Doll Play Narratives About Starting School in Children of Socially Anxious Mothers, and Their Relation to Subsequent Child School-Based Anxiety

Child social anxiety is common, and predicts later emotional and academic impairment. Offspring of socially anxious mothers
are at increased risk. It is important to establish whether individual vulnerability to disorder can be identified in young
children. The responses of 4.5 year-old children of mothers with social phobia (N = 62) and non-anxious mothers (N = 60) were compared, two months before school entry, using a Doll Play (DP) procedure focused on the social challenge of
starting school. DP responses were examined in relation to teacher reports of anxious-depressed symptoms and social worries
at the end of the child’s first school term. The role of earlier child behavioral inhibition and attachment, assessed at 14 months,
was also considered. Compared to children of non-anxious mothers, children of mothers with social phobia were significantly
more likely to give anxiously negative responses in their school DP (OR = 2.57). In turn, negative DP predicted teacher reported
anxious-depressed and social worry problems. There were no effects of infant behavioral inhibition or attachment. Vulnerability
in young children at risk of anxiety can be identified using Doll Play narratives.