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Anxiety in Children and Adolescents

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Children and Adolescents are not immune from Anxiety Disorders

Anxiety is a common problem for children and adolescents. Research estimates vary, but studies suggest that up to 20% of children and adolescents will have an anxiety disorder at some point in childhood (ref. 1). Anxiety disorders are the most common psychiatric conditions in adults and the majority of adults with anxiety disorders report that their symptoms began in childhood (ref. 2).

What causes anxiety disorders in children & adolescents? Researchers have found that anxiety disorders tend to run in families and that there is a significant genetic or inherited component to anxiety disorders. In addition, environmental factors (stress, social pressures, family conflicts) also play a role in childhood anxiety disorders.

Children and adolescents are prone to the same anxiety disorders that adults struggle with:

Panic Disorder
Generalized Anxiety Disorder
Phobias
Obsessive Compulsive Disorder
Posttraumatic Stress Disorder

In addition, children may also experience Separation Anxiety Disorder.

Treatment of Anxiety Disorders in Children and Adolescents

Therapy is effective in treating a wide range of anxiety disorders in childhood and adolescence (ref. 3). Moreover, research suggests that early intervention is best (ref. 3).

Treating children and adolescents is often more complicated that treating adults.

  • Children (and teens) are not miniature adults. Children and adolescents do not have the maturity that adults do. Thus, therapists need to recognize their unique developmental needs, and take these into account in treatment.
  • Distinguishing Anxiety from other disorders. One of the more challenging tasks therapists face in working with children is accurately diagnosing the nature of their problems. Children are not as good as adults in describing their symptoms/problems. Moreover, the symptoms of many childhood disorders often are quite similar. Thus, accurate assessment is essential.
  • Cognitive Behavioral Therapy (CBT). Cognitive behavioral therapy has been shown to be quite effective in treating anxiety disorders. However, CBT needs to be modified to work with children and adolescents, to take into account their developmental needs. Thus, we offer CBT, but combine it with other approaches and methods in our work with children and adolescents.
  • Family support is critical. Parents need to be involved in their child’s, and even their teen’s, treatment. Children and adolescents will need the support and structure that parents provide to help them overcome their anxiety.
  • A Comprehensive Approach to Treatment. Therapists must be aware of the child’s issues, the family environment, and the impact of school and the broader social environment. Moreover, therapists need to coordinate with other professionals, including physicians, to maximize treatment effectiveness.

In our handout: Understanding Anxiety in Children and Adolescents we discuss all of the issues noted above in more detail and offer specific resources for parents.

References cited regarding Anxiety Disorders in Children & Adolescents

Ref 1. Roma Vasa & Daniel Pine, Neurobiology, pp 3-28, in Tracy Morris & John March (eds). Anxiety disorders in Children and Adolescents. Guilford Press, New York, 2004.

Ref 2. Ronald C. Kessler, PhD; Patricia Berglund, MBA; Olga Demler, MA, MS; Robert Jin, MA; Kathleen R. Merikangas, PhD; Ellen E. Walters, MS, Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication, Arch Gen Psychiatry. 2005;62:593-602.

Ref 3. Kristen D’Eramo & Greta Francis, Cognitive Behavioral Psychotherapy, pp 305-328, in Tracy Morris & John March (eds), Anxiety disorders in Children and Adolescents. Guilford Press, New York, 2004.


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