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The Impact of Anxiety Disorders on Children and Adoloscents

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Too often, anxiety is viewed as a mental weakness or instability. These social stigmas can further discourage children with anxiety disorders and their parents from seeking help, which further perpetuates the problem. Anxiety disorders also cause a substantial burden for clients and their families, often leading to school absences, impaired relations with peers, and low self-esteem

Anxiety disorders also lead to impairment or disability in occupational, social, or interpersonal functioning.

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Anxiety refers to the brain response to danger, stimuli that an organism will actively attempt to avoid. This brain response is a basic emotion already present in infancy and childhood, with expressions falling on a continuum from mild to severe. Anxiety is not typically pathological as it is adaptive in many scenarios when it facilitates avoidance of danger. Strong cross-species parallels—both in organisms’ responses to danger and in the underlying brain circuitry engaged by threats—likely reflect these adaptive aspects of anxiety. One frequent and established conceptualization is that anxiety becomes maladaptive when it interferes with functioning, for example when associated with avoidance behavior, most likely to occur when anxiety becomes overly frequent, severe, and persistent. Thus, pathological anxiety at any age can be characterized by persisting or extensive degrees of anxiety and avoidance associated with subjective distress or impairment. The differentiation between normal and pathological anxiety, however, can be particularly difficult in children because children manifest many fears and anxieties as part of typical development

Although these phenomena might be acutely distressing, they occur in most children and are typically transient. For example, separation anxiety normatively occurs at 12 to 18 months, fears of thunder or lightning at 2 to 4 years, and so forth. Thus, given that such anxiety occurs in most children and typically does not persist, distress, in and of itself, represents an inadequate criterion for distinguishing among normal and pathological anxiety states in children.

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Thambirajah et al (2008) – Most children and young people go through occasional, infrequent and temporary non-attendance in school at some point in their school career. School attendance (children can be educated at home if approved by the LEA education officer) in the UK is compulsory for all young people under the age of 16 (young people under 18 have to be in some sort of Education, Training or Work). The issue of school attendance is currently at the focus of intense activity in schools, LEAs and the press. The most recent media interest surrounds the removal of children and young people from school for family holidays

This, until recently, resulted in fines given to parents/carers of these children. The term school refusal has been used to refer to the group of children who are reluctant to or fail to attend school for emotional reasons (Thambirajah et al, 2008). Thambirajah et al, (2008) clarifies the different terms used to describe different groups of children who fail to attend school, these terms are based around the core characteristics as they are currently understood by authorities and researchers and include; truancy, parentally condoned absence, school phobia, separation anxiety and school refusal. Official figures do not take school refusal into account and therefore there are no official estimates of the extent of the problem. As well as this it is hard for professionals and teachers to be aware of the problem this is due to; lack of awareness of the extent and impact of school refusal, difficulties in distinguishing school refusal from other groups, invisibility of these children, excluding medical conditions, blaming parents. Kahn and Nursten (1968) also provide an in depth analysis of the psychosocial problems that can lead to school refusal.

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Given these points, the regulation of such self-help therapies and lower levels of service contact have proven to be beneficial in promoting the engagement of sufferers with anxiety disorders, and thus may be supportive in the treatment of social phobia

In essence, although social anxiety can have a crippling effect on one’s life, it is essential to recognise that there are methods to overcome such phobic response – Whether you’re a parent, caregiver, peer or a member of a community, promoting social environments that are individually considerate and personally empowering are powerful ways of weaning child and adolescent sufferers away from detrimental behavior that interferes with their ability to be functioning and effective members of our society.

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Goodman, R., Scott, S. (2012) Child and Adolescent Psychiatry, Wiley & Sons: Chichester

Kahn, J., Nursten, J. (1968) Unwillingly to School, school phobia or school refusal, a medico-social problem, Pergamon Press: Oxford

Sewell, J. (2008) School Refusal, Australian Family Physician, Vol. 37, No. 4, PP 406-408

Thambirajah, M., Grandison, K., De-Hayes, L. (2008) Understanding school refusal: A handbook for professionals in education, health and social care, Jessica Kingsley Publishers: London

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