Poster #144 - Exposure to COVID-19 Disruptions Moderates the Effect of Temperament on Anxiety in Young Children

• In Event: Poster Session 14

Abstract

Background: The current prevalence of clinically elevated anxiety among children has doubled since the year prior to the COVID-19 pandemic (Racine et al., 2021). Examining factors that predict anxiety is critical to enhancing our understanding of how and when to intervene during this next phase of the pandemic. Children who have experienced a disaster like a pandemic are more likely to develop mental health symptoms if exposed to multiple life stressors, losses, and disruptions (Lai et al., 2017). This is especially true for very young children with shy or fearful temperament as they have elevated risk for early onset of anxiety disorders even in the absence of exposure to stressors (Hirshfeld, 1992). Therefore, we examined whether the association between anxious temperament at age two years and child anxiety symptoms one year later was moderated by exposure to parental work and family social disruptions during the beginning months of the COVID-19 pandemic. We hypothesized that children with shy or fearful temperament would be especially prone to develop clinical anxiety after pandemic-related disruptions.

Methods: Parents of 125 toddlers (Mage = 26 months, 54% girls, 80% White) completed a child temperament measure at baseline (Early Childhood Behavior Questionnaire, Fear and Shyness Scales; Putnam, 2006) and a child anxiety measure one year later (Preschool Anxiety Scale; Spence et al., 2001). Parents completed the Epidemic-Pandemic Impacts Inventory (EPII; Grasso et al., 2020) at the start of the pandemic to assess types of disruptions experienced.

Results: Shy temperament predicted higher anxiety symptoms (B=4.03, SE=0.94, p<.001) and this association was moderated by exposure to parental work disruptions (B=2.27, SE=0.79, p<.01). Specifically, ECBQ-Shyness predicted higher anxiety among children with high (B=6.53, SE=1.22, p<.001) but not low (B=1.98, SE=1.10, p=.07) parental work disruptions. This interaction effect was particularly strong for social and generalized anxiety. Fearful temperament also predicted higher anxiety symptoms (B=4.84, SE=0.98, p<.001) and this link was moderated by social activity disruptions (B=-2.59, SE=0.83, p<.01). Specifically, ECBQ-Fear predicted higher anxiety at both low (B=7.98, SE=1.36, p<.001) and high (B=2.79, SE=1.11, p=.01) levels of social activity disruption. However, this association was nearly three times less strong among those with high compared to low social activity disruptions (Bs=2.79 and 7.98, respectively).

Conclusions: Shy temperament increased anxiety symptoms among toddlers whose parents experienced work-related stressors and may themselves have been managing ongoing distress. This finding is consistent with extant literature demonstrating that shy temperament is a risk factor for anxiety in young children under conditions of family strain. In contrast, the link between fearful temperament and subsequent anxiety was weaker at high levels of social activity disruptions. One possibility is that reduced social demands enabled toddlers to spend more time with parents and avoid facing feared situations (e.g., separation), leading to less than expected observed anxiety. Future follow-up will assess whether anxiety in children with fearful temperament increased after social activities resumed. Overall, results suggest that anxious temperament may serve as a meaningful screening target for identifying the children most in need of support during this global health crisis.

Authors

• Madelaine R Abel, Massachusetts General Hospital
  Presenting Author

• Yael Dai, University of Connecticut

• Aude Henin, Massachusetts General Hospital

• Antonia Hamilton, Massachusetts General Hospital

• Alice S Carter, University of Massachusetts Boston

• Dina R. Hirshfeld-Becker, Mass General Hospital/ Harvard Medical School