Chapter 15 - Anxiety Disorders Flashcards
1
Q
What is anxiety characterized by?
A
Distress or uneasiness regarding danger, real or perceived, or concern about an upcoming stressful event
2
Q
According to Alpert and Haber (1960), how can anxiety be viewed?
A
As often facilitative and helpful
3
Q
How can anxiety serve a protective function?
A
By steering children and adults away from dangerous situations or excessive failure and disappointment
4
Q
When does anxiety become debilitative?
A
When it interferes with successful functioning in family, school, and work settings
5
Q
What role do fears play in the development of children?
A
They are integral and usually constructive
6
Q
What is the primary difference between fear and anxiety?
A
Fear pertains to imminent threats, whereas anxiety refers to worrying about future threats
7
Q
What are common worries for children throughout childhood?
A
Getting sick, failing in school, and looking foolish
8
Q
What is problematic about anxiety in children and adolescents?
A
It is common but often goes unnoticed, even by the mental health community
9
Q
How long has the mental health community been aware of anxiety problems in young people?
A
About the past 30 years
10
Q
At what stage do anxiety disorders begin to receive attention?
A
Early childhood
11
Q
What is the focus of the chapter on anxiety disorders?
A
Delineation of distinct forms of anxiety disorder
12
Q
What topics are discussed regarding anxiety disorders?
A
Diagnostic criteria, prevalence, sex differences, culture, and gender diversity
13
Q
What factors are considered in the emergence of anxiety disorders?
A
Physiological, family, societal, and peer-group factors
14
Q
What does the chapter conclude with?
A
Descriptions of successful treatments for children’s and adolescents’ anxiety disorder
15
Q
Fill in the blank: Anxiety is often considered _______.
A
[facilitative and helpful]
16
Q
True or False: Anxiety can only have negative effects on individuals.
A
False
17
Q
What is an anxiety disorder?
A
An umbrella term that includes a number of distinct disorders
18
Q
What is separation anxiety disorder?
A
Excessive distress about separating from one’s caregiver
19
Q
What does social anxiety or social phobia involve?
A
Fear of social contact, especially with unfamiliar individuals or negative evaluations
20
Q
What is a specific phobia?
A
Excessive fear of a specific situation or object, such as snakes or heights
21
Q
What characterizes panic disorder?
A
Repeated, short episodes of intense anxiety that appear suddenly and unpredictably
22
Q
What is agoraphobia?
A
Fear of crowds, often related to panic attacks
23
Q
What does generalized anxiety disorder refer to?
A
Frequent worry or fear occurring in a wide range of situations
24
Q
What is obsessive-compulsive disorder (OCD)?
A
Involves unwanted thoughts or impulses and repeated ritualistic behaviors
25
What is selective mutism?
Not speaking in some social situations where speaking is expected
26
At what age does selective mutism typically onset?
Before the child is 5 years old
27
What is the relationship between school refusal and anxiety disorders?
School refusal may manifest as separation anxiety, social anxiety, or generalized anxiety
28
What is the new category introduced in DSM-5 related to communication disorders?
Pragmatic (social) communication disorder
29
True or False: Panic disorder is commonly diagnosed in children.
False
30
Fill in the blank: School refusal is sometimes associated with _______.
anxiety disorders
31
What is the conceptual controversy regarding shyness?
Turning ordinary shyness into an illness
32
What do social critics attribute to the individual diagnosis of social anxiety?
Pressures of a mass society to conform to social norms
33
How do critics view the diagnosis of anxiety disorders?
As a means of marginalizing non-sociable individuals
34
What commonality is shared between ADHD and anxiety disorder diagnoses according to critics?
Both are seen as ways to suppress non-conformity and non-participation
35
What significant change occurred with the introduction of DSM-III in 1980?
Designation of a separate category for 'anxiety disorders of childhood'
36
What happened to the category of anxiety disorders in DSM-IV and DSM-5?
It was not retained; instead, it recognized that anxiety disorders occur across the lifespan
37
How do diagnostic criteria for anxiety disorders in children differ between DSM and ICD-10?
ICD-10 considers more conditions as anxiety disorders
38
What is a criticism of the modifications for diagnosing anxiety disorders in children?
