The development and modification of temperamental risk for anxiety disorders: Prevention of a lifetime of anxiety?

This review poses the question, is it possible to prevent the development of anxiety disorders through selective interventions? The article begins with a review of the major psychosocial risk factors for anxiety disorders. Evidence is reviewed to support the role of inhibited temperament, parent anxiety, environmental support of avoidant coping, and vicarious and instructional learning of avoidance as risks for anxiety. It is argued that the central focus of these risks is an inhibited temperament and that the other risk factors are likely to be both moderated and mediated by this temperamental style. Thus, a clear option for prevention would be to modify early inhibition. Some preliminary data are presented from the Macquarie University Preschool Intervention Project, a longitudinal study of a brief parent education program for the reduction of inhibited temperament in preschool children. Although there remains considerable room for stronger effects, preliminary results show clear promise that it may be possible to modify early risk for anxiety disorders. (C) 2002 Society of Biological Psychiatry.