Professional Documents
Culture Documents
Angela Lai
Shelina Hassanali
Christina Majcher
Anxiety Disorders
Most common of all psychiatric disorders affecting children and
youth
Long-term outcomes of anxiety disorders in childhood and
adolescence are still not well understood
Research into childhood anxiety did not begin until the 1980s
Fears and anxieties are a part of normal childhood development,
but for some children this expectation may end up masking the
presence of an existing or emerging anxiety disorder
Less than 20% of children requiring support for any disorder receive
necessary intervention
Separation Anxiety Disorder (SAD)Panic disordersPosttraumatic Stress DisorderAcute stress disorderAgoraphobia
Generalized anxiety disorder (GAD)Social Anxiety Disorder
Obsessive Compulsive Disorder (OCD)
Albano, Chorpita, and Barlow (Mash & Barkley, Eds., 2003, pp. 307-308) used the model of triplevulnerability to describe the development of anxiety and its disorders as a function of three interacting
dispositions:
Psychosocial Factors
Common Comorbidities
Anxiety Disorders are identified as
associated with the features of the
following disorders:
Different types of Anxiety Disorders (SAD
and Panic Disorder)
GAD with OCD
OCD: Tic Disorder, MDD, specific
developmental disorder, simple phobia,
adjustment disorder with depressed mood,
ODD, ADHD
Social Anxiety: Eating Disorders, Autism
Spectrum Disorder, MDD, Dysthymia,
Substance Abuse
(Beidal et al., 2007); Grabhorn, Stenner, Stangier, & Kaufhold
(2006)
Generalized
Anxiety Disorder
Excessive, uncontrollable
and often irrational worry
about everyday things that
is disproportionate to the
actual source of worry,
occurring more days than
not, for at least 6 months
To diagnose GAD in
children, there must also
be the presence of at least
one physiological
symptom.
Irritable
Test anxiety
Fixate on worries
Internalizing/externalizing behaviours
Social challenges
Difficulty concentrating
Obsessive
Compulsive
Disorder (OCD)
marked distress for
an individual and/or
significant
impairment in
functioning.
Recurrent and intrusive
obsessions and compulsions
that are time-consuming, or
which cause
Adolescents may find increased independence anxietyprovoking (i.e. dating, working, driving)
Attendance may be impacted
By Holly L. Niner
Social Anxiety
Disorder
(Social Phobia)
A marked and
persistent fear of
one or more social
or performance
situations in which
the person fears that
embarrassment may
occur.
Core Symptoms
Immediate anxiety responses or panic attack upon exposure of
the situation
earlier in childhood
o .5% in children and 2% and 4% in adolescents
o higher rates of Social anxiety disorders in females than
males (as cited in Chavira & Stein 2005)
Vulnerability
Increased self-consciousness
Increased demands due to changes in middle school
environment
Children: lower perceptions of cognitive competence, higher
trait of anxiety
Youth: later anxiety, major depressive disorders, substance
abuse disorder, suicide attempts, educational
underachievement
Subtypes
Generalized subtype is the most common form of Social Anxiety
Disorder in children and adolescents (Hofmann, Moscovitch,
Kim, & Taylor, 2004)
Generalized subtype appears to be a more pervasive and
disabling condition than non-generalized subtypes (Chavira &
Stein 2005)
DSM V
A. Marked fear of anxiety about one or more social situations in
which the individual is exposed to possible scrutiny by others.
E.g., social interactions: having a conversation, being observed:
eating or drinking, or performing in front of others: giving a speech.
B. The individual fears that he or she will act in a way or show
anxiety symptoms that will be negatively evaluated (e.g., be
humiliated, embarrassed, or rejected) or will offend others.
C. Is the same as "B" in DSM-IV-TR.
D. Remains the same.
E. The fear or anxiety is out of proportion to the actual threat posed
by the social situation.
DSM V
F. Remains the same.
G. The same as "E" in DSM-IV-TR (impairment in functions).
H. The same as "G" in DSM-IV-TR (not due to substance induced).
I. The disturbance is not better accounted for by another mental
disorder.
J. If another medical condition (e.g., stuttering, Parkinson's disease,
obesity, disfigurement from burns or injury is present, the fear,
anxiety, or avoidance is unrelated or is out of proportion to it).
Specify if: performance only; selective mutism.
Friends
Reluctant to join
group activities
Loneliness
Shy, quiet
Peer victimization
(Siegel, La Greca,
Harrison 2009)
School
Reading aloud
Request for assistance
Unstructured peer
encounters
Gym activities
Working in groups
Test taking
Eating in the Cafeteria
Home
Avoidance
of
extended family
gatherings, answering
the phone or doorbell
Refuse to order for
themselves in
restaurants
Lag behind peers in
meeting
developmental
challenges
Shows that combination therapy offers best chances for positive outcomes
If we have to choose one, CBT had better outcomes
Can help to inform reluctant parents about meds
Class Survey:
Diagnosing
Cartoon
Characters
58%
Generalized
Anxiety
Disorder
47% OCD
What diagnosis would you give to Gurgle (Finding Nemo)?
