Abstract

The recent literature on anxiety in children suggests that prevalence rates have been highly variable, ranging from a low of 1% in China and 3% in the U.S. and Canada to a high of 17% in Turkey and 25% in Greece. This variability may relate to age range differences of the samples or to different measures of anxiety (symptoms versus diagnoses). Very few negative effects of anxiety have been addressed including increased sensory and emotion processing problems, difficulty managing social fears, body image dissatisfaction, sleep disturbances and the development of bipolar disorder. Predictors/risk factors have been the primary focus in this literature and have included parent variables of prenatal depression and elevated hair cortisol, parental anxiety and different parenting styles (permissiveness, overprotectiveness and harsh disciplinary style). The child variables have included negative emotionality, irritability and fearfulness. Other child variables include less social skill, problematic technology use, attention bias toward negative stimuli, negative expectations, reading and spelling problems and low academic achievement. The most effective intervention has been Cognitive Behavioral Therapy, although others have appeared in this literature including attention training, guided breathing and exercise. Potential underlying mechanisms for anxiety in children include prenatal anxiety, lack of vagal flexibility, low levels of brain derived neurotrophic factor and lower total cortical and amygdala volume as revealed by fMRIs. Although the data highlight the prevalence and severity of anxiety in children, they have been primarily based on parent-report surveys that have yielded mixed results across samples.