Anxiety in children
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Anxiety in Children: Prevalence, Correlates, and Treatment
Prevalence of Anxiety in Children
Anxiety disorders are among the most common mental health issues affecting children and adolescents. Epidemiological studies have reported widely varying prevalence rates, ranging from as low as 2.6% to as high as 41.2% in pre-adolescent children2. This variation is often attributed to differences in study methodologies and diagnostic criteria. Notably, anxiety disorders are more prevalent than depressive and behavioral disorders in this age group2.
Anxiety in Children with Autism Spectrum Disorder (ASD)
Children with Autism Spectrum Disorder (ASD) are particularly susceptible to anxiety. Research indicates that young children with ASD exhibit higher levels of anxiety compared to their neurotypical peers, with prevalence rates ranging from 1.6% to 62%1. Common anxiety symptoms in these children include specific, social, and generalized fears. Correlates of anxiety in children with ASD include sensory over-responsivity, sleep disturbances, aggression, and attention deficit/hyperactivity disorder (ADHD)1 6.
Emotional Competence and Anxiety
Emotional competence plays a significant role in the development and management of anxiety in children. Anxious children often struggle with emotional expression, understanding, and self-efficacy. They are less aware and accepting of their emotions and tend to use maladaptive coping strategies such as avoidance and externalizing behaviors6. These emotional challenges highlight the importance of interventions that focus on improving emotional competence to mitigate anxiety symptoms.
Cognitive-Behavioral Interventions
Cognitive-behavioral therapy (CBT) is widely recognized as an effective treatment for anxiety in children. Meta-analyses have shown that CBT significantly reduces anxiety symptoms in young children, with improvements maintained over follow-up periods3 4. CBT interventions are particularly effective in addressing behavioral inhibition and anxiety symptoms, making them a first-line treatment for youth with anxiety disorders4.
Screening and Early Intervention
Early screening for anxiety is crucial for timely intervention. The US Preventive Services Task Force recommends screening for anxiety in children and adolescents aged 8 to 18 years, citing moderate net benefits8. However, the evidence is currently insufficient to recommend screening for children younger than 7 years8. Early identification and intervention can prevent the progression of anxiety disorders and improve long-term outcomes.
Conclusion
Anxiety disorders are prevalent and impairing in children, with particularly high rates observed in those with ASD. Emotional competence deficits and maladaptive coping strategies are common among anxious children. Cognitive-behavioral interventions have proven effective in reducing anxiety symptoms, emphasizing the need for early screening and targeted treatment. Continued research is essential to refine diagnostic criteria, improve intervention strategies, and enhance our understanding of anxiety in children.
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Most relevant research papers on this topic
A Scoping Review of Anxiety in Young Children with Autism Spectrum Disorder
Young children with autism spectrum disorder (ASD) experience higher levels of anxiety, with common symptoms being specific, social, and generalized fears, and cognitive behavioral treatments show promise in reducing anxiety.
Systematic Review
Rigorous Journal
Highly CitedAnxiety in a neglected population: prevalence of anxiety disorders in pre-adolescent children.
Anxiety disorders are fairly common in pre-adolescent children, with separation anxiety disorder being the most common diagnosis, and current treatment options for this age group are limited.
Systematic ReviewHighly CitedCognitive-behavioural interventions for prevention and treatment of anxiety in young children: A systematic review and meta-analysis.
Cognitive-behavioral interventions effectively reduce anxiety in young children, improving their emotional development and school readiness.
Meta-AnalysisEvidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety
CBT is an effective first-line treatment for youth with anxiety disorders, but there are other evidence-based approaches available for those who don't respond well to CBT.
Systematic ReviewHighly CitedReview of interventions for the management of anxiety symptoms in children with ASD
A combination of pharmacotherapy, psychosocial and CBT interventions, parent education, and school-based programs can effectively manage anxiety in children with ASD.
Systematic ReviewEmotional Competence and Anxiety in Childhood and Adolescence: A Meta-Analytic Review
Anxious youth exhibit less emotional competence, less awareness of their emotions, and less self-efficacy, leading to more support-seeking and less adaptive coping strategies.
Meta-AnalysisHighly CitedAnxiety in children and adolescents with autism spectrum disorders.
Anxiety is common in children and adolescents with autism spectrum disorders and may worsen during adolescence, highlighting the need for targeted interventions and future research.
Systematic ReviewHighly CitedScreening for Anxiety in Children and Adolescents: US Preventive Services Task Force Recommendation Statement.
Screening for anxiety in children and adolescents aged 8-18 years has a moderate net benefit, but current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety in children 7 years or younger.
Systematic ReviewHighly CitedWhat do childhood anxiety disorders predict?
Childhood anxiety disorders predict a range of psychiatric disorders in adolescence, with separation anxiety disorder (SAD) being the most predictive.
Observational StudyHighly CitedChildhood anxiety disorders.
Childhood anxiety disorders are receiving increasing attention, but more research is needed to address knowledge gaps and improve treatment options.
Literature ReviewHighly Cited