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Anxiety in children can cause difficulties in school and home life. How can you discern anxiety symptoms in children and formulate a diagnosis? In the initial post, discuss one specific form of anxiety seen in the pediatric population. Be sure to address symptoms of the disorder, as well as screening tools that can be used to make an accurate diagnosis. Include treatment options available for this diagnosis.
Behavioral Symptoms: Behaviors often serve as a way to avoid triggers or control their environment. This can include perfectionism, redoing schoolwork, seeking constant approval, and avoiding new or challenging situations. They may also struggle to concentrate on tasks.
A diagnosis of GAD is made by a qualified mental health professional or pediatrician. The process involves a thorough clinical interview with the child, their parents or guardians, and sometimes their teachers. The professional uses the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5-TR). To meet the criteria for GAD, the child's excessive worry must be present for at least six months and be accompanied by at least one of the following symptoms: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, or sleep disturbance. Critically, these symptoms must cause significant distress or impairment in their life.
Before a full diagnosis is made, clinicians may use a variety of screening tools to assess the presence and severity of anxiety symptoms. These tools are questionnaires or scales that can be completed by the child and/or their parents. A common tool is the Screen for Child Anxiety Related Emotional Disorders (SCARED), which is available in both child- and parent-report versions and can help identify various anxiety disorders, including GAD. Another widely used tool is the Generalized Anxiety Disorder 7-item (GAD-7) scale, which is particularly useful for adolescents and adults. These screening tools do not provide a diagnosis on their own but rather help clinicians determine if a full diagnostic evaluation is warranted.
Treatment for GAD in children is typically multi-modal and involves both therapy and, in some cases, medication.
Cognitive Behavioral Therapy (CBT): This is considered the gold-standard psychosocial treatment for GAD in children. A therapist helps the child identify and challenge the anxious thoughts, feelings, and behaviors that are maintaining their worry. Through techniques like exposure therapy, the child is gradually and safely exposed to situations they fear or avoid, learning to cope with their anxiety. Parents are often included in the therapy to learn skills for managing their child's anxiety at home.
Generalized Anxiety Disorder (GAD) is a prevalent and often misunderstood form of anxiety in the pediatric population. While it's normal for children to worry about things like school or a new activity, children with GAD experience excessive, persistent worry about a wide range of topics, often without a specific trigger. This worry is difficult to control and can significantly interfere with their daily functioning at school, home, and with friends.
Discerning anxiety symptoms in children can be challenging, as they may not be able to articulate their feelings as adults can. Instead, their anxiety often manifests through a combination of physical, emotional, and behavioral symptoms.
Physical Symptoms: Children with GAD frequently report physical complaints such as stomachaches, headaches, muscle tension, or fatigue. They might have trouble sleeping, complain of a racing heart, or experience dizziness when feeling overwhelmed.
Emotional Symptoms: The core emotional symptom is a state of perpetual worry. They may worry about grades, family members, friends, or future events. This can lead to irritability, restlessness, and a constant need for reassurance.