Considered minimal, insufficient, and of limited scientific validity
39
What specific recognition was made in DSM-5 regarding anxiety disorders?
Distinct ways anxiety disorders manifest during childhood
40
What is the status of diagnostic criteria for adolescents in ICD and DSM systems?
There are no specific diagnostic criteria for anxiety disorders in adolescents
41
At what stage do many anxiety conditions, especially social anxiety disorder, emerge?
During adolescence, when peer relations increase in importance
42
Fill in the blank: The increase in anxiety disorder diagnoses is attributed to increased _______.
awareness of the problem
43
True or False: The DSM-5 introduced significant changes to the diagnostic criteria for anxiety disorders.
False
44
What retrospective belief do adults suffering from anxiety disorders frequently indicate?
The problem started in childhood
45
What is the estimated lifetime prevalence of any anxiety disorder?
15–20 percent
## Footnote
This statistic represents the overall lifetime occurrence of anxiety disorders in the population.
46
What is the prevalence rate of separation anxiety among children and adolescents?
3–8 percent
## Footnote
Separation anxiety is one of the most frequent anxiety disorders in this demographic.
47
What percentage of children and adolescents are affected by social phobia?
About 7 percent
## Footnote
Social phobia is a significant anxiety disorder affecting this age group.
48
What is the prevalence rate for specific phobias in children and adolescents?
About 10 percent
## Footnote
Specific phobias are common among children and adolescents.
49
What is the estimated prevalence of generalized anxiety disorder in children and adolescents?
About 4 percent
## Footnote
This indicates a relatively lower occurrence compared to other anxiety disorders.
50
What percentage of children are affected by agoraphobia and panic disorder?
Fewer than 1 percent
## Footnote
However, up to 3 percent of adolescents may experience panic disorder.
51
What is the prevalence of agoraphobia among adolescents?
3–4 percent
## Footnote
This statistic highlights the occurrence of agoraphobia specifically in adolescents.
52
What is the estimated percentage of children and adolescents meeting diagnostic criteria for anxiety disorders at any specific moment in time?
Between 2.5 and 5 percent
## Footnote
This represents a snapshot of anxiety disorder occurrences in the population.
53
What is the range of comorbidity among children and adolescents displaying anxiety disorders?
40 to 60 percent
## Footnote
This indicates a significant overlap of anxiety disorders in affected individuals.
54
What is the most common comorbid condition with anxiety disorders?
Depression
## Footnote
Comorbidity rates for depression range from 16 to 62 percent among those with anxiety disorders.
55
What are the possible explanations for the comorbidity between anxiety and depression?
Chronic anxiety leading to depression and negative affect linkage
## Footnote
This highlights the interrelationship between the two disorders.
56
In the tripartite model, what distinguishes anxiety from depression?
Positive affect and physiological hyperarousal
## Footnote
Positive affect is low in depression, while physiological hyperarousal is prominent in anxiety.
57
What is the range of comorbidity between anxiety disorders and externalizing disorders?
17 to 34 percent
## Footnote
This indicates significant overlap, particularly in older child samples.
58
What factors may influence the relation between anxiety disorders and substance abuse in young people?
Peer approval or disapproval of substance abuse
## Footnote
This suggests that social context plays a role in substance use behaviors.
59
What is the typical age of onset for specific phobia and separation anxiety?
Often appears during childhood and decreases with the onset of adolescence.
## Footnote
Specific phobia and separation anxiety are closely linked with childhood developmental experiences.
60
At what age does social phobia typically appear?
Usually from about age 7 years, more typical from middle childhood onwards.
## Footnote
Some studies indicate an increase during adolescence.
61
Can generalized anxiety disorder appear at any age?
Yes, it can appear at any age within childhood and adolescent years.
## Footnote
This disorder has a broad age range for onset.
62
What is the male to female ratio for anxiety disorders?
Girls outnumber boys by a ratio of 2:1 or higher in most studies.
## Footnote
This trend is consistent across various types of anxiety disorders.
63
How does the risk of anxiety disorders differ by sex?
Girls and women are at higher risk for anxiety disorders at all ages.
## Footnote
In contrast, the male:female ratio for depression varies by age.
64
What are some explanations for the gender difference in anxiety disorders?
Differences in hormones, fear of maltreatment, and societal acceptance of emotional expression by males.
