Anxiety Disorders in Children and Adolescents

1. Anxiety Disorders in Children and Adolescents

2. Various Forms of Anxiety • Generalized Anxiety • Separation Anxiety • Specific Phobia • Panic Disorder • Selective Mutism • Social Anxiety • Somatization • Obsessive Compulsive Disorder • Post-Traumatic Stress

3. Fear is, I think, the greatest suffering for children George Sand (1854-1855)

4. Basics of Anxiety • Anxiety is a feeling state consisting of physical, emotional and behavioral response to a perceived threat • Often undetected or under treated • Fear and worry are common in normally developing children • Need to distinguish normal from abnormal

5. Basics of Anxiety • Worries and fears can be protective in moderation

6. Basics of Anxiety • Cognitive distortions • Anxious children tend to have negative distorted thoughts and perceive events in a negative way (attribution bias) • Anxiety becomes a disorder when… • Increased intensity/duration than expected • Impairment or disability • Disruption of daily activities • Clinically significant unexplained physical symptoms or intrusive thoughts

7. Basics of Anxiety Overestimated Likelihood x Harm Anxiety = Ability to cope Underestimated Beck et al. 1985

8. School refusal

9. Management of Anxiety • Recognize that it is there: develop insight, give it a name, make it less of a mystery. • Teach healthy coping: relaxation, distractions • Exposures: Do not recommending avoiding stimuli that cause anxiety. Rather learn to adapt. • Formal treatment: therapy or medication.