Emerging Evidence for Putative Neural Networks and Antecedents of Pediatric Anxiety in the Fetal, Neonatal, and Infant Periods

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Anxiety disorders are the most prevalent psychiatric disorders in youth and are associated with profound individual impairment and public health costs. Research shows that clinically significant anxiety symptoms manifest in preschool-aged children, and correlates of anxiety symptoms are observable in infancy. Yet, predicting who is at risk for developing anxiety remains an enduring challenge. Predictive biomarkers of anxiety are needed before school age when anxiety symptoms typically consolidate into diagnostic profiles. Increasing evidence indicates that early neural measures implicated in anxiety and anxious temperament may be incorporated with traditional measures of behavioral risk (i.e., behavioral inhibition) to provide more robust classification of pediatric anxiety problems. This review examines the phenomenology of anxiety disorders in early life, highlighting developmental research that interrogates the putative neurocircuitry of pediatric anxiety. First, we discuss enduring challenges in identifying and predicting risk for pediatric anxiety. Second, we summarize emerging evidence for putative neural antecedents and networks underlying risk for pediatric anxiety in the fetal, neonatal, and infant periods that represent novel potential avenues for risk identification and prediction. We focus on evidence examining the importance of early amygdala and extended amygdala circuitry development to the emergence of anxiety. Finally, we discuss the utility of integrating developmental psychopathology and neuroscience to facilitate future research and clinical work.

Original languageEnglish (US)
Pages (from-to)672-680
Number of pages9
JournalBiological psychiatry
Issue number7
StatePublished - Apr 1 2021

Bibliographical note

Funding Information:
This work was supported by the National Science Foundation Graduate Research Fellowship Program (to CMD and CL) and National Institute of Mental Health (Grant No. R01 MH104324 [to JTE]). The funders had no role in the study design, analysis, data interpretation, or writing of this article.

Publisher Copyright:
© 2020 Society of Biological Psychiatry


  • Amygdala
  • Anxiety
  • Infancy
  • Prediction


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