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 Underestimated Likelihood x Harm
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.