ANXIETY DISORDERS

IN CHILDREN AND
ADOLESCENTS
Institute of mental health and
neurosciences Kashmir
Psychosocial programme UNICEF

NASIR GEELANI
 WHAT IS ANXIETY

 Anxiety is a normal reaction to stress

 It can be helpful in lot of situations like

escaping from danger, preparing for some
exam, doing job etc.
WHEN CAN WE CALL IT A DISORDER

 Excessive/out-of-proportion

 Exists in reaction to ordinary situations

 Causing distress and or avoidance

 Impairment in daily functioning

 WHY TO IDENTIFY IT
 With respect to the children

 Because it is the Most common conditions

affecting a children and adolescents

 It Adversely affect self-esteem, academic

performance & social relationships

 It is Co-morbid with other conditions – will affect

the course & outcome

 It May continue into adulthood

NORMAL FEARS ACCORDING TO AGE
WHAT PRECIPITATES ANXIETY IN CHILDREN
Stressful life events

 Transition (place, school)

 Loss

 Bullying

 Parental divorce or separation

 Abuse

 Witnessing domestic violence

HOW IS ANXIETY MAINTAINED

 Dysfunctional family dynamics

(Faulty communication styles, parental discord
etc.)

 Maladaptive coping styles ( avoidance etc.)

CLINICAL FEATURES OF ANXIETY DISORDERS IN CHILDREN
General features

 Excessive fear
- feelings of apprehension, worry & dread
- avoidance and withdrawal from stimulus

 Physiological symptoms of arousal

- dry mouth, sweaty palms, tremors,
palpitations
COMMON TYPES OF ANXIETY DISORDERS IN CHILDREN
DEVELOPMENTAL CONSIDERATIONS

Features of Anxiety in preschoolers

Crying, tantrums, freezing, or clinging

Withdrawal in new situations/unwillingness to explore

Startle reaction; change in play patterns

Bed-wetting; sleep disturbances

Lack of talk & limited eye-contact (on observation)

  Features of Anxiety in School-aged children
Crying spells

Irritable/angry

Difficulty concentrating (school work)/memory problems

Somatic symptoms (headache, stomach pain)

Symptoms of physiological arousal (tremors, sweating)

Sleep disturbances
  Features of Anxiety in Adolescents

Concerns about their academics, future

Restlessness, fatigue, irritability

Panic attacks

Physical symptoms (headache, muscle tension)

Sleep disturbances
 CHALLENGES TO IDENTIFY

Difficulties in recognizing symptoms

Internalizing symptoms less observable

Children may lack verbal skills to communicate

concerns

Unlike adults, children are not required to acknowledge

that fears are unreasonable or excessive
 ACTIVITIES
My world

 The aim of this activity is to know the child and

develop rapport

 The child is instructed to draw a circle and divide it

into parts to represents different things contained in
his world.
 Also, he can freely draw things in his world

 This can be demonstrated to trainees in a group

where each member will draw his “my world’ with
assistance from trainer.
COMPLETING THE SENTENCE
 Helps children to unravel unexpressed and
unconscious feelings.

 Trainees will be given sheets with incomplete

statements which they will complete

 Related to daily activities, parents, school, playing

 Abuse can also be revealed through this activity.