8/8/2019 Childhood Anxieties: An Overview Slideshow

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Childhood Anxiety

Jane F. Gilgun, Ph.D., L ICSW

School of Social Work

University of Minnesota, Twin Cities, USAOctober 2010

Topics

Centrality of Parents

PTSD as an example

Temperament

Types of Childhood Anxieties

Anxieties & The Safety of Secure Relationships

A NEATS Analysis

Central Issue

What are the risks & protectivefactors identified with problematicchild behaviors?

If we can find out, we can buildthem into interventions & policy.

Centrality of Parents

Parents as safe havens

Anxiety in children shows in many ways

Dysregulation: avoidance & disorganized behaviors

Parents as active listeners

Parents may require support to be active listeners

Help children return to normal activities

On-going opportunities for self-expression

Temperament

Genes + experience influences neurobiology

Temperament appears to be neurobiological

Easy

Difficult

Slow to warm up

Types of Anxiety Separation Anxiety

Generalized Anxiety

Specific Phobia

Social Phobia

OCD

Panic

PTSD & Acute Stress

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Interactions of Elementsof the NEATS

NEATS=Neurobiology

Executive Function

Attachment

Trauma

Self-Regulation

neurobiology

Executivefunction (EF)

attac

enttrau

a

Self-regulation(SR)

Neurobiology

Cascades of risks encoded in brain circuits

Cascades of resilience encoded in brain circuits

Neurobiologyof Childhood Anxiety

In general

Brain scans show over-active amydala

anxieties show overactivation in some other areas ofbrain & underactivation in others

OCD

issue with serotonin-transmitter gene People may respond to SSRIs (selective serotonin

reuptake inhibitors)

Executive Function By definition, anxiety an issue with EF

People with anxieties may know their fears areirrational

Especially in early childhood some irrational fearsare normative

Persistence

Circumstances

Do children mirror parents?

Attachment

Sensitive, responsive parenting associated withresilience in neurobiologically vunerablechildren (Jaffe, 2007)

Reduction in internalizing and externalizingbehaviors in children by age 5 found in mutuallyresponsive orientations between mothers andyoung children (Calkins et al, 2007)

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Trauma

Many anxieties result from trauma

PTSD & Acute Stress Symptoms

Phobias may be related to trauma

Possibly other anxiety issues result from trauma incombination with predispositions

Genetic

Parental/family influences

Self-Regulation Almost by definition, the anxiety disorders are issues

with SR

Required to cope with anxieties: supportivefamilies/safe havens

Regulating Anxiety

Medication

Therapy

Psychoeducation

Support groups

Meditation

Aerobic exercise

Avoid caffeine & over-the-counter cold medications

A NEATS Analysis of Cognitive

Behavioral Therapy & Medications

Neurobiology

Meds: direct effect

CBT: New behaviors/cognitions: indirect effects

Executive Function

Meds: appear restore balance

CBT: Learn new behaviors & ways of thinking

A NEATS Analysis of Cognitive

Behavioral Therapy & Medications

Neurobiology

Meds: direct effect

CBT: New behaviors/cognitions: indirect effects

Executive Function

Meds: appear restore balance

CBT: Learn new behaviors & ways of thinking

Attachment

Meds: may affect emotional availability

CBT: group, family, & therapist relationships

A NEATS Analysis

of CBT, EMDR, & Meds Trauma

Meds: may make traumatic memories more/lessaccessible

CBT: deals directly with the trauma

EMDR may be an important adjunct

Self-Regulation

Meds: may contribute to reduced heart rate, breathing,& may allow for activation of circuits in the prefrontalcortex (PFC)

CBT: goal is SR

EMDR: by dealing directly with the underlying issues ofanxiety increases activation of circuits in the PFC

May be a form of exposure therapy is a safe setting

References Calkins, Susan D., Alysia A. Blandon, Amanda P.Williford, &

Susan P. Keane (2007). Biol ogical, behavioral, and relationallevels of resilience in the context of risk for early childhoodbehavior problems. Development and Psychopathology, 19, 675700.

Jaffe,Sara R. (2007). Sensitive, stimulating caregiving predictscognitive and behavioral resilience in neurodevelopmentally at-risk infants. Development and Psychopathology, 19, 631-647.

Masten, Ann S., KarinM. Best, & Norman Garmezy (l991).Resilience and development: Contributions from the study ofchildren who overcome adversity. Development andPsychopathology, 2, 425-444.