Treatments That Work for Anxiety Disorders for Children and Adolescents

Parents ask me often, "Is there any way to know what actually works to treat my child's anxiety?" The simple answer is 'yes,' but the more complicated answer about how we arrive at 'yes' is a bit more interesting. To understand the more-complicated answer, it's important to know more about the term 'meta- analysis.' A meta-analysis is a large analysis of many studies or analyses - bringing a large amount of data together under strict requirements to look at conclusions more broadly. About 15 years ago, psychologists Ollendick and King conducted a very influential meta-analysis of evidence-based psychosocial treatments for child and adolescent (referred to as youth from this point forward) anxiety disorders. They concluded that psychosocial treatments (i.e., cognitive and behavior therapies) were likely effective but that better methods and further research were needed before stronger conclusions were reached. In the interim years, methods for evaluating treatments have improved dramatically and strong conclusions now support the effectiveness of cognitive behavior therapy (CBT). This is explained further below, but first let's look at the scope of the problem.

Anxiety disorders are one of the most common disorders in youth. Depending on the report, in the United States between 5%-10% of youth have an anxiety disorder with some studies reporting as high as 20% (ref Silverman). The same article cites, a study based on surveys in New Zealand and Australia reporting between 3% and 44% of youth have an anxiety disorder! In these studies, the anxiety disorders include separation anxiety/school refusal (sometimes called school phobia), social anxiety, specific phobias (e.g., needles, animals, heights, etc.), and overanxious/generalized anxiety. Three anxiety disorders together - social anxiety, separation anxiety, and generalized anxiety - make up what clinicians call the 'anxiety triad' and are highly prevalent among youth. Most youth who have symptoms of one of these disorders often have symptoms of the other two. Similar prevalence rates in the 3% to 10% range occur for OCD (ref March and Storch, Drew article).

In 1998, Ollendick's and King's meta-analysis showed that behavioral procedures like imaginal (using guided instruction to imagine a real-life event) and in vivo (real life) desensitization (exposure therapy that uses small steps to help the brain turn off alarms related to a specific trigger) were "probably efficacious " (such a cautious statement!) for childhood phobias and that these same procedures were similarly effective with and without family anxiety management training. In 1998, the authors concluded (as researchers are wont to do) - that more research with better methodology was needed. Thankfully, better studies with better methodologies occurred, producing the updated meta-analysis by Silverman and colleagues and numerous publications about separate, effective OCD treatment for youth by March, Storch, and many others.

Studies included in the meta-analysis by Silverman and her colleagues were categorized from the most rigorous - randomized prospective clinical trials (random assignment, blinded assessments, inclusion/exclusion, adequate sample, state-of-the-science diagnostics, well-established and sound measures with clearly defined interventions and adherence in implementing the intervention). These very 'tight' studies are Type 1 studies. Other studies included ranged from 2, to 6. As the number descended, criticism of methods increased. For example, studies designated Type 6 were case studies or opinion papers. The carefully designed studies, which contributed greatly to the conclusions reached, had qualities like strict inclusion/exclusion criteria (for example, youth with low IQ, psychotic disorder, unstable family life, co-occurring mental disorders, and similar characteristics that could affect the viability of a treatment were excluded).

Compared to the tentative conclusions of the 1998 analysis by Ollendick and King, Silverman and her colleagues concluded: "The considerable progress made shows that cognitive behavioral treatments, in individual or group formats, with and without parent involvement lead to positive treatment outcomes in children and adolescents with phobic and anxiety disorders." Similar conclusions by March and Storch for OCD, support CBT's effectiveness for all anxiety disorders in youth.

These strong improvements in methodology and treatment study outcomes that support CBT open the way for more-detailed questions about what works in CBT. Scientists want to further refine information about treatment (e.g., how much of a treatment is needed specifically, what is it about the treatment that works, what other factors affect whether the treatment works, whether medicine should be included in treatment, which aspects of treatment over what period of time make the most difference, and other similar questions). From studies of specific aspects of CBT, we know, for example, that it is important to reduce anxious self talk. Also, a parent's anxiety or depression can negatively affect treatment. Refining treatment questions (what works/what doesn't) is a good thing because it helps provide better answers for families and more specific direction for treatment providers. How much treatment, the role played by medications, how to measure precisely, and other methodological issues will occupy researchers for awhile, but it's great as a clinician to be able to offer effective, evidence-based CBT interventions for anxiety disorders in youth.

