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Chapter 2. Anxiety Disorders in Children and Adolescents

Tami D. Benton, M.D.; Laura E. Sanchez, M.D.
DOI: 10.1176/appi.books.9781585622986.250519

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Excerpt

Children with anxiety disorders show a wide range of symptoms ranging from mild worries to overwhelming distress. The goal of treatment should never be the complete elimination of the subjective symptoms of anxiety in the child. The ability to experience anxiety under appropriate circumstances is adaptive and protective. Thus, appropriate goals for treatment are 1) to diminish the child's anxiety and its associated symptoms to the point that they no longer interfere with the child's functioning in social and academic spheres, the family's functioning, or normal development; 2) to improve the child's and the family's ability to identify and manage unproductive harmful worrying; and 3) to maximize the child's ability to experience anxiety without having to express the anxiety in dysfunctional ways.

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Table Reference Number
Table 2–1. Dosing guidelines for the use of anxiolytic agents in children and adolescents

References

Abikoff H, McGough J, Vitiello B, et al: Sequential pharmacotherapy for children with comorbid attention-deficit/hyperactivity and anxiety disorders. RUPP ADHD/Anxiety Study Group. J Am Acad Child Adolesc Psychiatry 44:418–427, 2005
[PubMed]
 
Albano AM, Malliok R, Tourain K, et al: Children and adolescents with social anxiety disorder: school refusal and improvement with venlafaxine ER relative to placebo. Eur Neuropsychopharmacol 14 (suppl 3):S307–S308, 2004
 
American Academy of Child and Adolescent Psychiatry: AACAP Official Action Practice Parameters for the Assessment and Treatment of Anxiety Disorders. J Am Acad Child Adolesc Psychiatry 32:1089–1098, 1997
 
Barrett PM, Dodds MR, Rapee RM: Family treatment of childhood anxiety: a controlled trial. J Consult Clin Psychol 64:333–342, 1996
[PubMed]
 
Bernstein GA, Borchardt CM, Perwien AR, et al: Imipramine plus cognitive-behavioral therapy in the treatment of school refusal. J Am Acad Child Adolesc Psychiatry 39:276–283, 2000
[PubMed]
 
Beidel DC, Turner SM, Morris TL: Behavioral treatment of childhood social phobia. J Consult Clin Psychol 6:1072–1080, 2000
 
Biederman J, Baldessarini RJ, Wright V, et al: A double-blind placebo controlled study of desipramine in the treatment of ADD, I: efficacy. J Am Acad Child Adolesc Psychiatry 28:777–784, 1989a
 
Biederman J, Baldessarini RJ, Wright V, et al: A double-blind placebo controlled study of desipramine in the treatment of ADD, II: serum drug levels and cardiovascular findings. J Am Acad Child Adolesc Psychiatry 28:903–911, 1989b
 
Birmaher B, Axelson DA, Monk K, et al: Fluoxetine for the treatment of childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry 42:415–423, 2003
[PubMed]
 
Black B, Uhde TW: Treatment of elective mutism with fluoxetine: a double-blind placebo-controlled study. J Am Acad Child Adolesc Psychiatry 33:1000–1006, 1994
[PubMed]
 
Bornstein B: The analysis of a phobic child: some problems of theory and technique in child analysis. Psychoanal Study Child 3:181–226, 1949
 
Campo JV, Perel J, Lucas A, et al: Citalopram treatment of pediatric recurrent abdominal pain and comorbid internalizing disorders: an exploratory study. J Am Acad Child Adolesc Psychiatry 43:1234–1242, 2004
[PubMed]
 
Casey RJ, Berman JS: The outcome of psychotherapy with children. Psychol Bull 98:388–400, 1985
[PubMed]
 
Chavira DA, Stein MB: Combined psychoeducation and treatment with selective serotonin reuptake inhibitors for youth with generalized social anxiety disorder. J Child Adolesc Psychopharmacol 12:47–54, 2002
[PubMed]
 
Cobham VE, Dodds MR, Spence SH: The role of parental anxiety in the treatment of childhood anxiety. J Clin Child Psychol 27:459–468, 1998
 
Compton SN, Grant PJ, Chrisman AK, et al: Sertraline in children and adolescents with social anxiety disorder: an open trial. J Am Acad Child Adolesc Psychiatry 40:564–571, 2001
[PubMed]
 