## Footnote
Kearney (2005) speculates boys may be less likely to discuss anxiety.
65
Do boys or girls receive professional help for anxiety more readily?
Boys may be referred for professional help more readily than girls.
## Footnote
This is because anxiety is more inconsistent with societal norms for boys' behavior.
66
What is taijin kyofusho?
A culture-specific manifestation of anxiety with higher prevalence among males than females.
## Footnote
Despite this, Japanese girls report more anxiety symptoms than boys.
67
Which group experiences higher levels of social anxiety according to Safren and Pantalone (2006)?
Gay and bisexual adolescents experience higher levels of social anxiety.
## Footnote
This is attributed to a lack of social support and other stressors.
68
What are some possible explanations for higher social anxiety in gay and bisexual adolescents?
Restricted social contacts, stress from concealing sexual orientation, teasing, bullying, and lack of role models.
## Footnote
More research is needed to understand this population better.
69
What cultural differences affect social behavior in East Asian cultures?
Higher rates of social anxiety are confirmed among East Asians than among people from English-speaking countries
## Footnote
This is due to cultural values that emphasize shyness and modesty.
70
What is the significance of 'face' in East Asian cultures?
'Face' refers to the reputation of an individual or their family, which can be a source of stress
## Footnote
This concern contributes to higher rates of social anxiety.
71
How do cultural values interact with developmental differences in children?
Core cultural values may affect parenting but may not be fully developed until adolescence or adulthood
## Footnote
This applies to concerns about face and shame in East Asian cultures.
72
What variability exists in studies of anxiety among children in Japan and China?
Studies show mixed results, with some indicating higher anxiety in East Asian children and others showing the opposite
## Footnote
Results can be influenced by children's willingness to disclose anxiety.
73
What is Taijin kyofusho?
A condition characterized by extreme fear of embarrassment, often involving fears related to body odor and making eye contact
## Footnote
This condition is discussed extensively in adult literature.
74
What is hikikomori?
A condition involving extreme social withdrawal, often resulting in individuals becoming recluses
## Footnote
It can involve refusing to attend school or see other people.
75
What are ataques de nervios?
A constellation of symptoms in Latin America including panic, troubled thinking, and somatic symptoms
## Footnote
Often perceived as a stress-related 'attack.'
76
How do ataques de nervios differ from panic attacks?
Ataques de nervios have broader symptoms than panic attacks, including breathing issues and shaking
## Footnote
The term encompasses a wide range of mental health problems.
77
What percentage of children in Puerto Rico and Hispanic neighborhoods of New York City were identified as having had an ataque?
4 to 5 percent
## Footnote
This statistic was revealed in a recent study of children and adolescents.
78
What is the estimated heritability range for anxiety disorders?
20 to 40 percent
## Footnote
Similar to those for depression but lower than for several other mental health disorders.
79
How much more likely are first-degree relatives of a person with an anxiety disorder to have the same disorder?
Four to six times more likely
## Footnote
Compared to the general population incidence of the particular disorder.
80
What is the concordance rate for monozygotic twins regarding anxiety disorders?
12–26 percent
## Footnote
Compared to 4–15 percent for dizygotic twins.
81
What challenge is faced when identifying the genes involved in anxiety disorders?
Complex interactions of several genes
## Footnote
Unlike some disorders that result from a mutation of a single gene.
82
What percentage of young children are classified as behaviorally inhibited?
10–15 percent
## Footnote
Characterized by fearfulness and withdrawal in unfamiliar situations.
83
What is the heritability estimate for behavioral inhibition?
.50 to .70
## Footnote
Indicates a significant genetic component in behavioral inhibition.
84
What is behavioral inhibition linked to in terms of anxiety disorders?
Emergence of social phobia
## Footnote
Sometimes linked to other anxiety disorders as well.
85
According to Schwartz, Snidman, and Kagan (1999), what percentage of inhibited toddlers developed social phobia by age 13?
34 percent
## Footnote
Compared to 9 percent of toddlers who were not inhibited.
86
What fundamental question arises regarding the relationship between temperament and psychopathology?
Are they separate but related constructs?
## Footnote
Or is psychopathology merely the upper extreme of the distribution of temperament?