At NeuroScience, Inc., we contribute to research while we practice as clinicians. One of our current studies explores the effects of a novel medication on the disorders of the 'anxiety triad' mentioned above. To learn more about this study or consult with one or our experts about treating youth anxiety disorders, please contact us at 703-787-9090 or visit our Youth Anxiety Disorder website.

Keith E. Saylor, Ph.D., Sc.M., the President and CEO of NeuroScience, Inc., received his Ph.D. in Health Psychology from Stanford University and his Master's degree in Public Health from the School of Hygiene and Public Health, Johns Hopkins University. Dr. Saylor is a licensed clinical psychologist (Virginia) who maintains active research and private practices.

Original article

Symptoms of Anxiety in Children

Many people often misinterpreted anxiety and fear, wherein the fact is that these two common emotions are just the same. Children with anxiety exhibit symptoms that are also present when fear is being felt. Parents must be alert at observing these symptoms in order for them to resolve while it's still earlier. There are times when the parents overreact on what their children's response on anxiety. Instead they are being comfort; they punish the child which is the worst thing to do when handling the symptoms of anxiety in children.

A child with anxiety often manifested with physical symptoms such as intense and irrational fear, headaches, nausea and vomiting, abdominal discomfort and muscle tensions. These symptoms can be an indication of other medical conditions. Parents are still responsible of noticing these symptoms for prompt management. Children with anxiety disorders often have behavioral symptoms as manifested by nervousness, jittery, irritability, inability to concentrate and hypersensitivity for no apparent reason. These symptoms are true in children with generalized anxiety disorders where they always wrap up with irrational fears and unrealistic worry about day to day life. With these symptoms manifested by children with anxiety, it can affect their lives in many aspects. Even if the children experiencing anxiety may realize that his emotions are overwhelming, they'll still have the hard time to cope their stress and tensions. Managing and controlling their exaggerated emotions are seem very difficult to do so since they are not yet capable of thinking what are the ways to handle their own problems.

This problem is also present in adult when anxious but mostly children are demonstrating these symptoms. Also, a child may have poor school performance and/or hesitate to go to school because of fear that he will be discriminated by his classmates and teacher. This behavioral problem is common among children with separation anxiety who are experiencing intense fear of being separated from their parents or caretaker. A child may afraid to participate in classroom activities and would rather to spend time alone in studying the academic subjects. This is a tough problem when dealing a child who is not open to tell his problems or what has been bothering with them. Parents may find it difficult how to handle the child's anxiety for he is keeping his own life issues.

For children with phobias, the feeling irrational fear is the always the symptom. A child becomes panicky when exposed to something that he is most afraid of. This can be object, animal, person or life events. With the tremendous fear he felt on a particular situation, he is likely to avoid it. A child's phobia is enough to cause him to manifest physical symptoms like heart palpitations; sweating; trembling; shortness of breath or even a feeling of being smothered as though one can't breathe; chest pain; dizziness; a fear of losing control and sane or even dying.

If your child is suffering from theses symptoms you may refer him to the nearest psychotherapist or pediatrician for you to be guided on what are the different approaches and therapies to manage and handle the anxiety of your child.

Please check out my blog on anxiety in children treatment.

Michael Workinstiney is a professional father who likes to write a lot about fatherhood and parental coaching. He likes meeting parents old and new and train them proven and effective ways of raising their children.

Original article

Anxiety Symptoms in Children To Watch Out For

According to studies, about 4 million adult Americans suffer from an anxiety disorder. It usually begins in childhood. If left unmanaged or untreated, this would be carried on for years. It is more common in women than in men.

Although the exact cause of an anxiety disorder is unknown, it is believed that it is caused by several factors. Research shows that genetics play a role in the development of anxiety. A person with a family history of an anxiety disorder increases his chance of developing an anxiety disorder. Another factor is physiologic, particularly in the brain. People with an anxiety disorder has abnormal levels of neurotransmitters, specifically serotonin, dopamine, norepinephrine, and Gamma-aminobutyric Acid (GABA). Abnormal levels of those neurotransmitters alter how the brain reacts to a stimulus. The last factor would be environmental. Anxiety may develop primarily because of traumatic events, and use and withdrawal of addictive substances.

