Community sample evidence on the relations among behavioural inhibition system, anxiety sensitivity, experiential avoidance, and social anxiety in adolescents

Social anxiety in adolescence can have severe consequences including underachievement and school drop-out, psychopathology, and substance use disorders. The development of social anxiety in adolescents is a complex and poorly understood process. Temperamental predispositions such as behavioural inhibition are significant risk factors but the specific path leading from behavioural inhibition to social anxiety remains unclear. One potential pathway is that temperament leads to social anxiety through learned self-regulation strategies and cognitive predispositions, a hypothesis that has not yet been investigated in adolescents. In an attempt to investigate further this idea, we ran parallel multiple mediation analysis to examine whether greater behavioural inhibition system sensitivity is linked to higher social anxiety via greater anxiety sensitivity and experiential avoidance levels in a random community sample of high-school adolescents (N= 718). The results confirmed our hypotheses. Independently of gender and after controlling for anxiety psychopathology and depression levels, greater behavioural inhibition system sensitivity was associated with more severe social anxiety in adolescents both directly and indirectly through greater experiential avoidance and more severe anxiety sensitivity. Given the fact that social anxiety is a serious cause of academic and social impairment in adolescence, the present findings suggest malleable risk factors that can be effectively addressed in targeted prevention and treatment interventions. Results are discussed in light of previous relevant findings and in relation to relevant theoretical and methodological issues and clinical implications.