Prevention of childhood anxiety disorders

Abstract

Anxiety disorders represent one of the most common and debilitating forms of psychopathology in children. While empirical research, mental health funding, and mental health professionals continue to focus on the treatment rather than prevention of anxiety disorders in children, preliminary research presents an optimistic picture for preventative strategies in the future. Knowledge of the risk factors, protective factors, and treatment strategies associated with childhood anxiety disorders, in conjunction with theories regarding the methods, timing, levels, and targets of prevention, equip us well for effectively preventing childhood anxiety disorders in the future.

Introduction

THE ADAGE THAT “prevention is better than cure” would seem to make intuitive sense and is certainly a concept embraced by the medical profession. Immunisation, breast cancer screening, pap smear tests, and media campaigns aimed at decreasing skin cancer, are but a few examples of the emphasis on prevention within the field of medicine. Prevention and treatment research within the medical domain are considered to be of equal importance by researchers, funding bodies, and the general public. Furthermore, medical practitioners spend a significant proportion of their time engaged in preventative strategies and in advocating preventative strategies to their patients.

In contrast, the mental health sector has not, until recently, shared the emphasis on prevention. Despite the enormous economic, personal and social costs of many mental health problems, and the vast number of people suffering from them, the focus within mental health has continued to be on treatment rather than prevention. While there has been an encouraging increase in the number of psychological academic journal articles relating to prevention, the majority of papers have been theoretical in nature rather than rigorous empirical tests of particular preventative strategies.

Children may suffer from a number of mental health problems, however anxiety disorders represent one of the most common forms of psychopathology in children. In an epidemiological study of the prevalence of anxiety disorders in children, Kashani and Orvaschel (1990) found that 21% of children and adolescents demonstrated an anxiety disorder of some description. While separation anxiety disorder is the only anxiety disorder categorised as typically beginning in childhood and adolescence according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (American Psychiatric Association, 1994), children may also suffer from any of the anxiety disorders outlined for adulthood. From the following discussion it will become apparent that while the prevention of childhood anxiety remains in its infancy, preliminary research presents an optimistic picture for the future.