Dummit SE, Klein RG, Tancer NK, et al: Fluoxetine treatment of children with selective mutism: an open trial. J Am Acad Child Adolesc Psychiatry 35:615–621, 1996
[PubMed]
 
Flannery-Schroeder EC, Kendall PC: Group and individual cognitive-behavioral treatments for youth with anxiety disorders: a randomized clinical trial. Cognit Ther Res 24:251–278, 2000
 
Flannery-Schroeder E, Choudhury MS, Kendall PC: Group and individual cognitive behavioral treatments for youth with anxiety disorders: 1-year follow-up. Cognit Ther Res 29:253–259, 2005
 
Fraiberg S: Selected Writings. Columbus, Ohio State University Press, 1987
 
Gardner RA: Therapeutic Communication With Children. New York, Jason Aronson, 1977
 
Garfinkel BD, Wender PH, Sloman L, et al: Tricyclic antidepressant and methylphenidate treatment of attention deficit disorder in children. J Am Acad Child Adolesc Psychiatry 22:343–348, 1983
[PubMed]
 
Geddes J, Reynolds S, Streiner D, et al: Evidence-based practice in mental health (editorial). BMJ 315:1483–1484, 1997
[PubMed]
 
Ginsburg GS, Drake KL: School-based treatment for anxious African American adolescents: a controlled pilot study. J Am Acad Child Adolesc Psychiatry 41:768–775, 2002
[PubMed]
 
Hayward C, Varady S, Albano AM, et al: Cognitive-behavioral group therapy for social phobia in female adolescents: results of a pilot study. J Am Acad Child Adolesc Psychiatry 39:721–726, 2000
[PubMed]
 
Kendall PC: Treating anxiety disorders in children: results of a randomized clinical trial. J Consult Clin Psychol 62:100–110, 1994
[PubMed]
 
Kendall PC, Braswell L: Medical application of cognitive behavioral interventions with children. J Dev Behav Pediatr 7:257–264, 1986
[PubMed]
 
Kendall PC, Southam-Gerow MA: Long-term follow-up of a cognitive behavioral therapy for anxiety disordered youth. J Consult Clin Psychol 64:724–730, 1996
[PubMed]
 
Kendall PC, Chansky TE, Friedman M, et al: Treating anxiety disorders in children and adolescents, in Child and Adolescent Therapy—Behavioral Procedures. Edited by Kendall PC. New York, Guilford, 1991, pp 131–164
 
Kendall PC, Kortlander E, Chansky TE, et al: Comorbidity of anxiety and depression in youth: treatment implications. J Consult Clin Psychol 60:869–880, 1992
[PubMed]
 
Kendall PC, Flannery-Schroeder E, Panichelli-Mindel SM, et al: Therapy for youth with anxiety disorders: a second randomized trial. J Consult Clin Psychol 65:366–380, 1997
[PubMed]
 
Layne AE, Bernstein GA, Egan EA, Kushner MG: Predictors of treatment response in anxious-depressed adolescents with school refusal. J Am Acad Child Adolesc Psychiatry 42:319–326, 2003
[PubMed]
 
Leonard HL, Rapoport JL: Separation anxiety, overanxious, and avoidant disorders, in Textbook of Child and Adolescent Psychiatry. Edited by Weiner JM. Washington, DC, American Psychiatric Press, 1991, pp 311–322
 
Marans S: Psychoanalytic psychotherapy with children: current research trends and challenges. J Am Acad Child Adolesc Psychiatry 28:669–674, 1989
[PubMed]
 
March J, Wells K: Combining medication and psychotherapy, in Pediatric Psychopharmacology: Principles and Practice. Edited by Martin A, Scahill L, Charney DS, et al. London, Oxford University Press, 2003, pp 426–446
 
Masi G, Toni C, Mucci M, et al: Paroxetine in child and adolescent outpatients with panic disorder. J Child Adolesc Psychopharmacol 11:151–157, 2001
[PubMed]
 
McDermott JF, Werry J, Petti T: Anxiety disorders of childhood and adolescence, in Treatments of Psychiatric Disorders: A Task Force Report of the American Psychiatric Association, Vol 1. Washington, DC, American Psychiatric Association, 1989, pp 401–446
 
