Research Therapies — 18 June 2012

Recent research suggests a simple screening tool developed in Canada may help identify those children who are at risk of developing anxiety disorders.

Asking parents to compare their kids’ levels of shyness and anxiety to those of their peers could predict potential anxiety disorders early on, Canadian researchers reported at the American Educational Research Association annual meeting in Vancouver in April.

University of British Columbia psychologists say two key questions – “Is your child more shy or anxious than other children his or her age?” and “Is your child more worried than other children his or her age?” – accurately identified 85% of children who went on to be diagnosed with an anxiety disorder within two years.

Here in Australia, child and adolescent psychiatrist, Dr Phil Brock, says there is an increasing effort to try to identify vulnerable children early, and the government has been seeking to introduce screening at age four for this purpose. If the Canadian screen test is validated in bigger studies, it could prove to be a useful tool, he says.

“You would want to ask in a screening context, for example alongside screening for hearing and vision, so they’re not talking about their child having a disorder at this particular age,” says Dr Brock.

“The experience of anxiety is normal, it’s whether that experience is processed in an adaptive way, or whether it leads to overreactions or behaviours that are not appropriate to the fear or anxiety,” he explains.

“Shyness can be a way of handling high autonomic reactivity – for some children their bodies react with a higher pulse rate or a higher output of cortisol, so physiologically they’re programmed to react strongly, and to modify that reaction they try to keep their environment fairly stable and unchanging,” he adds.

Sarah Perini, clinical director of Macquarie University’s Emotional Health Clinic, agrees that screening is a good idea, provided it’s done sensitively.

“It’s important to distinguish between a screener that’s kind of a flag to say this is worth investigating more, and a two-question measure and then saying, ‘oh, this child has an anxiety disorder,’” Ms Perini says.

“There’s definitely a good argument for doing early detection,” she says. “If someone has an anxiety disorder quite young that can set them up for other negative experiences, such as school bullying, that actually put them at risk for further mental health disorders.”

But if picked up early, effective interventions are available. For example, Ms Perini and her colleagues have developed a program for parents of anxious preschoolers, which teaches them how to build their child’s confidence and parent without exacerbating the problem. That program has been shown to prevent anxiety disorders later in life.

“There are things that can be done that don’t involve medication, that don’t involve a lot of time, necessarily, or money, that can have a big impact,” Ms Perini says.

As first appeared in Medical Observer

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