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Anxiety

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Alexia Casalinuovo

on 11 July 2015

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Transcript of Anxiety

Normative Fear







Clinical Anxiety Disorders

Possible Childhood Symptoms of Anxiety
Academic
Social
Physical

Separation Anxiety
Social Anxiety

Selective Mutism
In the DSM-5 OCD and PTSD have been removed from Anxiety Disorders to different sections

the skills important for normal functioning are no longer adaptable to situations causing distress and impairment
reactions are disproportionate to the actual situation
A person develops an "Anxiety Disorder" when:
Resulting in experiences of persistent
fear
avoidance
Anxiety is one of the most common mental health disorders in childhood.
Why is it so important to recognize and treat?
If left untreated it could become chronic and persist into adulthood.
BERGMAN, R., LANGLEY, A., & PIACENTINI, J. (2002). Assessment of childhood anxiety. International Review of Psychiatry, (14), 102–113.
Citations:
BERGMAN, R., LANGLEY, A., & PIACENTINI, J. (2002). Assessment of childhood anxiety. International Review of Psychiatry, (14), 102–113.
Issues with diagnosis and treatment:
Children are less likely to be identified and treated compared to adults
lack the vocabulary to express distress
some anxiety associated with the child's stages of development
Continuous changes in the DSM makes it difficult for comparative analysis between research journals articles
Many interventions treat children as "little adults"
BERGMAN, R., LANGLEY, A., & PIACENTINI, J. (2002). Assessment of childhood anxiety. International Review of Psychiatry, (14), 102–113.
Barrett, P. D. (2000). Treatment of childhood anxiety: Developmental aspects. Clinical Psychology Review, 20(4), 479–494.
Barrett, P. D. (2000). Treatment of childhood anxiety: Developmental aspects. Clinical Psychology Review, 20(4), 479–494.
Cognitive Behavioral Therapy Programs
Emotional
Common Childhood Anxiety Disorders
Generalized Anxiety Disorder
Other disorders in the DSM-5 not mentioned in the textbook include:
Cognitive Behaviour Therapy
Yoga
Where to find help
online and in Ontario

For More Information About Each Resource Please See The Anxiety Disorders Handout
Children with anxiety disorders compared to non-anxious children more often report:
difficulties in maintaining peer relationships
possessing problem Social behaviors and severe self-consciousness

Hudson, J., McLoone, J., & Rapee, R. (2006). Treating anxiety disorders in a school setting. Education & Treatment of Children, 29(2), 219-242.
Hudson, J., McLoone, J., & Rapee, R. (2006). Treating anxiety disorders in a school setting. Education & Treatment of Children, 29(2), 219-242.
Females are 1.5 - 2 times more likely to develop anxiety disorders compared to males.
Hudson, J., McLoone, J., & Rapee, R. (2006). Treating anxiety disorders in a school setting. Education & Treatment of Children, 29(2), 219-242.
School Settings are Ideal Locations for the Treatment and Prevention of Anxiety Disorders
provides access to youth including at risk students
reduces the stigma associated with receiving mental health services
"financial parity for service delivery to all students" (Hudson, McLoone & Rapee, 2006)
Hudson, J., McLoone, J., & Rapee, R. (2006). Treating anxiety disorders in a school setting. Education & Treatment of Children, 29(2), 219-242.
Children with anxiety have lower levels of self-esteem compared to non-anxious children
Hudson, J., McLoone, J., & Rapee, R. (2006). Treating anxiety disorders in a school setting. Education & Treatment of Children, 29(2), 219-242.
Anxious children typically experience:
Higher levels of concentration and attention difficulties
Lower levels of academic achievement (there are exceptions)
Hudson, J., McLoone, J., & Rapee, R. (2006). Treating anxiety disorders in a school setting. Education & Treatment of Children, 29(2), 219-242.
Goal of CBT
Not to "Cure" but to teach children how to manage anxiety
BEIDAS, R., BENJAMIN, C., COHEN, J., EDMUNDS, J., & MYCHAILYSZYN, M. (2011). Assessing and treating child anxiety in schools. Psychology in the Schools, 48(3), 223-233.
BEIDAS, R., BENJAMIN, C., COHEN, J., EDMUNDS, J., & MYCHAILYSZYN, M. (2011). Assessing and treating child anxiety in schools. Psychology in the Schools, 48(3), 223-233.
BEIDAS, R., BENJAMIN, C., COHEN, J., EDMUNDS, J., & MYCHAILYSZYN, M. (2011). Assessing and treating child anxiety in schools. Psychology in the Schools, 48(3), 223-233.
many anxious situations contributing to this disorder is linked to school experiences
"Interventions led by teachers and school nurses are comparable to the reductions in anxiety when compared to interventions led by psychologists"
(BEIDAS, BENJAMIN, COHEN, EDMUNDS & MYCHAILYSZYN, 2011)
Waller, R. (2006). Fostering child & adolescent mental health in the classroom. (pp. 77-92). California: Sage Publications Inc.
Anxiety: the most common psychiatric illness in the world (2013, October 01). [Online forum comment]. Retrieved from http://mindyourmind.ca/community/blog/35-mental-health-a-coping/4872-anxiety-the-most-common-psychiatric-illness-in-the-world
Waller, R. (2006). Fostering child & adolescent mental health in the classroom. (pp. 77-92). California: Sage Publications Inc.


