The teenage years are awkward for everyone, but some adolescents experience more anxiety than most when it comes to social interactions.
Fear and dread over reading aloud in class, playing sports, speaking in public, or attending dances and parties may be signs of a social anxiety disorder - one of the most common psychiatric disorders among children and adolescents, researchers say.
While social anxiety disorder affects between 6% and 18% of children and adolescents, researchers are still attempting to identify early predictors of the condition.
On Wednesday, the journal Child Development published a paper that suggested early interactions between an infant and his or her caregiver, as well as early childhood shyness, may forecast a teenage anxiety disorder, especially in boys.
The study found that children who were insecurely attached to their parents as infants, and whose behavior was inhibited throughout their childhood, were more likely to report higher levels of anxiety in social situations as teens.
"The cost of persistent shyness may be greater for boys than for girls in terms of psychosocial functioning, given that this behavior violates societal expectations to a greater extent when it occurs in males than in females," wrote lead author Erin Lewis-Morrarty - a child development researcher at the University of Maryland - and her colleagues.
Behavioral inhibition is when a young child will consistently withdraw or react negatively to unfamiliar situations, objects and people. While such inhibition occurs in 15% to 20% of all children, and is a risk factor for social anxiety disorder, inhibition alone does not mean a child will develop social anxiety as a teen, researchers say.
However, researchers say that when someone is insecurely attached to a parent as an infant and also shows behavioral inhibition as a young child, he or she reports experiencing more anxiety as a teen.
Child behaviorists attempt to classify an infant's attachment to its caregiver through an assessment called the "strange situation procedure."
During the test, the infant's response to its surroundings and a parent is observed after they are placed in an unfamiliar room together and the child is introduced to a stranger and new objects. At one point the mother will leave the room and return after a short period of time.
More than half of the infants that undergo the strange situation will explore their surroundings and, if they become anxious, will be calmed by the parent's return to the room.
Others, however, will behave in a way that suggests an insecure attachment to their parent. Those behaviors include ignoring their caregiver when they return, becoming angry with their caregiver or failing to be calmed when they return.
"We found a specific positive association between consistently high behavioral inhibition in childhood and adolescent anxiety symptoms only among those with insecure attachment in infancy," the authors wrote.
The researchers' findings were based on a longitudinal study of 165 white, middle- to upper-middle-class children who were followed from infancy to age 14 or 17.
Study authors wrote that while their results confirmed their hypothesis, more research must be done to establish a connection. They noted also that the research was limited by the fact that it focused solely on white children.
"Results of the present study enhance our understanding regarding how biology and the early environment interact to predict one of the most prevalent types of anxiety disorders among adolescents," the authors wrote.
"Altering parent behaviors among at-risk dyads by teaching parents to provide sensitive, responsive care may be particularly important in the prevention of anxiety disorders among children who show behavioral inhibition over time."