87
What is the implication of the genetic complexity in anxiety disorders?
Identifying specific genes is difficult
## Footnote
Due to inconsistent results across studies and types of anxiety disorders.
88
What do twin studies provide evidence for in terms of anxiety disorders?
Heritability
## Footnote
They indicate higher concordance rates in monozygotic twins compared to dizygotic twins.
89
What is the primary function of the neural 'fear-circuitry'?
Processes and responds to danger and threat in one’s surroundings
## Footnote
This circuitry is crucial for understanding fear responses.
90
Which brain structure is primarily involved in the neural 'fear-circuitry'?
Amygdala
## Footnote
The amygdala is located in the medial temporal lobe.
91
Name two additional brain regions involved in the neural 'fear-circuitry'.
* Ventral prefrontal cortex (vPFC)
* Anterior cingulate cortex
## Footnote
These regions work alongside the amygdala in processing emotional stimuli.
92
What type of stimuli does the amygdala help process?
Salient emotional stimuli
## Footnote
This includes both positive and negative stimuli.
93
True or False: The amygdala only processes negative emotional stimuli.
False
## Footnote
The amygdala processes both positive and negative emotional stimuli.
94
Fill in the blank: The amygdala is located in the _______.
medial temporal lobe
## Footnote
This location is critical for its role in emotional processing.
95
What areas of research focus on how individuals attend and respond to threatening stimuli?
Brain and anxiety research
## Footnote
This research examines factors that modulate responses to threats.
96
What are the two frequently used task paradigms in research on anxiety?
Emotional face processing and attention orienting
## Footnote
These paradigms are especially useful in studies involving children.
97
Which brain structure is particularly responsive when individuals view fearful faces?
Amygdala
## Footnote
The amygdala reacts to signals of danger in the environment.
98
What type of facial expressions engage the amygdala more than neutral or other emotional expressions?
Fearful facial expressions
## Footnote
Supported by multiple fMRI studies.
99
What do lesion studies indicate about adults with amygdala lesions?
They have difficulty recognizing fearful faces but not other facial emotions
## Footnote
This highlights the amygdala's role in processing fear.
100
How does amygdala activity in adolescents with anxiety disorders compare to those without psychiatric disorders?
Higher levels of amygdala activity in response to fearful faces
## Footnote
This suggests a heightened sensitivity to threats.
101
What do adolescents with high social anxiety symptoms show in terms of amygdala response?
Greater amygdala response to fearful faces
## Footnote
Indicates an increased emotional reaction to perceived threats.
102
In the context of anxiety, what effect does thinking about fear while viewing fearful faces have?
Increased amygdala response
## Footnote
This was observed in anxious adolescents during studies.
103
What type of face viewing task has been used to study socially anxious adolescents?
Peer evaluation simulation task
## Footnote
This task assesses the threat of peer acceptance or rejection.
104
What occurs in the amygdala activity of socially anxious adolescents while awaiting peer evaluation?
Greater amygdala activity
## Footnote
Indicates heightened anxiety regarding social interactions.
105
What does abnormal amygdala function in anxious adolescents suggest?
They are influenced by threatening cues, compromising emotion regulation
## Footnote
This can perpetuate chronic anxiety.
106
What is a characteristic of anxiety in terms of attention?
Hypervigilance and enhanced attention to threat
## Footnote
This trait is assessed through various paradigms.
107
What is attention bias to threat?
Greater if it takes longer to draw attention away from a threat cue
## Footnote
Example: An individual focusing on an angry face.
108
How do adults with high anxiety levels orient their attention compared to those with low anxiety levels?
They orient toward threat while those with low anxiety orient away
## Footnote
Behavioral studies support this distinction.
109
Do children and adolescents with anxiety disorders show biases toward threat stimuli?
Yes, they show biases toward threat stimuli such as angry faces
## Footnote
This is consistent across various studies.
110
What does neuroimaging research reveal about adolescents with anxiety disorders regarding amygdala activity?
They show more amygdala activity to threat stimuli than psychiatrically healthy adolescents
## Footnote
This is associated with attention bias measured by response time.
111
What is the relationship between amygdala activations and attention bias in adolescents with anxiety disorders?
Higher amygdala activations are positively associated with greater attention bias
## Footnote
Measured by response time to stimuli.
