Attention Bias to Threat as a Mediator Between Childhood Behavioral Inhibition and Social Anxiety: A Structural Model
Downloads
Objective: This study examined whether attention bias to threat statistically accounts for part of the association between retrospectively reported childhood behavioral inhibition and current social anxiety symptoms in adults.
Methods and Materials: A cross-sectional correlational study included 250 adults aged 20–45 years recruited in the Isfahan University context, Iran, by convenience sampling. Participants completed the Retrospective Measure of Behavioral Inhibition and the Liebowitz Social Anxiety Scale and performed a computerized dot-probe task. Structural modeling was conducted in SPSS 26 and AMOS 24. Indirect effects were evaluated with 5,000 bootstrap resamples.
Findings: Behavioral inhibition was positively associated with attention bias (β= .32, p<.001) and social anxiety (β= .39, p< .001), while attention bias was associated with social anxiety (β= .43, p< .001). The reported indirect effect was .14 (95% CI [.08, .22], p < .001). Model-fit indices were RMSEA = .05, CFI = .94, GFI = .92, and χ²/df = 2.18.
Conclusion: The results are consistent with a cognitive–temperamental account in which threat-related attention may statistically link childhood inhibition with adult social anxiety. Because the design is cross-sectional and childhood inhibition was assessed retrospectively, the indirect effect should not be interpreted as evidence of temporal or causal mediation. Replication with longitudinal designs and more reliable attention-bias measures is warranted.
Downloads
Alomari, N. A., Bedaiwi, S. K., Ghasib, A. M., Kabbarah, A. J., Alnefaie, S. A., Hariri, N., Altammar, M. A., Fadhel, A. M., Altowairqi, F. M., & Ghasib, A. (2022). Social anxiety disorder: Associated conditions and therapeutic approaches. Cureus, 14(12), e32687. https://doi.org/10.7759/cureus.32687
Alves, F., Figueiredo, D. V., & Vagos, P. (2022). The prevalence of adolescent social fears and social anxiety disorder in school contexts. International Journal of Environmental Research and Public Health, 19(19), 12458. https://doi.org/10.3390/ijerph191912458
Brunetti, M., Sette, S., Longobardi, E., Laghi, F., & Coplan, R. J. (2024). Loneliness and aloneliness as mediators of the associations between social withdrawal and internalizing problems in late childhood and early adolescence. The Journal of Early Adolescence, 44(6), 790–814. https://doi.org/10.1177/02724316231207282
Fox, N. A., Zeytinoglu, S., Valadez, E. A., Buzzell, G. A., Morales, S., & Henderson, H. A. (2023). Annual Research Review: Developmental pathways linking early behavioral inhibition to later anxiety. Journal of Child Psychology and Psychiatry, 64(4), 537–561. https://doi.org/10.1111/jcpp.13702
Gladstone, G. L., & Parker, G. B. (2005). Measuring a behaviorally inhibited temperament style: Development and initial validation of new self-report measures. Psychiatry Research, 135(2), 133–143. https://doi.org/10.1016/j.psychres.2005.03.005
Gladstone, G. L., Parker, G. B., Mitchell, P. B., Wilhelm, K. A., & Malhi, G. S. (2005). Relationship between self-reported childhood behavioral inhibition and lifetime anxiety disorders in a clinical sample. Depression and Anxiety, 22(3), 103–113. https://doi.org/10.1002/da.20082
Jefferies, P., & Ungar, M. (2020). Social anxiety in young people: A prevalence study in seven countries. PLOS ONE, 15(9), e0239133. https://doi.org/10.1371/journal.pone.0239133
Khoshouei, M. S. (2007). Psychometric properties of the Persian version of the Liebowitz Social Anxiety Scale (LSAS). Iranian Journal of Psychiatry, 2(2), 80–86. https://doaj.org/article/dad81beabe034e0f9eaf414408797fcd
