed between the two subtypes, according to an independent t-test. However, this result was not significant (ASI: F = 2.363, p = 0.127; STAI-T: F = 0.004, p = 0.949; RSRI: F = 1.518, p = 0.220) after adjusting for LSAS total score. The comparison of anxiety-related traits did not show any difference between the subtypes after adjusting for illness severity. These results may suggest that the two SAD subtypes are on a continuum of the same illness, differentiated only by symptom severity.

A Common Genetic Variant in the Neurexin Superfamily Member CNTNAP2 Is Associated with Increased Risk for Selective Mutism and Social Anxiety-Related Traits

Selective mutism (SM), considered an early-onset variant of social anxiety disorder, shares features of impaired social interaction and communication with autism spectrum disorders (ASDs) suggesting a possible shared pathophysiology. We examined association of a susceptibility gene, contactin-associated protein-like 2 (CNTNAP2), for ASDs and specific language impairment with SM and social anxiety-related traits. Sample 1 subjects were 99 nuclear families including 106 children with SM. Sample 2 subjects were young adults who completed measures of social interactional anxiety (n = 1028) and childhood behavioral inhibition (n = 920). Five single nucleotide polymorphisms in CNTNAP2 (including rs7794745 and rs2710102, previously associated with ASDs) were genotyped. Analyses revealed nominal significance (p = .018) for association of SM with rs2710102, which, with rs6944808, was part of a common haplotype associated with SM (permutation p = .022). Adjusting for sex and ancestral proportion, each copy of the rs2710102*a risk allele in the young adults was associated with increased odds of being >1 SD above the mean on the Social Interactional Anxiety Scale (odds ratio = 1.33, p = .015) and Retrospective Self-Report of Inhibition (odds ratio = 1.40, p = .010). Although association was found with rs2710102, the risk allele (a) for the traits studied here is the nonrisk allele for ASD and specific language impairment. These findings suggest a partially shared etiology between ASDs and SM and raise questions about which aspects of these syndromes are potentially influenced by CNTNAP2 and mechanism(s) by which these influences may be conveyed.

Childhood history of behavioral inhibition and comorbidity status in 256 adults with social phobia

Background Behavioral inhibition (BI), a heritable temperament, predisposes one to an increased risk of social phobia. Recent investigations have reported that BI may also be a precursor to anxiety as well as depressive and alcohol-related disorders, which are frequently comorbid with social phobia. In the present study, we explored the relationship between BI and psychiatric disorders in 256 adults with a primary diagnosis of social phobia. Methods BI severity was retrospectively assessed with the Retrospective Self-Report of Inhibition (RSRI). The severity of social phobia and the presence of comorbid diagnoses were evaluated with the Liebowitz Social Anxiety Scale (LSAS) and the Mini-International Neuropsychiatric Interview, respectively. Results The RSRI score was significantly and positively correlated with both the LSAS score and the occurrence of a major depressive disorder. No significant association was found with other anxiety and substance-related disorders. Limitation The assessment of BI was retrospective and self-reported. Conclusion A childhood history of BI was associated with an increased risk of depressive comorbidity in social phobia.

児童期のレトロスペクティブな行動抑制傾向測定尺度(The Retrospective Self-Report of Inhibition)日本語版の開発 (資料)

児童期のレトロスペクティブな行動抑制傾向測定尺度(The Retrospective Self-Report of Inhibition)日本語版の開発 (資料)

Psychometric properties of the Retrospective Self Report of Inhibition (RSRI) in a representative German sample

The present study examined the internal consistency, factorial structure, and construct validity of the German version of the Retrospective Self Report of Inhibition (RSRI), a questionnaire measure of behavioral inhibition. The research was based on data from a German prospective-longitudinal community study of 3021 adolescents and young adults (aged 14-24 years at baseline). Diagnostic assessment was based on the DSM-IV/M-CIDI and general psychopathological distress was assessed with SCL-90-R. Results of confirmatory factor analysis indicated adequate fit of the two-factor model, suggested by the authors of the original version. Indices of internal consistency of the RSRI and its subscales 'social/school' and 'fear/illness' were shown to be sufficient for the total sample and even higher in subgroups of subjects with certain DSM-IV diagnoses. Associations with variables such as mental distress, parental psychopathology, and DSM-IV disorders were in line with theoretical assumptions and confirm different aspects of the validity (convergent, concurrent, predictive) of the instrument. The psychometric properties of the German RSRI were found to be comparable to those of the English version. The applicability of this questionnaire in German-speaking countries is therefore recommended for adolescents and young adults.

