Anxiety disorders in childhood: types and treatments

Know the anxiety disorders that occur in childhood It is very important, given the delicate stage of life that minors go through.

In this article we will see what disorders of this type are and how they can be treated.

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Types of anxiety disorders in children

Children and adolescents, like adults, can present symptoms of anxiety and, despite the similarities, the consequences can be more damaging as it runs the risk that they affect their socio-emotional development and they even become chronic, turning into a more severe pathology.

That is why it is important to detect any signs of anxiety early. during childhood. Some situations such as the change of school, the passage to the institute, the birth of a brother, the separation of parents, the loss of a relative or the move to another city, can cause the appearance of anxiety. On the other hand, generalized anxiety disorder has a higher incidence, but separation anxiety disorder is very common and specific in children.

Anxiety disorders that appear during childhood They can be classified into the following categories.

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1. Generalized anxiety disorder (GAD)

Generalized anxiety disorder is defined clinically, in both children and adults, as an exacerbated and difficult to control worry In many situations, present most days for at least six months.

According to the DSM IV Manual of Psychiatry, anxiety is associated with three or more of the following symptoms: restlessness or impatience, ease fatigue, difficulties concentrating or blanking out, irritability, muscle tension and impaired dream.

Anxiety affects parents and child, impairing their school performance and social relationships, and worries can encompass many situations: school or sports performance, social approval, competition staff, etc.

Children and adolescents with this disorder are often conformists, perfectionists and insecure of themselves, and anxiety may be accompanied by headache and muscle pain, nausea, diarrhea, irritable bowel syndrome and other symptoms of physical discomfort.

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2. Separation anxiety disorder (SAD)

During childhood it is common to feel anxiety when separating from attachment figures. Normally this fear appears at six months and intensifies at two years, responding to an adaptive need since it constitutes a protection mechanism against hazards of the environment. However, if the anxiety is disproportionate based on the evolutionary development of the child and / or affects the functioning of it, we may be facing a separation anxiety disorder.

It is the most frequent anxiety disorder in children under 12 years of age and with the earliest appearance, suffering from it about 4% of boys and girls and 1.6% of adolescents. The presence of this pathology decreases with age, but the concerns of those who suffer from it also change. Thus, adolescents with separation anxiety disorder have more catastrophic concerns, for example, accidents, abductions, or the death of the attachment figure.

For the clinical diagnosis of SAD, it is necessary for the child or adolescent to suffer from three or more of the following symptoms: excessive anxiety about separation or anticipation, excessive concern for the loss or well-being of attachment figures, opposition to leaving home, opposition to being alone, opposition to sleeping away from attachment figures, nightmares about separation and complaints of physical discomfort (headache or stomach pain, nausea or vomiting, etc.) when separation occurs or is anticipated.

What processes are involved in the appearance and maintenance of SAD?

Learning deficits, that is, the scarcity of separations, prevent the child from getting used to being without parents. To eliminate the fear of separation, it is necessary to gradually increase the frequency and duration of experiences in which the child is away from attachment figures. Therefore, if the child is not exposed to these situations in a natural environment, the fear may persist.

Traumatic or unexpected separation experiencessuch as parental divorce, schooling, the hospitalization of an attachment figure, or the death of a close person, can also give rise to anxiety and even trigger the disorder.

Finally, positive reinforcement is one of the factors that most influences the appearance and maintenance of the disorder. If the father figures reward excessive attachment and dependency behaviors, the child will associate them with the reward received, either the attention or the simple presence of the parents.

Treatment of anxiety disorders in childhood

Since an anxiety disorder can impair the functioning of those who suffer from it in the short and long term, it is It is necessary to intervene as soon as possible and not be guided by the thought that it is a phase or that it will pass only.

In the case of childhood anxiety, according to the Society for Clinical Child and Adolescent Psychology of the APA (American Psychiatric Association), the best established treatment is cognitive behavioral therapy, which should be the first therapeutic choice. Its efficacy has been demonstrated in individual treatments with the child and with the parents and in group treatments in the family and school environment. Specifically, the three most used procedures are exposure, cognitive techniques and relaxation.

On the one hand, gradual exposure, live or in imagination, is the main component of the cognitive behavioral therapy.

The self-instruction training It is also a fundamental part of therapy, and consists of modifying the child's internal verbalizations to replace them with others that allow them to face anxiety.

Regarding relaxation, the most widely used method is progressive relaxation, according to which reducing body tension it will alleviate subjective feelings of anxiety. It is also a coping strategy that will help the young person keep anxiety at sustainable levels.

Intervention programs for parents and children

In addition, in recent decades several programs have been developed focused on parents and children whose objective is to prevent and treat childhood specific anxiety disorders.

The guide "Coping Cat" or The Brave Cat is especially useful for teach parents to educate without overprotecting and to promote the autonomy of the child. It consists of a program divided into two phases in which, on the one hand, work is done with the parents and, on the other, individual sessions are held with the child tackling tasks such as psychoeducation, relaxation, exposure, cognitive restructuring, problem solving, and self-control.

We can also meet the FRIENDS program, divided into four versions according to the child's age, and the FORTIUS program which, based on the Olympic motto “Citius, Altius, Fortius” (faster, higher, more strong), teaches 8-12 year olds to cope with difficult situations and control emotions negative.

These programs based on cognitive-behavioral therapy are adapted to the peculiarities of children and adolescents and to the characteristics of conduct disorders at these ages, something that greatly benefits the population childish.