The Link Between Behavioral Inhibition And Social Anxiety Disorder
Behavioral inhibition (BI) is a temperament trait common in children, though it can continue into adulthood. BI is characterized by shyness, social withdrawal, discomfort, and anxiety. Many consider BI a behavioral indicator for developing anxiety disorders later in life, particularly social anxiety disorder. If you recognize BI or social anxiety in your child, a loved one, or yourself, evidence-based steps are available to help reduce symptom severity and decrease the likelihood of worsening social anxiety.
What is behavioral inhibition?
Behavioral inhibition is a temperament type often identified in early childhood and is seen in approximately 15% to 20% of children. Individuals with BI are characterized as being:
- Fearful of novel situations and people
- Shy
- Prone to avoidant behavior in social situations
- Vigilant
- Uncomfortable in social situations
- Withdrawn
Behavioral inhibition is not the same as being shy or reserved. While children who experience shyness experience social discomfort, those with BI experience inhibition in novel social and non-social situations. It is believed that an overactive amygdala (the center of the brain that processes fear and threat detection) may be responsible for heightened fear responses to novel situations.
Certain parenting styles can reduce behavioral inhibition. For example, parents can slowly and methodically expose children to novel situations while providing reassurance, thus helping them reduce reliance on avoidance to cope with fear. Research shows that parents who utilize similar parenting methods can successfully help their children transition from behavioral inhibition to a more uninhibited temperament.
What is social anxiety disorder?
Social anxiety disorder (SAD), also called social phobia, is a mental illness characterized by a fear of social interactions. Individuals with SAD describe a fear of being judged, and they may experience self-consciousness, embarrassment, or anxiety in social settings. Social anxiety disorder sometimes leads to avoidant behaviors, which can impact daily life and functioning.
The symptoms of social anxiety disorder include but are not limited to:
- Worrying about being embarrassed in social settings
- An overwhelming fear of talking to unfamiliar people
- Fear of looking anxious in social settings
- Fear of being judged
- Worrying about physical manifestations of anxiety in social settings, including sweating, blushing, stuttering, or shaking
- Avoiding certain situations, such as public speaking, being the center of attention, or going to work parties
- Evaluating performance after social interactions
- Pessimism and catastrophism about the potential outcomes of engaging in social situations
- Blushing
- A racing heart
- Sweating
- Muscle tension
Social anxiety disorder is common, with approximately 12% of adults in the United States experiencing it at some point in their lives. Though SAD can disrupt daily life, some people find that they can address their symptoms with psychiatric medications and psychotherapy.
How are social anxiety and behavioral inhibition related?
Research consistently demonstrates that behavioral inhibition predicts anxiety later in life. However, many children who experience behavioral inhibition do not develop social anxiety disorder. Those with stable BI personalities that persist through adolescence and young adulthood are most likely to be diagnosed with social anxiety disorder.
However, BI is not the only predictor of social anxiety. Other risk factors can make an individual more likely to develop social anxiety disorder, including the following:
- Parental overcontrol and psychopathology
- Trauma and other adverse life events
- A family history of social anxiety disorder
- The existence of other mental health conditions
- Visible injuries or physical differences
- Substance use
- A low socioeconomic status
- Cultural differences
- Gender roles and differences in parental interactions based on gender
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.
Addressing behavioral inhibition and social anxiety disorder
Behavioral inhibition can decrease social behavior, encourage avoidant coping mechanisms, and make anxiety and depression more likely later in life. An unaddressed anxiety disorder may develop, sometimes resulting in serious consequences. These consequences may include loneliness, social avoidance, low self-esteem, poor work or school performance, depression, and excessive substance use.
Loneliness and social isolation can increase the risk of stroke, heart disease, depression, and premature death. Addressing BI and SAD can improve mental health and overall well-being. The following steps may also help you manage behavioral inhibition and social anxiety:
Try to identify BI early
Behavioral inhibition interventions in childhood may reduce the risk of social anxiety disorder, with one study reporting a 25% reduction in anxiety disorder development. If you are concerned that your child is experiencing behavioral inhibition, contact their pediatrician or a child psychologist. Adapting parenting methods can often reduce fear and encourage uninhibited childhood temperament.
Effective strategies may encourage confidence and independence through exposure to new situations. A child psychologist can also help you determine if overprotective parenting contributes to your child's condition.
Enroll in social skills training
Studies show that social skills training alone may not effectively reduce social anxiety symptoms. However, it may provide additional benefits when combined with exposure therapy.
Effective medications
If you believe you have social anxiety disorder symptoms, you can contact a medical practitioner or psychiatrist for guidance. They can provide you with a diagnosis, and medical doctors (including psychiatrists) can evaluate whether medications may help reduce your symptoms.
Some people experience side effects with certain medications, so your doctor may increase your dosage slowly to reduce that risk. They may try several different medications to find the one that works best for you. Always consult a doctor before starting, changing, or stopping a medication.
Consider professional support
Cognitive-behavioral therapy (CBT) is an effective therapeutic modality for reducing the symptoms of social anxiety. During exposure-based CBT sessions, therapists often help clients practice gradual exposure to social situations that cause fear. This type of therapy is shown to instill self-confidence in social settings.