Gender differences in anxiety-related traits in patients with panic disorder.

This study examined gender differences in anxiety-related personality traits in patients with panic disorder with or without agoraphobia (PD+/-AG). Outpatients (101 total) with SCID confirmed PD+/-AG completed the Anxiety Sensitivity Index (ASI), the Trait form of the State-Trait Anxiety Inventory (STAI-T), the NEO Personality Inventory Revised (NEO PI-R), and the Retrospective Self-Report of Inhibition (RSRI) as part of their assessment. Significant gender differences were not detected for the total ASI scores. Females scored significantly higher than males on the Physical Concerns subscale of the ASI, whereas males scored significantly higher than women on the Social Concerns subscale. Women scored higher than men on the Extraversion scale of the NEO PI-R as well as on certain subscales of this domain. Although a significant gender difference was not detected on the Neuroticism subscale, men scored higher on the angry hostility and depression facets of this trait. Significant gender differences were not found for the STAI-T or the RSRI. These findings suggest that gender differences exist among patients with PD+/-AG in the feared consequences of anxiety symptoms as well as in the personality characteristics of extraversion.

Behavioural inhibition and symptoms of anxiety and depression: is there a specific relationship with social phobia?

The aim of the study was to examine the relationships between tendencies towards different mental health problems assessed via questionnaires (social phobia, agoraphobia, general anxiety/panic, depression), the two latent dimensions of behavioural inhibition (childhood social/school fears, non-social fears/ illness), and sensory-processing sensitivity. A cross-sectional design was employed. Volunteer participants (N = 234) from anxiety and depression self-help organizations completed five mailed questionnaires. These were the Social Phobia and Anxiety Inventory, Beck Depression Inventory II and Beck Anxiety Inventory; the Highly Sensitive Person Scale, a measure of trait sensitivity to environmental stimuli; and the Retrospective Self-Report of Inhibition. Higher levels of anxiety, but not depression, were associated with increased self-reported sensitivity to environmental stimuli. Recalled childhood social/school fears were related to elevated scores on measures of social phobia and depression, while recalled non-social fears/illness were not associated with any index of psychopathology. These results extend those of previous research by suggesting specific patterns of relationships of both sensitivity to environmental stimuli and behavioural inhibition with symptoms of anxiety and depression. It is suggested that in investigating long-term outcome, prospective behavioural inhibition studies would benefit from examining the temporal corollaries of the underlying social and non-social dimensions. Sample and design limitations are discussed.

Retrospective and concurrent self-report of behavioral inhibition and their relation to adult mental health

AbstractFour studies are reported in which an interview or questionnaire is used to measure the relation between behavioral inhibition, defined as consistent restraint in response to unfamiliar social or nonsocial stimuli, and adult mental health. In Study 1, undergraduates were tested using a retrospective self-report questionnaire. Those who reported more behaviors suggesting childhood inhibition also reported more mental health problems. Study 2 was an attempt to establish the postdictive validity of the measurement of childhood inhibition. College students and their parents completed the questionnaire independently and were in extremely strong agreement regarding the student's inhibited behaviors as a child. In Study 3, self-reported contemporary behaviors suggesting inhibition correlated with the retrospective self-report of inhibition. Both measures correlated with the State Anxiety Subscale of the State-Trait Anxiety Inventory and the Center for Epidemiologic Studies Depression Scale, and both accounted for unique variance in anxiety, but only contemporary inhibition accounted for unique variance in depression. In Study 4, adults who had been treated for panic disorder or depression were interviewed and reported more behaviors indicative of inhibition during childhood than did control subjects. These four studies support the usefulness of retrospective self-report as a measure of childhood inhibition and are compatible with the hypothesis that a tendency toward inhibited behavior in childhood or adulthood may be a risk factor for mental health problems.