title: A controlled study of behavioral inhibition in children of parents with panic disorder and depression.
abstract: OBJECTIVE
  "Behavioral inhibition to the unfamiliar" has been proposed as a precursor to anxiety disorders. Children with behavioral inhibition are cautious, quiet, introverted, and shy in unfamiliar situations. Several lines of evidence suggest that behavioral inhibition is an index of anxiety proneness. The authors sought to replicate prior findings and examine the specificity of the association between behavioral inhibition and anxiety.
  
  
  METHODS
  Laboratory-based behavioral observations were used to assess behavioral inhibition in 129 young children of parents with panic disorder and major depression, 22 children of parents with panic disorder without major depression, 49 children of parents with major depression without panic disorder, and 84 children of parents without anxiety disorders or major depression (comparison group). A standard definition of behavioral inhibition based on previous research ("dichotomous behavioral inhibition") was compared with two other definitions.
  
  
  RESULTS
  Dichotomous behavioral inhibition was most frequent among the children of parents with panic disorder plus major depression (29% versus 12% in comparison subjects). For all definitions, the univariate effects of parental major depression were significant (conferring a twofold risk for behavioral inhibition), and for most definitions the effects of parental panic disorder conferred a twofold risk as well.
  
  
  CONCLUSIONS
  These results suggest that the comorbidity of panic disorder and major depression accounts for much of the observed familial link between parental panic disorder and childhood behavioral inhibition. Further work is needed to elucidate the role of parental major depression in conferring risk for behavioral inhibition in children.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, 02114, USA. jrosenbaum@partners.org
authors.forename: J F
authors.initials: JF
authors.lastname: Rosenbaum
authors.forename: J
authors.initials: J
authors.lastname: Biederman
authors.forename: D R
authors.initials: DR
authors.lastname: Hirshfeld-Becker
authors.forename: J
authors.initials: J
authors.lastname: Kagan
authors.forename: N
authors.initials: N
authors.lastname: Snidman
authors.forename: D
authors.initials: D
authors.lastname: Friedman
authors.forename: A
authors.initials: A
authors.lastname: Nineberg
authors.forename: D J
authors.initials: DJ
authors.lastname: Gallery
authors.forename: S V
authors.initials: SV
authors.lastname: Faraone
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology; D002648:Child; D002652:Child Behavior / Q000145:classification*; D016241:Child of Impaired Parents / Q000145:classification*; D002675:Child, Preschool; D015897:Comorbidity; D016001:Confidence Intervals; D003866:Depressive Disorder / Q000453:epidemiology*; D004198:Disease Susceptibility; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D016017:Odds Ratio; D016584:Panic Disorder / Q000453:epidemiology*; D010290:Parents / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors