Saturday, February 21, 2015

Anxiety Disorders in Children and Adolescents

Tracy L. Morris and John S. March edited Anxiety Disorders in Children and Adolescents, Second Edition in 2004. This text contains 17 chapters written by seventeen groups of professionals. Like all such texts, readability is somewhat variable from chapter to chapter and redundancies occur. As a lay person rather than a trained psychological practitioner, this repetition did not bother me as much as it might for someone more well versed. The intended audience of the book is both practitioners and parents, a diverse population.

The book is divided into three sections: foundations, disorders and treatments. The treatments section is, in large part, a review of information found within the disorder chapters. The writing is such that one could read a single chapter of interest and gain the requisite information desired. While it is a decade old, the DSM has undergone a further revision, and a great deal of research has gone on in the intervening years, it still offers some useful insights. Disorders covered include: generalized anxiety disorder, social phobia, separation anxiety disorder, panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, specific phobia and selective mutism. These chapters are likely to be the most interesting to readers looking for information about a disorder. The chapters do present outlines of treatments, for specific CBT (Cognitive Behavior Therapy) you would need to look elsewhere.

General points of interest:
  • All anxiety disorders have multiple causes and multiple pathways.
  • Treatment with CBT is the gold standard; medication can be added to severe cases and should not be assumed to be a long-term solution, nor should medication alone be used as treatment.
  • Not enough clinicians are available to provide CBT to individuals who need it.
  • Nearly all children and adolescents with an anxiety disorder have comorbid conditions including, but not limited to, other anxiety disorders, ADHD, and depression.
  • Untreated anxiety significantly increases the likelihood of substance abuse, failure in school including failure to complete high school, and self-harm or suicide. Treated properly, the vast majority of patients advance to mild/moderate anxiety or no clinically identifiable disorder.
  • Up to 15% of children and adolescents may suffer from an anxiety disorder.
  • Children and adolescents represent an understudied group and more clinical studies need to be performed to better understand how to best treat these conditions.
We owe it to our children to stop being afraid of mental illness and start implementing appropriate treatment. If a child or adolescent in our purview exhibits symptoms, we owe it to him or her to try and secure effective treatment. This may mean educating parents, providing free or sliding scale services and increasing the availability of quality intervention providers.

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