Where does anxiety come from? While there are still limitations to our understanding, we know that anxiety is not caused by one specific factor, but rather is the result of a dynamic interaction between multiple factors. Many factors influence childhood development of anxiety including:
- Genetics: There is strong research support to suggest that there is a hereditary component of anxiety. In fact, studies have shown that children with anxiety disorders are much more likely to have a parent who also has an anxiety disorder.
- Temperament: Temperament refers to the personality or the characteristics we are born with. Children with anxiety tend to have a withdrawn and reserved temperament. They may take a longer time than to communicate with strangers, prefer to be physically close to care givers, and be more reserved or controlled in social interactions than other same age peers. Children with this temperament also tend to cope with stressors by avoiding things they find threatening and therefore, can become upset or withdrawal when they are faced with something new.
- Parent-Child Relationship: Given the likelihood that parents of a child with anxiety may also experience anxiety themselves, a child’s anxious behaviors may be learned through observing and modeling their parent’s reactions to stressors. Further, a parent who is anticipating danger will likely make strong efforts to protect their child from threat, which may inadvertently make it easier for the child to avoid things that make them feel anxious/afraid. Interestingly, this is a reciprocal process, which means that observing their child’s avoidance may also increase a parent’s urgency to protect them.
- Exposure to Negative Life Experiences: In general, individuals living in an environment of adversity have a greater likelihood of experiencing negative events that serve to reinforce their perception of the world as threatening or dangerous. While negative life experiences are likely to affect any child, a child with a withdrawn or reserved temperament may be more likely to take in messages learned from these experiences. On the other hand, children with a withdrawn or reserved temperament are likely to avoid situations that they interpret as threatening which protects them from genuine risk, but also limits their exposure to more mild risks and consequently reinforces their tendency to continue to avoid.
Why is treatment important? Research indicates that children experiencing anxiety disorders may also experience significant impacts on their functioning with peers, at school, and in extracurricular activities. Further, families of children who experience significant anxiety are also impacted in their functioning as a unit.
What can I expect for treatment? Treatments for children and adolescence experiencing anxiety disorders that have strong research to support their effectiveness generally fall under the category of skills-based or cognitive-behavior treatments (CBT). There are many approaches to treatment that fall in this category and can be discussed more specifically with your treating clinician to better understand which program would best address the child or adolescent’s individual needs. Generally these programs primarily include:
- Psychoeducation- learning about how anxiety and our thoughts, feelings, and behaviors all work
- Cognitive restructuring- identifying patterns of thinking that may be getting us “stuck” and learning to consider alternate perspectives
- Relaxation techniques- learning specific skills to help slow down our bodies and make experiencing our emotions more manageable so we can learn to approach rather than avoid them
- Gradual exposure- collaboratively exploring feared outcomes with the clinician to create a plan for slowly learning to approach rather than avoid them
- Additional Learning can include: assertiveness, social skills, and problem solving
Does treatment work? Structured programs like the one described have been shown to show significant reductions in disorder and symptoms. Overall, skills-based treatment programs result in approximately 55-60% of children recovering from an anxiety disorder. These results have also been shown to continue for several years after completing treatment.
Rapee, R. M., Schniering, C. A., & Hudson, J. L. (2009). Anxiety disorders during childhood and adolescence: Origins and treatment. Annual Review of Clinical Psychology, 5(1), 311-341. doi:10.1146/annurev.clinpsy.032408.153628
Michelle Meleka, M.S.