Anxious children fear particular things (e.g. other people, separation) and this fear is more than is seen in other kids of their age. Anxious children will talk about their fears if asked, so as parents we need to ask and listen. They will describe worries just like adults do and will avoid situations and activities. Ron Rapee
Ron Rapee is a Clinical Psychologist (PhD) who specialises in Anxiety Disorders. He has been Director of the Child and Adolescent Anxiety Clinic at Macquarie University in Sydney.
Jasmine Arthur Jones interviewed Ron about Childhood Anxiety for our website.
Jasmine: What are the statistics for childhood anxiety in Australia?
Ron: There is no data on the prevalence of anxiety disorders in children in Australia. However, there is data from New Zealand and the USA and there is no reason to believe that Australia should be dramatically different. Overall, anxiety disorders are as common, or more so, as so-called oppositional and conduct disorders combined. In other words, as a group, anxiety disorders are the most common problems in children and adolescents.
In fact, one recent study of 13-18 year old Dutch adolescents, found that the two most common disorders of all were simple phobia and social phobia, being diagnosed in 12% and 9% respectively. In that study, a diagnosis of any anxiety disorder was found in 24% of the sample, while disruptive disorders were found in only 8%, mood disorders in 7%, and substance abuse in 4%. Despite the fact that suicide and drug abuse grab all the publicity, anxiety is far more common.
Jasmine: At what age can a child develop an anxiety disorder?
Ron: There is no particular age, but anxiety and fears are often obvious from a very early time. Obsessive Compulsive Disorder (OCD) is seen in children as young as 5. Specific phobias, such as phobias of spiders, the dark, dogs, etc. are common in young children anywhere from 7-9 years. Social fears and shyness can often show signs from very early ages - 5, 6, or 7 and up, even though this problem then often becomes more common and more intense in the teenage years. Separation fears are more common at younger ages, and become obvious whenever separation from a care giver has begun (say, with the beginning of school, or even day care).
The main disorder which is not typically seen in young children is panic disorder. Panic attacks are very rare in young children, become a little more seen in adolescents (although still not common) and are most likely to begin in the 20's. One of the main issues, however, is to distinguish what we might call an actual "anxiety disorder" from a general tendency to be anxious. Researchers have found that it is possible to identify children as early as 18 months who show anxious behaviours that increase the chances of developing anxiety disorders later. These children who are high on what is called an "anxious temperament" show crying, clinging, and avoidance in the face of new, or unusual events. They are shy with strangers (more than the average) and are slow to warm up in groups.
So, in a sense we can say that anxiety is a general personality style and a life-long pattern that can be seen to some extent very early. At Macquarie University we are just beginning a large research project to examine the effectiveness of teaching parents of high anxious temperament four year old children, strategies to help their child control his or her anxiety. In the next one to two years we can begin to report on how this has gone.
Jasmine: How can a parent tell if their child has an anxiety disorder?
Ron: Most parents will know if their child has a problem with anxiety. Anxious children fear particular things (e.g. other people, separation) and this fear is more than is seen in other kids of their age. Anxious children will talk about their fears if asked, so as parents we need to ask and listen. They will describe worries just like adults do and will avoid situations and activities.
The bottom line is to ask yourself whether the degree of anxiety that your child shows is interfering with his or her life - is it reducing opportunities, is it reducing academic work, is it interfering with friendships or social activities? If so, then it would be good to do something about it. Whether it is technically called an "anxiety disorder" or not, is irrelevant.