Mendlowitz SL, Manassis K, Bradley S, et al: Cognitive-behavioral group treatments in childhood anxiety disorders: the role of parental involvement. J Am Acad Child Adolesc Psychiatry 38:1223–1229, 1999
[PubMed]
 
Muratori F, Picchi L, Bruni G, et al: Two-year follow-up of psychodynamic psychotherapy for internalizing disorders in children. J Am Acad Child Adolesc Psychiatry 42:331–339, 2003
[PubMed]
 
Muris P, Bogie N, Hoogsteder A: Effects of an early intervention group program for anxious and depressed adolescents: a pilot study. Psychol Rep 88:481–482, 2001
[PubMed]
 
Nauta MH, Scholing A, Emmelkamp PM, et al: Cognitive-behavioral therapy for children with anxiety disorders in a clinical setting: no additional effect of a cognitive parent training. J Am Acad Child Adolesc Psychiatry 42:1270–1278, 2003
[PubMed]
 
Pearson A: Handbook of Psychoanalysis. New York, Basic Books, 1968
 
Pina AA, Silverman WK, Fuentes RM, et al: Exposure-based cognitive-behavioral treatment for phobic and anxiety disorders: treatment effects for phobic and anxiety disorders: treatment effects and maintenance for Hispanic/Latino relative to European American youths. J Am Acad Child Adolesc Psychiatry 42:1179–1187, 2003
[PubMed]
 
Research Unit on Pediatric Psychopharmacology (RUPP) Anxiety Study Group: Fluvoxamine for the treatment of anxiety disorders in children and adolescents. N Engl J Med 344:1279–1285, 2001
 
Robert R, Blakeney PE, Villarreal C, et al: Imipramine treatment in pediatric burn patients with symptoms of acute stress disorder: a pilot study. J Am Acad Child Adolesc Psychiatry 38:873–882, 1999
[PubMed]
 
Ryan TJ, Antman EM, Brooks NH, et al: 1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). J Am Coll Cardiol 34:890–911, 1999
[PubMed]
 
Rynn MA, Siqueland L, Rickels K: Placebo-controlled trial of sertraline in the treatment of children with generalized anxiety disorder. Am J Psychiatry 158:2008–2014, 2001
[PubMed]
 
Rynn MA, Kunz NR, Lamm LW, et al: Venlafaxine XR for treatment of GAD in children and adolescents. Paper presented at the American Academy of Child and Adolescent Psychiatry Annual Meeting. San Francisco, CA, October 24, 2002
 
Sarnoff CA: Psychotherapeutic Strategies in the Latency Years. Northvale, NJ, Jason Aronson, 1987
 
Seedat S, Stein DJ, Ziervogel C, et al: Comparison of response to a selective serotonin reuptake inhibitor in children, adolescents, and adults with post traumatic stress disorder. J Child Adolesc Psychopharmacol 12:37–46, 2002
[PubMed]
 
Silverman WK, Kurtines WM, Ginsburg GS, et al: Treating anxiety disorders in children with group cognitive-behavioral therapy: a randomized clinical trial. J Consult Clin Psychol 67:995–1003, 1999
[PubMed]
 
Tyson RL: Notes on the analysis of a prelatency boy with a dog phobia. Psychoanal Study Child 33:427–460, 1978
[PubMed]
 
Wagner KD, Berard R, Stein MB, et al: A multicenter, randomized, double-blind, placebo-controlled trial of paroxetine in children and adolescents with social anxiety disorder. Arch Gen Psychiatry 61:1153–1162, 2004
[PubMed]
 
Weiss B, Weisz JR: The impact of methodological factors on child psychotherapy outcome research: a meta-analysis for researchers. J Abnorm Child Psychol 18:639–670, 1990
[PubMed]
 
Weisz JR, Weiss B, Alicke MD, et al: Effectiveness of psychotherapy with children and adolescents: a meta-analysis for clinicians. J Consult Clin Psychol 55:542–549, 1987
[PubMed]
 
Wilens TE, Biederman J, Baldessarini RJ, et al: Cardiovascular effects of therapeutic doses of tricyclic antidepressants in children and adolescents. J Am Acad Child Adolesc Psychiatry 35:1491–1501, 1996
[PubMed]
 
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