Why services for vulnerable children should be different
Panos Vostanis in Helping Children and Young People Who Experience Trauma, 2021
Emotional problems can be expressed in different ways which can be spotted by carers, but they invariably become prominent and debilitating if not recognised and dealt with promptly. These include generalised anxiety, expressed through excessive worries and associated cognitions; and physical (somatic) symptoms such as abdominal or other pains, nausea, sickness, sweating and muscular tension. Phobias are persistent and irrational fears of objects, animals or social situations that lead to anxiety and avoidance. Obsessive–compulsive presentations include intrusive thoughts that cause distress, are resisted and are recognised by the child as their own (in contrast with psychosis). Urges include touching an object a certain number of times, accompanied by thoughts that they might do or say something incompatible with their values; and/or actions they feel compelled to repeat such as hand washing, or arranging their room in exactly the same way. Post-traumatic stress reactions follow the experience of a recent or distant event, which can be re-lived through thoughts, images or nightmares; by avoiding related places or situations; and symptoms such as arousal and hyper-vigilance. Although the primary aim of separation anxiety has already been described as protecting children, when this is not resolved by enabling the child to function away from the main carer it can result in significant distress at the prospect of separation, becoming clingy, not sleeping on their own, worrying about themselves or the parent, or refusing to go to school.
Phobias
Judy Z. Koenigsberg in Anxiety Disorders, 2020
Do individuals with specific phobia tend to seek treatment, is the treatment effective, and how effective is it when compared to other anxiety disorders? The length of time that it takes for patients with specific phobia to seek treatment is more extensive than the length of time it takes for patients with other anxiety disorders to seek therapy (Iza et al., 2013; ten Have, de Graaf, van Dorsselaer, & Beekman, 2013). Research has shown that although specific phobia is the most treatable of the emotional disorders (Barlow, 2004), most individuals seek to avoid the feared objects or situations (Comer, 2015). The treatment rates of specific phobia were shown to be more elevated in countries with a high income than in those with a low income (Wardenaar et al., 2017). In general, post-treatment, phobias have higher success rates than does generalized anxiety disorder (Ray, 2018).
Psychiatry
Fazal-I-Akbar Danish in Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Anxiety in response to specific issues:1 Eating disorder (anorexia nervosa; bulimia nervosa).2 Somatisation disorder (Briquet’s syndrome).3 Phobias (social phobia; agoraphobia [crowd phobia or situations where escape is difficult]; claustrophobia [fear of enclosed spaces]; arachnophobia [fear of spiders]).4 Post-traumatic stress disorders (caused by experiencing or witnessing a traumatic event, e.g. major accident, fire, assault, military combat).
Students’ interaction anxiety and social phobia in interprofessional education in Hong Kong: mapping a new research direction
Published in Annals of Medicine, 2023
Fraide A. Ganotice, Xiaoai Shen, Jacqueline Kwan Yuk Yuen, Yin Man Amy Chow, Anita M. Y. Wong, Karen M. K. Chan, Binbin Zheng, Linda Chan, Pauline Yeung Ng, Siu Chung Leung, Elizabeth Barrett, Hoi Yan Celia Chan, Wing Nga Chan, Kit Wa Sherry Chan, Siu Ling Polly Chan, So Ching Sarah Chan, Esther W. Y. Chan, Yuet Ying Jessica Cheuk, Jacky Choy, Qing He, Julienne Jen, Jingwen Jin, Ui Soon Khoo, Ho Yan Angie Lam, May P. S. Lam, Yik Wa Law, Jetty Chung Yung Lee, Feona Chung Yin Leung, Ann Leung, Rebecca K. W. Liu, Vivian Wei Qun Lou, Pauline Luk, Zoe Lai Han Ng, Alina Yee Man Ng, Maggie Wai Ming Pun, Mary Lok Man See, Jiangang Shen, Grace Pui Yuk Szeto, Eliza Y. T. Tam, Winnie Wan Yee Tso, Ning Wang, Runjia Wang, Janet Kit Ting Wong, Janet Yuen Ha Wong, Grace Wai Yee Yuen, George Lim Tipoe
Social anxiety is construed as a ‘fear of social situations in which embarrassment may occur (e.g. making conversation, meeting strangers, dating) or there is a risk of being negatively evaluated by others’ (e.g. seen as stupid, weak, or anxious [5]). Phobia, on the other hand, is an intense and irrational fear of certain objects and situations. Studies have shown that student social interaction anxiety has adverse effects on various outcomes: academic achievement [6,7], school completion [8,9] and well-being [10]. In IPE, social phobia is considered a barrier to promoting teamwork and collaboration among students [11,12]. Furthermore, reports indicate that students with Asian heritage tend to experience higher levels of social anxiety compared with their European and American counterparts [13,14].
Comparative effectiveness of cognitive behavioral treatment, serotonin, and serotonin noradrenaline reuptake inhibitors for anxiety in children and adolescents: a network meta-analysis
Published in Nordic Journal of Psychiatry, 2023
Alexandra Arnardóttir, Gudmundur Skarphedinsson
There has been one previous analysis of the comparative effectiveness of CBT and pharmacotherapy for childhood ADs using indirect comparisons within an NMA framework [14]. However, the authors included diagnoses of specific phobias in their analysis. This may be cause for concern, as evidence shows that exposure-based CBT is the only evidence-based treatment for specific phobias [15]. This implies that specific phobias should be excluded in the comparative effectiveness of different AD treatments. The authors further included studies that did not use a clinical interview or other method to confirm that the participants did indeed have an AD. Furthermore, Wang et al. [14] included nonrandomized comparative studies in their meta-analysis, which may have affected the findings, suggesting that further evidence is needed on the treatment efficacy for childhood AD to establish a specialized clinical guideline for the treatment of ADs in youth [8].
Identifying and Understanding Anxiety in Youth with ASD: Parent and School Provider Perspectives on Anxiety within Public School Settings
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2022
Nuri M. Reyes, Katherine Pickard, Tanea Tanda, Megan A. Morris, Judy Reaven
Regarding triggers for anxiety in school settings, parents and school providers indicated that youth with ASD and anxiety can often be triggered by school-specific environments or situations, such as loud events, changes in school routines, and social situations/academic groups. Diagnostically, these symptoms may be suggestive of specific phobias (e.g., fire alarms, idiosyncratic phobias of noises), fear of change (e.g., changes in routines), and social anxiety (e.g., school assembly). That is, different from their peers, youth with ASD may experience increased difficulties associated with social anxiety and specific phobias (Kerns et al., 2017). Importantly, anxiety symptoms likely interfere with these students’ ability to fully engage and participate in a variety of activities across the school day (Adams et al., 2018). Notably, school providers seemed to believe that the current political climate (e.g., increased negative views toward immigrants) appeared to play a role in increasing anxiety symptoms in Latinx children.
Related Knowledge Centers
- Agoraphobia
- Anxiety Disorder
- Distress
- Syncope
- Fear
- Blood Phobia
- Traumatophobia
- Panic Attack
- Emetophobia
- Specific Phobia