Kline, R. B. (2023). Principles and practice of structural equation modeling (5th ed.). Guilford Press. https://www.guilford.com/books/Principles-and-Practice-of-Structural-Equation-Modeling/Rex-Kline/9781462551910
Koyuncu, A., İnce, E., Ertekin, E., & Tükel, R. (2019). Comorbidity in social anxiety disorder: Diagnostic and therapeutic challenges. Drugs in Context, 8, 212573. https://doi.org/10.7573/dic.212573
Liebowitz, M. R. (1987). Social phobia. Modern Problems of Pharmacopsychiatry, 22, 141–173. https://doi.org/10.1159/000414022
Mathews, A., & MacLeod, C. (1986). Discrimination of threat cues without awareness in anxiety states. Journal of Abnormal Psychology, 95(2), 131–138. https://doi.org/10.1037/0021-843X.95.2.131
Molloy, A., & Anderson, P. L. (2020). Evaluating the reliability of attention bias and attention bias variability measures in the dot-probe task among people with social anxiety disorder. Psychological Assessment, 32(9), 883–888. https://doi.org/10.1037/pas0000912
Meissel, E. E. E., Liu, H., Stevens, E. S., Evans, T. C., Britton, J. C., Letkiewicz, A. M., & Shankman, S. A. (2022). The reliability and validity of response-based measures of attention bias. Cognitive Therapy and Research, 46(1), 146–160. https://doi.org/10.1007/s10608-021-10212-w
Rostami, H., Zeinali, S., Satatrineya, M., Ghanizadeh, S., & Nouri, E. (2024). The relationship between maternal overprotection and anxious beliefs with child anxiety: The mediating role of child inhibition in clients referred to Urmia Police Force Counseling Center. International Journal of Body, Mind and Culture, 11(4), 345–356. https://doi.org/10.22122/ijbmc.v11i4.517
Sandstrom, A., Uher, R., & Pavlova, B. (2020). Prospective association between childhood behavioral inhibition and anxiety: A meta-analysis. Research on Child and Adolescent Psychopathology, 48(1), 57–66. https://doi.org/10.1007/s10802-019-00588-5
Tahmasebi, S., Keykhosrovani, M., & Amini, N. (2025). Comparative effects of cognitive bias modification and MBCT on cognitive avoidance and negative self-talk in university students with social anxiety. International Journal of Body, Mind and Culture, 12(3), 245–255. https://doi.org/10.61838/ijbmc.v12i3.927
Tan, E., Zeytinoglu, S., Morales, S., Buzzell, G. A., Almas, A. N., Degnan, K. A., Chronis-Tuscano, A., Henderson, H., Pine, D. S., & Fox, N. A. (2024). Social versus non-social behavioral inhibition: Differential prediction from early childhood of long-term psychosocial outcomes. Developmental Science, 27(1), e13427. https://doi.org/10.1111/desc.13427
Thai, N., Taber-Thomas, B. C., & Pérez-Edgar, K. E. (2016). Neural correlates of attention biases, behavioral inhibition, and social anxiety in children: An ERP study. Developmental Cognitive Neuroscience, 19, 200–210. https://doi.org/10.1016/j.dcn.2016.03.008
Van Bockstaele, B., Aktar, E., Majdandžić, M., Pérez-Edgar, K., & Bögels, S. M. (2021). The relation between early behavioural inhibition and later social anxiety, independent of attentional biases to threat. Cognition and Emotion, 35(7), 1431–1439. https://doi.org/10.1080/02699931.2021.1963682
Warnock-Parkes, E., Wild, J., Thew, G., Kerr, A., Grey, N., & Clark, D. M. (2022). “I’m unlikeable, boring, weird, foolish, inferior, inadequate”: How to address persistent negative self-evaluations central to social anxiety disorder with cognitive therapy. The Cognitive Behaviour Therapist, 15, e56. https://doi.org/10.1017/S1754470X22000496
Wermes, R., Lincoln, T. M., & Helbig-Lang, S. (2018). Attentional biases to threat in social anxiety disorder: Time to focus our attention elsewhere? Anxiety, Stress, & Coping, 31(5), 555–570. https://doi.org/10.1080/10615806.2018.1483497
Copyright (c) 2026 International Journal of Body, Mind and Culture
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
