Prevention of childhood anxiety disorders
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.
Section snippets
Risk and protective factors for anxiety disorders
The risk factors, protective factors, and treatment strategies associated with a particular disorder are important considerations when devising prevention strategies. Enquiry into the area of childhood anxiety has identified many risk factors, somewhat fewer protective factors, and a number of treatment strategies.
Prevention
While many effective treatment approaches to child anxiety exist and are highly effective for the majority of children Barrett, Dadds, & Rapee 1996, Cobham et al. in press, Kendall 1994, there are a number of reasons why prevention of anxiety disorders is preferable to treatment. Prevention can be defined as interventions that occur before the onset of a clinically diagnosable disorder that aim to reduce the number of new cases of that disorder (Munoz, Mrazek, & Haggerty, 1996). In order to
Conclusions
The above discussion has highlighted the debilitating consequences of childhood anxiety disorders and the benefits of prevention. Our knowledge of the many risk factors, protective factors, and effective treatment strategies for anxiety, equips us well for effectively preventing childhood anxiety disorders. It is evident that while further research is necessary, models already exist regarding the timing of preventative efforts (Spence, in press) and the different levels at which prevention
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