# Biobehavioral Trajectories of Social Anxiety from Early to Middle Adolescence

> **NIH NIH R01** · PENNSYLVANIA STATE UNIVERSITY, THE · 2022 · $819,081

## Abstract

Social Anxiety Disorder (SAD) is among the most common forms of pediatric psychopathology. These
symptoms are associated with significant impairment encompassing familial, social and academic domains,
and they are often comorbid with other internalizing symptoms (e.g., depression) especially in adolescence
and into adulthood. Efforts to address the burden of SAD suffer from the limited understanding of its underlying
pathophysiology. SAD symptoms peak in adolescence making this developmental transition an important
period to study. However, considerable heterogeneity in symptomatology, risk factors, and underlying biology
exists across anxious adolescents, which has implications for (1) understanding the developmental etiology of
who is at highest risk, (2) identifying individual profiles of symptom course, (3) matching treatments to symptom
patterns and (4) determining for whom these treatments are most effective. A substantial clinical literature
exists focused on anxiety problems in children and adolescents examining clinical features with little focus on
developmental processes and biological mechanisms. In contrast, the developmental literature is dominated by
a temperament approach whereby extreme fearful temperament is our strongest individual differences
predictor of anxiety. Exclusive focus on either model creates a barrier to progress in the field. Specifically, (1)
identification of anxiety problems is typically diagnostic, with classification based solely on reported anxious
behavior (rather than convergent information from different types of measures to predict a dimensional
outcome); (2) we have a limited understanding of the underlying processes linking fearful temperament and
anxiety across development; (3) most anxiety in children is benign, yet we lack methods to separate the true
cases from false positives; and (4) although early temperament variation is ideal for identifying risk and
potential mechanisms, we know little about how variation in temperament influences symptom course and
effectiveness of treatments. The current study will employ a longitudinal design including continuation of a sub-
sample followed since 24-months and characterized for fearful temperament. We add to this addition youth
recruited for a range of SAD symptoms. Together this sampling will capture a wide range of anxiety symptom
presentation (i.e., low risk, temperamental risk, and clinical anxiety). We will follow adolescents (N = 240)
annually across the transitions to middle- and high-school – ages 13, 14, 15, & 16 years. We will implement a
rich assessment of anxiety symptoms, temperament, attention bias, endocrine (cortisol), physiological (RSA)
and neurobiological (N1, P2, N2 evoked potentials of attention) processes. This multi-method approach aligns
with the NIMH objective 2.2 to identify biomarkers and behavioral indicators of illness trajectories and explicitly
tests components of the Research Domain Criteria (RDoC). Specifically, we will exa...

## Key facts

- **NIH application ID:** 10440397
- **Project number:** 5R01MH114974-05
- **Recipient organization:** PENNSYLVANIA STATE UNIVERSITY, THE
- **Principal Investigator:** Kristin A Buss
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $819,081
- **Award type:** 5
- **Project period:** 2018-08-17 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10440397

## Citation

> US National Institutes of Health, RePORTER application 10440397, Biobehavioral Trajectories of Social Anxiety from Early to Middle Adolescence (5R01MH114974-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10440397. Licensed CC0.

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