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					ANXIETY
DISORDERS IN
CHILDHOOD      Anxiety is a
              common
              disorder
              amongst
              children that
              often goes
              undiagnosed.




ARE YOU WORRIED?
 We all worry from time to time, however it becomes a problem when the anxiety persists. It becomes clinically
significant when it impedes daily functioning. It is a common disorder experienced by children but is often
undiagnosed and under reported.

In DSM-IV Anxiety Disorder refers to a              activities. It is difficult to control the worry. it
number of overlapping subcategories including:      causes clinically significant distress and
Generalized Anxiety Disorder, Panic Disorder        impairment in social, academic or other areas of
with or without agoraphobia, Post Traumatic         function.
Stress Disorder, Obsessive Compulsive               Associated behaviour : Restlessness, feeling
Disorder, Social Phobia, Specific phobia,           on edge, poor concentration, fatigue, irritability,
Separation anxiety disorder and Acute Stress        muscle tension, sleep disturbance.
Disorder                                            Persistence: at least 6 months.
                                                    It has a prevalence rate of 2-10% and occurs
The most common of these are:                       with ADHD (but with less impulsivity) in about
- Generalized Anxiety Disorder                      20-24% of cases.
- Social Phobia                                     Mean onset: at age 9 but often occurs earlier as
- Separation Anxiety Disorder                       well. These disorders overlap, so something
                                                    that might begin as generalized anxiety disorder
This leaflet will describe these three categories   might become more specifically described as a
of the disorder including their definitions,        social phobia.
associated behaviour, persistence before
                                                                                                           Generalized anxiety disorder: a
diagnosis. There will be a generalized list of
                                                                                                           persistent and excessive anxiety
treatment and management strategies.
                                                                                                           and worry about a number of
Generalized Anxiety Disorder redefined in
                                                                                                           events or activities.
DSM-IV as a persistent and excessive anxiety
and worry about a number of events or



                                                                           [1]
Social Phobia: the persistent fear of one or                                                          - Work on strategies to help them keep
more social or performance situations where        Anxiety attacks are painful                          their cool.
exposure to unfamiliar people or scrutiny from
others may occur. The child should be able to
                                                   and embarrassing                                   - provide students with a safe area in the
                                                                                                        classroom or the school
                                                   Students will engage in behaviours to avoid the
have age - appropriate relationships with                                                             - Consistent behaviour management
                                                   occurrence of an attack such as avoiding
familiar people but the anxiety will manifest                                                         - Collaboration between all staff
                                                   people, joining “tough” groups, thrill seeking
itself in peer and adult settings.                                                                    - A safe place and safe person at school
                                                   and engaging in substance use thus treatment
Associated behaviours - crying, tantrums,                                                               who they can talk to
                                                   and management should focus on reducing the
freezing, shrinking from unfamiliar people.
                                                   effect of the anxiety inducing situation.
Individuals facing experiencing social phobia
engage in behaviour that enable the avoidance
of the situation. Thus the crying or tantrum or    Professionally offered options:
“meltdown” may occur just before the               Cognitive Behavioural Therapy
particular social or performance situation.        where one works on changing the automatic
[Note: Selective mutism seems to be an             thoughts and feelings resulting from their
expression of social phobia as it allows the       thoughts about the anxiety. Therapy also
                                                   involves learning techniques that reduce or
child to avoid the social performance of talking
                                                   replace the negative behaviour patterns.
in public.]
                                                   Psychotherapy focuses on the resolution
Mean onset: start of high school but, may not
                                                   of conflicts and stresses
have have been recognised earlier.
                                                   Behavioural therapy concentrates on
Persistence: at least 6 months
                                                   techniques such as guided imagery,
    Separation Anxiety Disorder describes the      relaxation training, progressive
anxiety when separation from an attachment         desensitization and flooding as a way to
figure occurs or is expected. it includes worry    reduce anxiety responses or address
that something bad will happen to the              specific phobias as in certain social
attachment figure or that something will lead to   situations.
separation from the attachment figure.
Associated Behaviours include being fearful
and reluctance to be alone (excessive
                                                   Management at Home and
clinginess), as well as tummy aches, child         School should focus on identifying and
crying, a pre-occupation with reunion with the     eliminating or reducing the source of anxiety.
attachment figure, headaches, nausea, truancy,
                                                   - The child can keep a diary of current
isolation and feelings of fear.
                                                     worries and regularly review their
Mean Onset: It occurs most commonly with
                                                     concerns with a helpful and patient adult.
infants and toddlers but sometimes happens
                                                     Retrospective analysis such as this can
with older individuals.
                                                     help desensitize the student to the
Persistence: at least 4 weeks before being
                                                     anxiety inducing concern or and help
diagnosed.
                                                     alleviate the pattern of anxiety.

DIAGNOSIS                                          - If the specific anxiety is known, students
                                                     should practice the task whether it’s a
If you should suspect that a student is              test or a performance.
experiencing significant anxiety, refer the        - Establish a safe environment within the
student to the in school team so that he or she      classroom; avoid causing public
                                                     embarrassment to any student.                      Students with
can be diagnostically evaluated preferably by a                                                         parents with
multidisciplinary team of professionals.           - Praise the child for the things they do            anxiety
Evaluation might include a questionnaire as          well, play up their competencies, find             disorder are
well as an interview in which the professional       ways and roles whereby the student can             more likely to
observes the student as he or she responds.          feel needed. AVOID FALSE PRAISE!                   develop
                                                                                                        anxiety
                                                                                                        disorder.

                                                          • John, S.C.F. (2005). Distinguishing
   Anxiety can be treated                              Anxiety in Childhood: clinical and cognitive    • http://helpguide.org/mental/generaliz
   easily through consistent treatment                 characteristics (Doctoral dissertation).          ed_anxiety_disorder.htm
   thus reducing development into more                 Available from Dissertations and Theses
                                                                                                       • http://helpguide.org/mental/social_an
   serious and debilitating adult mental               database. (UMI No. 0494076798)
                                                                                                         xiety_support_symptom_causes_tre
   disorders. As students with parents                    • Levine, M, Educational Care,                 atment.htm
   with anxiety disorder are more likely to            Educators Publishing Service, 1994
   develop an anxiety disorder, the best
   course of treatment would include a
   component of family therapy as well as            • http://www.keepkidshealthy.com/wel
   therapy for the parent in question.                 come/conditions/anxiety_disorders.ht
        Sources and helpful links:                     ml




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posted:7/21/2011
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