For individuals who have not sought support due to fear or discomfort associated with face-to-face therapy, online therapy may be an effective alternative. In a 2018 study, researchers studying the effectiveness of online-cognitive behavioral therapy found that social anxiety symptoms were significantly reduced in most participants.
Platforms like BetterHelp offer online CBT that addresses SAD symptoms and avoidant behaviors. In addition to the efficacy of online platforms, online therapy can be flexible and cost-effective. Through a platform, you can often match with a therapist within 48 hours and choose between phone, video, or chat sessions, depending on your preferences.
Takeaway
Many people can manage social anxiety disorders with exposure-based psychotherapy or psychiatric medications. Consider reaching out to a licensed therapist if you're interested in learning more about this method.
What is an inhibited behavior?
According to the American Psychological Association (APA), inhibited behavior is “restraint in engaging with the world combined with a tendency to scrutinize the environment for potential threats and to avoid or withdraw from unfamiliar situations or people.”
The term “inhibited behavior” is sometimes mistaken for inhibitory control— a trait characterized as the “suppression of goal-irrelevant stimuli and behavioral responses.”
What is the trait of behavioral inhibition?
As a trait, behavioral inhibition (BI) is a pattern of behavior in which individuals are fearful and withdrawn in new or novel situations. It’s often associated with extreme shyness and inhibited social and emotional development. It is most commonly identified in early childhood, but people of any age can have behavioral inhibition.
Behaviorally inhibited children may have difficulty with emotional functioning and are often at greater developmental risk for generalized anxiety and other anxiety-related disorders later in life.
What is the behavioral approach and inhibition?
The behavioral approach system (BAS) is a therapeutic strategy that regulates appetitive motives and shapes behavior through exposure to reward stimuli. For example, a child may receive money for getting a good grade on a test. According to BAS, the child will be motivated to get good grades in the future because they’ll be paid.
The behavioral inhibition system (BIS) regulates aversive motives and shapes behavior through exposure to negative consequences. For example, if a child is punished for getting a bad grade on a test, according to BIS, they may try to get better grades on future tests to avoid further punishment.
What causes behavioral inhibition?
Experts believe that a combination of genetic, environmental, and psychological factors likely causes behavioral inhibition. Some potential contributors to BI include:
- Genetics— Some individuals might be genetically predisposed to higher levels of behavioral inhibition. Studies suggest that specific genes can influence the tendency toward inhibition.
- Environmental Factors— Early experiences and environmental factors such as traumatic events, unstable family environments, or overprotective parenting styles may contribute to the development of behavioral inhibition and anxiety.
- Neurobiology— Early research from Harvard University by Kagan J, Reznick JS, and Snidman N demonstrated a strong correlation between BI and brain structure and functioning. Later studies probed deeper into this relationship and found that differences in the amygdala and other brain regions associated with emotional processing and regulation may contribute to varying levels of inhibition.
- Social Learning— Observation and learning from the behavior of others, particularly caregivers or peers, can impact the development of behavioral inhibition. Children may learn to be more cautious or avoidant based on the responses and reactions of those around them.
- Temperament Traits— BI often aligns with certain temperamental traits, such as introversion or sensitivity. In extremes, these inherent personality characteristics can put an individual at increased risk for anxiety disorders.
What are examples of inhibition?
Examples of inhibition may include:
- A child experiences fear or trauma after being dropped off at school because they’re afraid to be left with the other children and teachers.
- A preteen avoids going to parties or having other kids over because they’re afraid of being shunned or judged by their peers.
- A toddler shows hypervigilance in unfamiliar surroundings and displays symptoms of fear when approached by other people.
What are the signs of behavioral inhibition?
Inhibited children often withdraw and avoid contact with new situations, people, and environments. People with behavioral inhibition may also have an early temperament of fear or distress. Infant temperament indicators of BI include withdrawal from people, crying when placed in unfamiliar surroundings, and overly cautious and fearful behaviors.
How do you overcome behavioral inhibition?
Interventions for behavioral inhibition may include applying parenting styles that reinforce healthy social and emotional adjustment by providing reassurance in unfamiliar situations or when a task demands interaction with others.
Research also indicates that early cognitive-behavioral interventions such as cognitive behavioral therapy (CBT) are effective in reducing behavioral inhibition and reducing the developmental trajectories of anxiety disorders later in life.
Is behavioral inhibition inherited?
There is a vast body of evidence showing that there is a strong correlation between genetics and childhood behavioral inhibition.
What is the difference between behavioral activation and behavioral inhibition?
According to the reinforcement sensitivity theory (RST), two primary motivational mechanisms influence behaviors and emotions. The behavioral activation system (BAS) is controlled by non-punishment and reward stimuli and is associated with positive emotions. Once activated, the BAS encourages behaviors of interaction and approach.
Conversely, punishment and non-reward stimuli motivate the behavioral inhibitions system (BIS). It’s typically associated with negative emotions, resulting in fearful, avoidant behaviors. Research suggests that the BIS mechanism puts some at greater risk for anxiety.
Is behavioral inhibition stable?
Behavioral inhibition is often stable throughout childhood and is often a risk factor for developing social anxiety disorder.
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