Even though anxiety disorders are psychologic, it also results to physical symptoms. The child would feel an excessive worry to a particular situation, which is primarily due to abnormal levels of neurotransmitters in the brain. He would also have an unrealistic view of problems. He is always pessimistic about something, and sometimes they may feel a sense of impending doom. He becomes restless and irritable. He may also experience muscle tension, trembling, headaches, and sweating. He also tends to lose focus, because he is excessively worried about something. Due to excess worrying, he may experience nausea and feel the urge to go to the bathroom frequently, either to defecate or urinate. Due to the stress he is experiencing, he becomes tired; however he would have trouble sleeping. He can be easily startled, since he lost his focus and his mind is wandering and focusing on something else.

When these symptoms show, it is important to help the child relax. This is achieved by teaching the proper breathing technique; letting him vent out his feelings about the certain situation; teaching him to redirect his thoughts to something that is relaxing. You, yourself, should also be calm during an anxiety attack because if you also become anxious, it may worsen the child's anxiety. You should also reassure the child that everything is going to be fine and that you are there for him no matter what happens. Also, establish an exercise routine for the child because it can help in relaxation. Ensure that the child is given proper nutrition by giving him those healthy foods that he likes. And, lastly, give a child a relaxing environment as he sleeps and make sure he gets at least 7-10 hours of sleep at night.

In today's crazy world, it's not surprising that childhood anxiety symptoms are becoming more and more prevalent. To know more about it, check out http://www.childhoodanxietydisorderhelp.com/

Original article

Generalized Anxiety Disorder In Children

A few weeks ago I knew I was in for it. I left talk radio on as my ten year old and I were on our way to grandma's house. It seemed like a harmless enough story about the discovery of water on the moon. I've learned to tune away quickly from stories about global climate change, swine flu and war, but this didn't seem like a dangerous topic. I mean it's not even about something on this world!

But then one of scientists happened to mention in passing that knowing which planets might have water might be useful since our planet only had a limited time to exist. "Or, in case one of those world destroying comets happens to be spotted heading our way," the moderator joked. And right then I knew I was in for it.

You see I'm the father of a ten year old with GAD: Generalized Anxiety Disorder. So for the next three weeks I was bombarded by questions about how long the Earth had to live. How would we get off of Earth when the comet came? Could we survive in space? Would Grandma be able to go on the space ship too, even though she smokes? How would we know if a comet or meteorite was headed our way? Could we stop it somehow from hitting the Earth? Etc. Etc.

When you live with generalized anxiety disorder in children you get used to spending hours putting out fires like this. It doesn't take much to get them going. This hyperactive worrying is really the main part of generalized anxiety disorder in children but here are some of the other typical symptoms to watch out for if you think your kid might have GAD:

Stomachaches and Headaches

Children with generalized anxiety disorder literally worry themselves sick. They often, especially on school days, complain of stomachaches. Because school is the focus of most kids' lives, GAD children worry about the things that happen there: will they make friends, keep friends, do well on tests, do well in sports, etc. My kid is on a first name basis with the school nurse-Rosie if you're wondering-and his stomachaches tend to happen on Sunday nights because school starts the next day, and on Thursdays, because Fridays are test days. It's like clockwork.

Trouble Sleeping

Insomnia is another problem that is worst on Sundays and Thursdays but it is pretty much a problem every night. A barking dog, the creak of the house, the wind blowing on the gate outside, a screeching car-any of those are enough to keep him awake. It is not unusual for me to see the light on in his room and come in to find him awake and doing nothing in particular. I used to not believe him when he said he never sleeps but now I know the truth about this slight exaggeration.

Irritability and Hyperactivity

Finally, anxiety disorder children are always seemingly wound up and tend to be very testy. This is partly because they are tired from not sleeping but also because worrying about everything, as we adults well know, can really wear you down. It's like when you are working on a big project that you are barely keeping up with. Everything seems more irritating and you are much more likely to lash out at the smallest of triggers. They are like this all the time.

If these symptoms seem to describe one of your children then you should know that there are treatments for anxiety disorder children. Although this is a condition that is likely to be with them for their whole lives, there are techniques you can learn that will help them to cope with their conditions. So don't despair. Learn more about anxiety disorders and how to treat them.

Tom Tait is focused on helping those with panic attacks. Here is more information on Anxiety Stress Disorder. There is even more information about Panic Attacks on the website Panic Attacks.

Original article