112
What is electroencephalographic asymmetry in children with behavioral inhibition and anxiety?
Children show relatively greater activation of the right frontal lobe than the left frontal lobe
## Footnote
According to Perez-Edgar and Fox (2005), this asymmetry is measured using EEG.
113
What do the left and right frontal regions of the brain direct?
The left frontal region directs approach emotions and behaviors; the right frontal region guides withdrawal behaviors
## Footnote
This distinction helps in understanding motivational systems related to approach and withdrawal.
114
What accompanies behavioral inhibition in children?
Increased amygdala response to novel, feared stimuli
## Footnote
This has been highlighted in studies indicating greater amygdala activation in response to unfamiliar faces.
115
What did the longitudinal neuroimaging study by Schwartz et al. (2003) find about behaviorally inhibited young adults?
Greater amygdala activation in response to unfamiliar faces
## Footnote
This suggests a pattern of exaggerated amygdala response may develop in behaviorally inhibited individuals.
116
What has been found regarding adolescents who were behaviorally inhibited in childhood?
Heightened amygdala response to fearful faces
## Footnote
This was reported by Perez-Edgar et al. (2007).
117
What is the role of the prefrontal cortex (PFC) in adolescent anxiety problems?
Hyperactivity of the PFC may indicate failure to inhibit inappropriate responses
## Footnote
This has been discussed by Thayer and Lane (2000).
118
What does the ventral prefrontal cortex (vPFC) show in response to threat stimuli in anxiety disorders?
Heightened activity
## Footnote
This has been observed in studies by Guyer et al. (2008), McClure et al. (2007), and Monk et al. (2008).
119
How does the vPFC function in threat processing?
It comes online during longer durations of threat processing to regulate the amygdala
## Footnote
This occurs after the immediate response period when the amygdala acts as a fast threat detector.
120
What is the relationship between children's anxiety problems and diurnal cortisol levels?
Time of day matters; higher afternoon cortisol levels have been noted in socially wary preschoolers
## Footnote
Studies by Essex et al. (2010) and Smider et al. (2002) support this.
121
What did Forbes et al. (2006) report about cortisol levels in children with anxiety disorders?
Higher cortisol levels in the 2 hours preceding sleep compared to children with depression or without psychiatric diagnoses
## Footnote
This finding indicates active HPA axis systems in anxious children.
122
True or False: Many studies have shown that children's anxiety problems are associated with cortisol awakening response (CAR) or morning cortisol levels.
False
## Footnote
Studies by Freitag et al. (2009), Greaves-Lord et al. (2009), and Hastings et al. (2009) indicate no association.
123
Fill in the blank: Behavioral inhibition in children is associated with increased _______ response to novel stimuli.
amygdala
124
What parental behaviors may lead to greater anxiety in children?
Parental behaviors that arise from children's anxiety can lead to greater anxiety in those children
## Footnote
Wood et al. (2003) indicated that children's anxiety generates parental behaviors that may exacerbate the situation.
125
How can parenting styles be categorized based on parental warmth and control?
Parenting styles can be categorized as either models of affectionless control or affectionate control
## Footnote
These styles are based on the dimensions of parental warmth and control.
126
What is a central issue believed to contribute to anxiety disorders in children?
The belief that anxiety disorders arise when children feel they have no control over their lives or social situations
## Footnote
Control is considered crucial in the context of anxiety disorders.
127
Describe the characteristics of overcontrolling parents.
Overcontrolling parents may dominate devoid of warmth and affection or be overprotective while conveying affection
## Footnote
Chorpita and Barlow (1998); DiBartolo and Helt (2007) discuss these characteristics.
128
What did the meta-analysis by Van der Bruggen et al. (2008) reveal about parental anxiety?
The meta-analysis found no significant links between parental anxiety and overcontrol of their children
## Footnote
However, it found significant links between children's anxiety and parental control.
129
What interesting finding was observed regarding fathers' anxiety and parental control?
Fathers' anxiety was associated with lower levels of parental control
## Footnote
This was noted in a study by Van der Bruggen, Bögels, and Van Zeilst (2010).
130
How do mothers' levels of anxiety relate to controlling behavior?
