Anxiety disorders remain prevalent among children and adolescents and have been reported to be on the rise [89]. Some of these disorders present in similar ways as in adults, while others may present differently [90] or have slightly different diagnos-
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tic criteria [11]. When working with youth, it is very important to take developmen- tal considerations into account. This is true in assessment and diagnosis, as well as in treatment. Without proper consideration of these factors, clinicians are likely to miss important nuances of diagnosis and be less effective in treating these individu- als. Although anxiety disorders may be less likely to be noticed by others compared to disorders that frequently present as behavioral problems (e.g., attention-deficit/
hyperactivity disorder or oppositional defiant disorder), they remain a serious prob- lem worthy of intervention.
Research supports the efficacy of CBT and SSRIs to treat children and adoles- cents with anxiety [17], and the treatment gains have been shown to be maintained years later [26, 90–92]. Nevertheless, some youth do not benefit fully from these treatments and remain symptomatic, and pediatric anxiety disorders may persist and be chronic [90]. This points to the need for further research to identify why these treatments do not benefit some youth, what treatment might be effective for those individuals, and what treatment would work best for different youth. In this vein, future research is needed to explore both the mechanisms of change within these interventions and the significant predictors of treatment outcome. With a better understanding, new treatments, based on theory and prior research, can be developed to help children and adolescents who do not currently benefit from CBT or SSRIs. Additionally, as noted earlier, further research is needed on alternate interventions, particularly parent therapies and acceptance-, mindfulness-, and meditation- based interventions, which have shown promise in previous research with adults.
As research in the field progresses, it is important that studies look at anxiety disorders and their treatment in youth, specifically. Although many features of the disorders and their treatments may span from childhood to adulthood, youth are not simply “little adults,” and thus we cannot rely on the literature in adults or assume the features of the disorders and successful components of treatment remain stable over development [93, 94]. Future research should explore the pathways anxiety disorders may take, both in their presentation in childhood and adolescence, as well as how they may develop, progress, or change over the course of development.
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