32%
Specific
Phobia
37% Social
Phoba
32% GAD
53% OCD
What diagnosis would you give to Rabbit (Winnie the Pooh)?
58%
Separation
Anxiety
Disorder
37% GAD
What diagnosis would you give to Daffy Duck?
26% OCD
53% GAD
What diagnosis would you give to Lion (Wizard of Oz)?
32% Social
Phobia
References
Albano, A. M., Chorpita, B. F., & Barlow, D. H. (2003). Childhood Anxiety Disorders. In
Barkley, R. A. & Mash, E. J. Editor (Ed.)., Child psychopathology, 2nd edition, pp. 279329. New York: Guilford Press.
American Psychiatric Association (2007). Diagnostic and Statistical Manual of Mental
Disorders: Fourth Edition: Text Revision. Washington, DC.
American Psychiatric Association, The future of psychiatric diagnosis. (2012). DSM-V
Development. Retrieved from http://www.dsm5.org/Pages/Default.aspx
Andrews G, Hobbs MJ, Borkovec TD, Beesdo K, Craske MG, Heimberg RG, Rapee
RM, Ruscio AM, Stanley MA. Generalized Worry Disorder: A review of DSM-IV
Generalized Anxiety Disorder and Options for DSM-V. Depression & Anxiety, 2010;
27:134-147.
AnxietyBC (2012, June 26). Jacob monologue. Retrieved October 12, 2012 from
http://youtube.com/4RSdV9R8wXQ
References
AnxietyBC (2012, June 26). Christine monologue. Retrieved October 12, 2012 from
http://www.youtube.com/watch?v=dgbQ5tnTxto&feature=share&list=ULdgbQ5tnTxt
AnxietyBC (2012, June 26). Rob monologue. Retrieved October 12, 2012 from
http://www.youtube.com/watch?v=LFM8M33k2UI&feature=share&list=ULLFM8M33k2UI
Beidel, B. C., Turner, S. M., Young, B. J., Ammerman, R. T., Sallee, F. R., & Crosby, L.
(2007). Psychopathology of adolescent social phobia. Journal of Psychopathological
Behavioural Assessment 29:47-54. DOI: 10.1007/s10862-006-9021-1
Chavira, D. A.,& Stein, M. B. (2005). Childhood Social Anxiety Disorder: From
Understanding to Treatment. Children and Adolescent psychiatric clinical (14): 797-818.
Kickthefaucet (2010, April 25). Dr. Oz: What is OCD? Retrieved October 15, 2012 from
http://www.youtube.com/watch?v=_wEU-165NRY
Friends in Canada (n.d.) Friends for life: Preventing and treating anxiety in children.
Retrieved from http://www.friendsinfo.net/ca.htm
References
Grabhorn, R., Stenner, H., Stangier, U., & Kaufhold, J. (2006). Social Anxiety in
Anorexia and Bulimia Nervosa: The mediating role of shame. Clinical psychology and
psychotherapy 13:12-19. DOI: 10.1002/ccp.463
Hofmann, S. G., Moscovitch D. A., Kim, H. J., & Taylor, A. N. (2004), Changes in SelfPerception during treatment of social phobia. Journal of Consulting and Clinical
Psychology: 72: 588-596
Hudson, J.L. & Dodd, H.F. (2012). Informing Early Intervention: Preschool Predictors of
Anxiety Disorders in Middle Childhood. PLoS ONE 7(8): 1-7.
Maclean, K. L., (2004). Peaceful piggy meditation. Morton Grove, III: Albert Whitman &
Co.
OCD Center of Los Angeles (2012). http://www.ocdla.com/index.html
Siegel, R., S., Greca, A. M. L., & Harrison, H. M. (2009). Peer Victimization and social
anxiety in adolescents: prospective and reciprocal relationship. Journal of Youth
Adolescence (38):1096-1109.
References
Steffloverrsyou82 (2010, Dec 13). Scaredy Squirrel Read Aloud. Retreived
October 12, 2012 from http://youtu.be/DasoZb0cvdE.
Walkup, J.T., Albano, A.M., Piacentini, J., Birmaher,B., Comton, S.N., Sherrill J.T.,
Ginsburg, G.S., Rynn, M.A., McCracken, J., Waslick, B., Iyengar, S., March, J.S., &
Kendall, P.C. (2008). Cognitive Behavioral Therapy, Sertraline, or a Combination in
Childhood Anxiety. The New England Journal of Medicine, 359(26): 2753-2766.