Mothers with very high and very low levels of anxiety controlled their children more than those with moderate levels of anxiety
## Footnote
This finding suggests that moderate anxiety can be facilitative.
131
What did Manassis (2001) suggest about insecure attachment styles?
Different insecure attachment styles would be associated with different forms of anxiety disorders
## Footnote
Manassis elaborated on the link between attachment patterns and anxiety.
132
Which type of attachment is linked to separation anxiety disorder?
Ambivalent attachment is linked to separation anxiety disorder
## Footnote
This involves alternating between seeking contact and displaying distress.
133
What pattern might children with avoidant attachment develop?
Children with avoidant attachment may develop a pattern of limiting social contacts leading to social phobia
## Footnote
Manassis speculated this connection.
134
What correlation was found between secure child-parent attachment and anxiety?
Secure child-parent attachment is generally linked with lower levels of both social anxiety and separation anxiety
## Footnote
Studies by Bar-Haim et al. (2007) and others support this correlation.
135
What did Colonnesi et al. (2011) find regarding anxiety and attachment?
Anxiety was moderately correlated with insecure attachment
## Footnote
This was based on a summary of forty-six studies with almost 9,000 participants.
136
What is the impact of having relatives with anxiety disorders on children?
Children are more likely to develop anxiety disorders if they have relatives with anxiety disorders
## Footnote
This increased risk applies to both fathers and mothers.
137
How do fathers of anxious children typically behave?
Fathers of anxious children are highly controlling, provide little guidance, and may not engage in playful interactions
## Footnote
Observational studies have shown this behavior.
138
What did Greco and Morris (2002) demonstrate about fathers of anxious children?
Fathers frequently physically intervened in tasks, taking over from their children
## Footnote
This graphic demonstration illustrates controlling behavior.
139
What did Perry and Millimet (1977) find about children's relationships with parents?
Highly anxious children indicated they got along better with their mothers than with their fathers
## Footnote
This suggests a difference in parenting impact between mothers and fathers.
140
How does fathers' anxiety affect their parenting compared to mothers' anxiety?
Fathers' parenting is more affected by their own anxiety than mothers' parenting
## Footnote
This is particularly true for social anxiety.
141
What correlation was found in McShane and Hastings (2009) regarding fathers' supportiveness?
Fathers' supportiveness was correlated with lower levels of anxiety among daughters but not sons
## Footnote
This highlights a gender difference in the impact of fathers' parenting.
142
What spiral do shy children experience according to Rubin and colleagues?
Shy children are rejected by peers, leading to negative self-concept, increased anxiety, and social withdrawal
## Footnote
This spiral can culminate in anxiety disorders or depression.
143
What role do parents play in the development of withdrawn children?
Parents can either grant autonomy or overcontrol and overprotect their withdrawn child
## Footnote
This may influence the child's progression along the social spiral.
144
What do studies indicate about the peer reputation of anxious children?
Anxious children are often disliked by their peers
## Footnote
Studies confirm this through various observational methods.
145
What did Spence, Donovan, and Brechman-Toussiant (1999) find regarding children with social phobia?
Children with social phobia receive relatively few positive responses from peers
## Footnote
They also face negative remarks and are bullied.
146
What impact does bullying have on anxious children?
Bullying increases anxiety and affects cortisol levels in the brain
## Footnote
This can create a vicious cycle of anxiety and victimization.
147
How can friendships affect the consequences of being disliked?
Friendships may provide support to buffer the effects of being disliked
## Footnote
However, the quality of these friendships can vary.
148
What findings are inconsistent regarding friendships of socially anxious children?
Studies show mixed results on the support and intimacy of friendships for socially anxious children
## Footnote
Quality friendships can improve responses to psychotherapy.
149
What distinguishes anxious children in social interactions according to raters?
Anxious children are often rated as awkward in body language, speech, and facial expressions
## Footnote
This distinction is evident in videotaped interactions.
150
What were the behaviors of anxious children during interactions with friends?
Anxious children were found to be quiet, unassuming, and reluctant to engage in competition
## Footnote
This affects their social interactions even with close friends.
151
How do anxious children perceive the concept of friendship?
They expect friends to satisfy their psychological needs rather than recognizing the reciprocal nature of friendship
## Footnote
This reflects a less mature understanding compared to their peers.
