Generalized Anxiety Disorder

Characterized by...

• Excessive worry
• Unrealistic, uncontrollable fear in multiple domains, often where child feels over-responsibility
• Physical symptoms: headaches, abdominal pain, sleeplessness, fatigue
• Difficult focus/concentration, inattention, irritability
• Little to no risk-taking behaviors (takes small steps and/or feels paralyzed by tasks)
• Constant need for reassurance
• Perfectionism
• Disabling fear of making mistakes and criticism
• School difficulties, test failure/breakdown
• "Contagion by association" -- any negative piece of news that happens to others, fears will happen to them (i.e. divorce, illness, car accidents, food poisoning, etc.)
• Hypervigiliance

Differential: 

• Depression or dysthymia
• Social anxiety disorder and other anxiety subtypes
• PTSD
• OCD
• ADHD
• Substance-induced anxiety disorder
• Oppositional defiant disorder (ODD)
• Hypochondriasis
• Trichotillomania
• Somaticizing
• Hypo/hyperthyroidism
• Anorexia nervosa
  

Anxiety Assessment & Screening

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Screening tools:

• Preschool Anxiety Scale (adapted from Spence)
• Spence Children's Anxiety Scale
• Screen for Child Anxiety Related Disorders (SCARED) - CHILD form (free) / auto-scoring version
• Screen for Child Anxiety Related Disorders (SCARED) - PARENT form (free) / auto-scoring version
• GAD-7 (pre-teen through adult)

Treatment Models

Psychotherapeutic:
Cognitive behavioral therapy (CBT)
Exposure therapy
Acceptance and commitment therapy
Intolerance of uncertainty therapy
Motivational interviewing

Pharmacological:
Selective serotonin reuptake inhibitors (SSRI)
Anti-anxiety drugs: Buspirone (long-term) or benzodiazepines (fast-acting)

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Articles

• Cognitive Behavioural Therapy for Anxiety Disorders in Children and Adolescents (James, et al, 2015)

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Resources

• EffectiveChildTherapy.com (resources and education for parents and professionals)​

Organizations

For Professionals:

• American Academy of Pediatrics (AAP) Resilience Project
• National Institute of Mental Health: specifically Mood and Anxiety Disorders Program
• ABCT (Association for Behavioral and Cognitive therapies)​
• Academy of Cognitive Therapy
• National Association of Cognitive Behavioral Therapists

For Patients/Caregivers:

• Anxiety & Depression Association of America (ADAA)
• Freedom From Fear
• Worry Wise Kids
• Coping Cat Parents
• The Mighty page on Anxiety