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Development of the characteristics of social phobia often requires a diathesis in the form of a temperamental bias. A behavioral profile marked by vigorous motor activity and crying to unfamiliar stimuli at 4 months of age - called high reactivity- is characteristic of about 20% of healthy, Caucasian infants. This pattern predicts shy behavior in preschool children and symptoms of social anxiety at age 7, and, at age 11, a subdued personality and biological features that are consonant with a hypothesis of amygdalar excitability. The biological variables that best characterize the children who had been high-reactive infants are right-hemisphere activity in the electroencephalogram (EEC), a larger evoked potential from the inferior colliculus, higher sympathetic tone in the cardiovascular system, and larger event-related potentials to discrepant stimuli. About a quarter of 11-year-olds who had been high reactives displayed behavioral and biological characteristics that are in theoretical accord with the hypothesis of amygdalar excitability, while only 1 of 20 displayed a profile characterized by features in opposition to their temperament. The evidence points to a modest temperamental contribution to the development of symptoms currently regarded as diagnostic of social phobia.

Childhood predictors of states of anxiety