152
What is the distinction between homotypic continuity and heterotypic continuity in anxiety disorders?
Homotypic continuity refers to having the same exact form of anxiety disorder at follow-up, while heterotypic continuity refers to having any form of anxiety disorder or psychopathology.
153
What is the stability rate for homotypic continuity at two specific time points?
The stability rate may be no higher than 15 or 20 percent.
154
What happens to specific phobia during adolescence?
Specific phobia may disappear with the onset of adolescence.
155
What is the likelihood of individuals with childhood anxiety disorders suffering from anxiety or depression in later life?
It is very likely that they will suffer from some type of anxiety disorder and/or depression during a substantial part of adolescence or adulthood.
156
What percentage of cases experience full remission from anxiety disorders according to most studies?
Full remission occurs in fewer than one-third of cases.
157
Why is there less known about the long-term prognosis for children with anxiety disorders?
Recognition of children's anxiety disorders as a widespread and debilitating problem is recent, leading to fewer longitudinal studies in the past.
158
What social consequences can early anxiety lead to?
Early anxiety often leads to social exclusion and later depression.
159
How do anxiety disorders affect school participation and academic achievement?
Anxiety disorders negatively affect school participation, academic achievement, and enrolment in school.
160
What percentage of adult patients with anxiety disorders reported leaving school prematurely in the study by Ameringen, Mancini, and Farvolden?
49 percent reported leaving school prematurely.
161
What reason did 24 percent of those who left school prematurely cite for their decision?
They cited anxiety as the reason for leaving school.
162
Fill in the blank: Specific phobia may ________ with the onset of adolescence.
disappear
163
True or False: Most children with anxiety disorders achieve full remission by adulthood.
False
164
What is the focus of primary prevention in anxiety disorders?
Content of cognitive-behavioral interventions may be useful to the general population of children and adolescents
165
Who adapted the Coping Cat program for primary prevention techniques?
Several Australian researchers
166
Where has the primary prevention program been mostly delivered?
In schools, by psychologists or schoolteachers
167
What was the outcome for participants at risk of developing anxiety disorders in the prevention program?
Less likely to develop full-blown disorder than control groups
168
How many school-based prevention and early-intervention programs were reviewed in the meta-analysis by Neil and Christensen (2009)?
Twenty programs
169
What percentage of school-based programs were successful in reducing anxiety according to Neil and Christensen (2009)?
Three-fourths
170
What is a notable shortcoming of the prevention programs evaluated?
Very few researchers gathered long-term follow-up data
171
What is the most widely used form of treatment for children and adolescents with anxiety disorders?
Cognitive-behavior therapy (CBT)
172
Who introduced the pioneering cognitive-behavioral intervention for children with anxiety disorders?
Phillip Kendall
173
What are the four basic components of the Coping Cat program?
* Recognizing anxiety and its physical manifestations
* Learning to recognize and label emotions
* Learning to cope using self-talk and relaxation
* Learning to praise oneself for progress
174
What age groups does the Coping Cat program cater to?
Children from 8 to 13 years old and adolescents 14 to 17 years old
175
What is an exposure hierarchy in the Coping Cat program?
A list of situations from slight to highly anxiety-provoking
176
What types of assignments are typically part of the Coping Cat program?
* Practice of new skills
* Observation of specific situations
177
What was the conclusion of Silverman, Pina, and Viswesvaran (2008) regarding cognitive-behavioral therapy?
Both individual and group CBT could be rated as 'probably efficacious'
178
What percentage of children in treatment groups improved to the point of no longer being diagnosable as having anxiety disorders?
About 57 percent
179
What percentage of participants in control groups experienced spontaneous recovery?
About 30 percent
180
What does follow-up indicate about the maintenance of improvement for children with anxiety disorders?
Very satisfactory maintenance for many children
181
What do many former participants of CBT experience after therapy?
Some degree of anxiety, often not enough for re-diagnosis
182
How do children and adolescents with social anxiety respond to CBT compared to other forms of anxiety disorder?
Do not seem to respond as well
183
What additional training may be necessary for long-term success in children with social anxiety?
Social skills training
184
What was the methodological advance made by Hudson et al. (2009) in their study of CBT?
