Parents and family members who have been accommodating avoidance over many years need help refraining from attending to anxiety-driven behavior and encouraging independence and effective engagement in the world. Medication can be particularly useful to reduce the overall anxiety burden, but will not necessarily result in improved coping and adaptation skills that are learned through a comprehensive therapy program.
In summary, indicators of anxiety disorders may present as wide array of symptoms, including physical complaints, shyness, avoidance of social settings, and behavioral outbursts. These symptoms are reinforced by efforts of the youth and family members to avoid and eliminate anxiety-provoking situations and stimuli. Therefore, the symptoms and avoidant behaviors grow over time, as individuals miss the opportunities to learn how to cope with and adapt to uncomfortable situations.
As children age into adolescence and early adulthood, demands of work and school increase, creating an environment that emerging adults with anxiety are not equipped to face. Treatment for this specific developmental stage includes group and individual treatment to decrease specific anxiety symptoms, while simultaneously focusing on the family and individual to foster independence and effective functioning.
Avital Falk, PhD, is a postdoctoral fellow at New York-Presbyterian Hospital and Weill Cornell Medical College where she is working at the New York-Presbyterian Youth Anxiety Center. John T. Walkup, MD, is a professor of psychiatry, the DeWitt Wallace Senior Scholar, and the vice chair of psychiatry, and director of the Division of Child and Adolescent Psychiatry, at New York-Presbyterian Hospital and Weill Cornell Medical College. He is also the co-program director at the NewYork-Presbyterian Youth Anxiety Center.
References
- Beesdo K, Knappe S, Pine, DS. Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V. Psychiatric Clinics of North America. 2009; 32(3), 483-524. doi: 10.1007/s10802-011-9590-7.
- Bar-Haim Y. Lamy D, Pergamin L, Bakermans-Kranenburg MJ, Van Ijzendoorn MH. Threat-related attentional bias in anxious and nonanxious individuals: a meta-analytic study. Psychological Bulletin. 2007; 133(1).
- Roy AK, Klein RG, Angelosante A, et al. Clinical features of young children referred for impairing temper outbursts. Journal of Child and Adolescent Psychopharmacology. 2013 23(9), 588-596.
- Pine DS, Cohen P, Gurley D, Brook J, Ma Y. The risk for early adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Arch Gen Psychiatry. 1998; 55:56–64.
- Walkup JT, Albano AM, Piacentini J, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med. 2008; 359:2753–2766.