19.3.1: Fear and Anxiety
- Page ID
- 247166
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- Explain the characteristics and symptoms of common anxiety disorders in children.
Fear and anxiety are common emotional experiences for children, especially during middle childhood. Although the two are related, they are distinct. Fear is a reaction to a specific, identifiable threat, like a barking dog or a thunderstorm. Anxiety, on the other hand, is more often a response to a vague or future threat, such as worrying about failing a test or not having friends at school (Muris & Field, 2010).
Figure \(\PageIndex{1}\). An anxious girl hiding behind a cloth. Image is hosted by PickPik in the public domain.
As children get older, their fears tend to become more realistic. Younger children may fear imaginary creatures or being alone at night, while older children may worry about school performance, social acceptance, or safety in the real world. Research shows that girls are more likely than boys to report fears and anxiety, especially in social or academic settings (Broeren & Muris, 2009).
Although it is normal for children to experience some anxiety, high levels of persistent anxiety can interfere with daily functioning. When this happens, the child may have an anxiety disorder. The exact cause of anxiety disorders is usually unknown, but they likely result from a combination of genetic and environmental factors. Brain imaging studies have shown that in people with anxiety disorders, the amygdala—a brain region involved in emotional responses—tends to be hyperactive, which may make them more sensitive to perceived threats (Monk et al., 2008).
Several types of anxiety disorders can appear in middle childhood. These are outlined in the table below.
| Diagnosis | Description | Common symptoms |
|---|---|---|
| Specific phobia | Intense fear of a particular object or situation that lasts at least 6 months | Avoidance, crying, panic, physical complaints |
| Separation anxiety disorder | Excessive fear of being away from a parent or caregiver to whom the child is attached (more so than what is age-appropriate) | Refusal to go to school, clinginess, nightmares, physical symptoms when apart |
| Social anxiety disorder | Intense fear of being judged or embarrassed in social situations, particularly by peers | Avoiding peers or group activities, extreme self-consciousness, silence in groups |
Children with anxiety disorders often try to avoid situations that make them feel nervous, which can interfere with school, friendships, and daily life. If left untreated, anxiety can continue into adolescence and adulthood. Longitudinal studies show that childhood anxiety disorders often predict later problems, such as depression, substance use, or continued anxiety in adulthood (Copeland et al., 2009). This shows that anxiety in children is not something they simply grow out of, and early support and intervention are important.
References, Contributors and Attributions
Broeren, S., & Muris, P. (2009). The relation between cognitive development and anxiety phenomena in children. Journal of Child and Family Studies, 18(6), 702–709. https://doi.org/10.1007/s10826-009-9279-5
Copeland, W. E., Shanahan, L., Costello, E. J., & Angold, A. (2009). Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Archives of General Psychiatry, 66(7), 764–772. https://doi.org/10.1001/archgenpsychiatry.2009.85
Monk, C. S., Telzer, E. H., Mogg, K., Bradley, B. P., Mai, X., Louro, H. M. C., Chen, G., McClure-Tone, E. B., Ernst, M., Pine, D. S., & Blair, R. J. R. (2008). Amygdala and ventrolateral prefrontal cortex activation to masked angry faces in children and adolescents with generalized anxiety disorder. Archives of General Psychiatry, 65(5), 568–576. https://doi.org/10.1001/archpsyc.65.5.568
Muris, P., & Field, A. P. (2010). The role of verbal threat information in the development of childhood fear. Behaviour Research and Therapy, 48(1), 27–34. https://doi.org/10.1016/j.brat.2009.09.001