Compared cognitive-behavioral treatment with a control condition receiving equivalent support
185
What did control-group participants indicate about the treatment in Hudson et al. (2009)?
Found the treatment credible and expected to improve
186
What was the result of comparing cognitive-behavioral intervention with the control group in Hudson et al. (2009)?
Cognitive-behavioral intervention was clearly superior
187
What is the research support for psychotherapies other than CBT in treating anxiety disorders among children and adolescents?
Extremely limited
## Footnote
Other approaches have been tried but lack substantial research backing.
188
What are the core goals of brief psychoanalytic therapy?
Insight, self-expression through play, and the experience of a close therapeutic relationship
## Footnote
(Warren and Messer, 1999)
189
What type of counseling has shown effectiveness for early adolescents suffering from emotional distress?
School-based humanistic counseling
## Footnote
Effective for adolescents with anxiety problems according to a study by Cooper et al. (2010)
190
Why cannot approaches other than CBT be considered science-based at this point?
Very limited basis in research compared to substantial data from CBT studies
## Footnote
CBT has demonstrated successful treatment of children’s and adolescents’ anxiety.
191
What is the distinction between computer-based therapy and computer-assisted therapy?
Computer-based therapy is delivered entirely online, while computer-assisted therapy uses electronic means for part of the content
## Footnote
Kendall et al. (2011) emphasize this distinction.
192
What are the potential communication methods between therapist and treatment participant in computer-assisted therapy?
Email, chat, or telephone
## Footnote
Reflects contemporary communication realities for children and adolescents.
193
What has demonstrated viability for treating children and adolescents with anxiety disorders?
Computer-assisted therapy
## Footnote
Supported by several studies including March et al. (2009).
194
What is virtual-reality therapy?
A technique that simulates an anxiety-inducing environment visually and auditorily
## Footnote
Intensity or proximity can be adjusted by the software.
195
For which conditions has virtual-reality therapy been used successfully?
Specific phobia or school refusal
## Footnote
Still beginning to be used for children and adolescents.
196
What potential does virtual-reality therapy have in relation to CBT?
Facilitating the exposure component of CBT for anxiety problems including social phobia
## Footnote
As noted by Bouchard (2011).
197
What is believed to be crucial in the treatment of anxiety disorders in children?
Parent involvement
## Footnote
Many professionals advocate for parent involvement, but empirical evidence is inconsistent.
198
What program was developed to enhance child-parent communication and reduce overcontrol by parents?
Building Confidence program
## Footnote
Developed by Wood and colleagues in 2006.
199
What age group did the Building Confidence program target?
Children and early adolescents aged 6 to 13 years old.
200
How did children whose parents participated in the Building Confidence program fare compared to a control group?
They improved more than the control group that received traditional child-focused CBT.
201
What was the focus of the intervention in the study by Cartwright-Hatton and colleagues (2011)?
Parent-child communication and appropriate discipline.
202
What was the age range of children involved in the study by Cartwright-Hatton and colleagues?
Children aged 2.5 to 9 years old.
203
What type of medication is commonly known for relieving anxiety in children and adolescents?
Benzodiazepines
## Footnote
The most common benzodiazepine is Valium (diazepam).
204
What are some problems associated with benzodiazepines?
Short-term effectiveness, addiction, and tolerance.
205
Which class of medications is effective in reducing anxiety disorders and has fewer side effects?
SSRIs (serotonin reuptake inhibitors).
206
What is a potential risk of SSRIs for children and adolescents?
Agitation and increased suicidal thoughts.
207
What is the current consensus on combining CBT with pharmacotherapy?
No evidence that it leads to greater effectiveness than either therapy alone.
208
What do experts believe about the awareness of anxiety disorders in children and adolescents?
Awareness is just beginning and many cases remain unnoticed and untreated.
209
What factor complicates the treatment of anxiety disorders in children?
Interaction styles rooted in individual temperament and parental overcontrol.
210
What is the expectation for research and treatment developments in anxiety disorders in the coming years?
No sudden, revolutionary developments are expected.
211
What is necessary for achieving optimal effectiveness in existing interventions for anxiety disorders?
Fine tuning of interventions.
212
What is likely to contribute to further progress in the field of anxiety disorders?
Continuing along the trajectory of awareness and existing knowledge.