-Steiner et al. explored the feasibility of conducting yoga sessions in urban schools to target
students with emotional disorders and anxiety
-teachers reported higher levels of relaxation, attention and positive behaviour
but results concerning effectiveness in treating anxiety were non-conclusive


Steiner, N. J., Sidhu, T. K., Pop, P. G., Frenette, E. C., & Perrin, E. C. (2013). Yoga in an urban school for children with emotional and behavioral disorders: A feasibility study. Journal of Child and Family Studies, 22(6), 815-826. doi:http://dx.doi.org/10.1007/s10826-012-9636-7
-CBT makes clear connections between the thoughts and feelings that influence behaviours
-Chiu et al. found that delivering modular CBT in elementary schools may be effective in reducing anxiety in children and could increase the number of children who receive treatment
-95% of children who received modular CBT at school were free of any anxiety diagnosis at the end of treatment compared to 16% of the comparison wait list group

Chiu, A. W., Langer, D. A., McLeod, B. D., Har, K., Drahota, A., Galla, B. M., . . . Wood, J. J. (2013). Effectiveness of modular CBT for child anxiety in elementary schools. School Psychology Quarterly, 28(2), 141-153. doi:http://dx.doi.org/10.1037/spq0000017
Mindfulness
-mindfulness is “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally”
-self-management of attention to a neutral stimulus (e.g. the breath) creates a space from which to observe thoughts/emotions/body sensations
-six-week, school-based mindfulness training program found improvements for all children in either academic, internalizing or externalizing problems

Guided Imagery
Semple, R. J., Reid, E. F. G., & Miller, L. (2005). Treating anxiety with mindfulness: An open trial of mindfulness training for anxious children. Journal of Cognitive Psychotherapy, 19(4), 379-392. Retrieved from http://search.proquest.com/docview/89071356?accountid=14771
-academic coping imagery with relaxation training led to decreases in test anxiety and increased academic performance in college students in comparison to controls
-subjects were trained to visualize academic images of competence (i.e. successful test-taking experience) as well as to employ progressive relaxation techniques

Harris, G. M., & Johnson, S. B. (1983). Coping imagery and relaxation instructions in a covert modeling treatment for test anxiety. Behavior Therapy, 14(1), 144-157. Retrieved from http://search.proquest.com/docview/616739624?accountid=14771
Discussion Questions
1. Which activities could you see being particularly useful in the classroom? Why?
2. How could a teacher incorporate these activities/programs into the classroom?
3. Can you think of any issues in implementing these resources in a classroom setting?
4. Have you used similar techniques in the classroom? How effective have they been?
"'School Refusal' behaviours refers to any refusal to attend school or difficulty attending classes for an entire day,"

severe misbehaviours
somatic complaints
lateness/skipping
Physical Symptoms of Anxiety are:
fatigue
stomachaches
headaches
flushing
trembling
nausea
restlessness
excessive sweating
heart palpitations
dizziness
shortness of breath
Waller, R. (2006). Fostering child & adolescent mental health in the classroom. (pp. 77-92). California: Sage Publications Inc.
Less likely to participate in lessons
Presentation Goals:
Understand anxiety disorders and their symptoms
Recognize the main changes in the DSM-5
Latest research continued
Treatment and classroom strategies
Resources
Group activities and discussion
Chiu, A. W., Langer, D. A., McLeod, B. D., Har, K., Drahota, A., Galla, B. M., . . . Wood, J. J. (2013). Effectiveness of modular CBT for child anxiety in elementary schools. School Psychology Quarterly, 28(2), 141-153. doi:http://dx.doi.org/10.1037/spq0000017
Harris, G. M., & Johnson, S. B. (1983). Coping imagery and relaxation instructions in a covert modeling treatment for test anxiety. Behavior Therapy, 14(1), 144-157. Retrieved from http://search.proquest.com/docview/616739624?accountid=14771
Semple, R. J., Reid, E. F. G., & Miller, L. (2005). Treating anxiety with mindfulness: An open trial of mindfulness training for anxious children. Journal of Cognitive Psychotherapy, 19(4), 379-392. Retrieved from http://search.proquest.com/docview/89071356?accountid=14771
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