Anxiety Disorders in Childhood and Adolescence: Prevalence and Diagnostic Considerations

• Alegría, M., Green, J. G., McLaughlin, K. A., & Loder, S. (2015). Disparities in child and adolescent mental health and mental health services in the US. William T. Grant Foundation.

  Google Scholar 

• Alegria, M., Shrout, P. E., Canino, G., Alvarez, K., Wang, Y., Bird, H., et al. (2019). The effect of minority status and social context on the development of depression and anxiety: A longitudinal study of Puerto Rican descent youth. World Psychiatry, 18(3), 298–307.

  Article  PubMed  PubMed Central  Google Scholar 

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

  Book  Google Scholar 

• Anderson, E. R., & Mayes, L. C. (2010). Race/ethnicity and internalizing disorders in youth: A review. Clinical Psychology Review, 30(3), 338–348. https://doi.org/10.1016/j.cpr.2009.12.008

  Article  PubMed  Google Scholar 

• Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40(1), 57–87.

  Article  PubMed  Google Scholar 

• Asnaani, A., Richey, J. A., Dimaite, R., Hinton, D. E., & Hofmann, S. G. (2010). A cross-ethnic comparison of lifetime prevalence rates of anxiety disorders. The Journal of Nervous and Mental Disease, 198(8), 551.

  Article  PubMed  PubMed Central  Google Scholar 

• Becerra-Culqui, T. A., Liu, Y., Nash, R., Cromwell, L., Flanders, W. D., Getahun, D., et al. (2018). Mental health of transgender and gender nonconforming youth compared with their peers. Pediatrics, 141(5).

  Google Scholar 

• Becker-Haimes, E. M., Tabachnick, A. R., Last, B. S., Stewart, R. E.,Hasan-Granier, A., & Beidas, R. S. (2020). Evidence Base Update for Brief, Free, and Accessible Youth Mental Health Measures. Journal of clinical child and adolescent psychology: the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 49(1), 1–17. https://doi.org/10.1080/15374416.2019.1689824

• Beidas, R. S., Suarez, L., Simpson, D., Read, K., Wei, C., Connolly, S., & Kendall, P. (2012). Contextual factors and anxiety in minority and European American youth presenting for treatment across two urban university clinics. Journal of Anxiety Disorders, 26(4), 544–554.

  Article  PubMed  PubMed Central  Google Scholar 

• Benjamin, C. L., Harrison, J. P., Settipani, C. A., Brodman, D. M., & Kendall, P. C. (2013). Anxiety and related outcomes in young adults 7 to 19 years after receiving treatment for child anxiety. Journal of Consulting and Clinical Psychology, 81(5), 865–876. https://doi.org/10.1037/a0033048

  Article  PubMed  Google Scholar 

• Bernstein, G. A., & Borchardt, C. M. (1991). Anxiety disorders of childhood and adolescents: A review. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 519–532.

  Article  PubMed  Google Scholar 

• Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 545–553. https://doi.org/10.1097/00004583-199704000-00018

• Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(10), 1230–1236. https://doi.org/10.1097/00004583-199910000-00011

• Burstein, M., Beesdo-Baum, K., He, J. P., & Merikangas, K. R. (2014). Threshold and subthreshold generalized anxiety disorder among US adolescents: Prevalence, sociodemographic, and clinical characteristics. Psychological Medicine, 44(11), 2351.

  Article  PubMed  PubMed Central  Google Scholar 

• Chavira, D., Stein, M., Bailey, K., & Stein, M. (2004). Child anxiety in primary care: Prevalent but untreated. Depression and Anxiety, 20, 155–164.

  Article  PubMed  Google Scholar 

• Chorpita, B. F., Moffitt, C. E., & Gray, J. (2005). Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample. Behaviour research and therapy, 43(3), 309–322. https://doi.org/10.1016/j.brat.2004.02.004

• Comer, J. S., Blanco, C., Hasin, D. S., Liu, S. M., Grant, B. F., Turner, J. B., & Olfson, M. (2010). Health-related quality of life across the anxiety disorders: Results from the national epidemiologic survey on alcohol and related conditions (NESARC). The Journal of Clinical Psychiatry, 72(1), 43–50.

  Article  PubMed  PubMed Central  Google Scholar 

• Costello, E., Mustillo, S., Keeler, G., & Angold, A. (2004). Prevalence of psychiatric disorders in children and adolescents. In B. Levine, J. Petrila, & K. Hennessey (Eds.), Mental health services: A public health perspective (pp. 111–128). Oxford University Press.

  Google Scholar 

• Cummings, C. M., Caporino, N. E., & Kendall, P. C. (2014). Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychological Bulletin, 140(3), 816.

  Article  PubMed  Google Scholar 

• Cunningham, J. M., & Suldo, S. M. (2014). Accuracy of teachers in identifying elementary school students who report at-risk levels of anxiety and depression. School Mental Health: A Multidisciplinary Research and Practice Journal, 6(4), 237–250. https://doi.org/10.1007/s12310-014-9125-9

• de Lijster, J. M., Dierckx, B., Utens, E. M., Verhulst, F. C., Zieldorff, C., Dieleman, G. C., & Legerstee, J. S. (2017). The age of onset of anxiety disorders: A meta-analysis. Canadian Journal of Psychiatry, 62(4), 237.

  Article  PubMed  Google Scholar 

• de Lijster, J. M., Dieleman, G. C., Utens, E. M., Dierckx, B., Wierenga, M., Verhulst, F. C., & Legerstee, J. S. (2018). Social and academic functioning in adolescents with anxiety disorders: A systematic review. Journal of Affective Disorders, 230, 108–117.

  Article  PubMed  Google Scholar 

• de Miranda, D. M., da Silva Athanasio, B., de Sena Oliveira, A. C., & Silva, A. C. S. (2020). How is COVID-19 pandemic impacting mental health of children and adolescents? International Journal of Disaster Risk Reduction, 51, 101845.

  Article  Google Scholar 

• Dowdy, E., Furlong, M., Raines, T. C., Bovery, B., Kauffman, B., Kamphaus, R. W., et al. (2015). Enhancing school-based mental health services with a preventive and promotive approach to universal screening for complete mental health. Journal of Educational and Psychological Consultation, 25(2–3), 178–197.

  Article  Google Scholar 

• Egger, H. L., Costello, E. J., & Angold, A. (2003). School refusal and psychiatric disorders: A community study. Journal of the American Academy of Child and Adolescent Psychiatry, 42(7), 797–807. https://doi.org/10.1097/01.CHI.0000046865.56865.79

  Article  PubMed  Google Scholar 

• Essau, C. A., Lewinsohn, P. M., Olaya, B., & Seeley, J. R. (2014).Anxiety disorders in adolescents and psychosocial outcomes at age 30. Journal of affective disorders, 163, 125–132. https://doi.org/10.1016/j.jad.2013.12.033

• Essau, C. A., Lewinsohn, P. M., Lim, J. X., Moon-ho, R. H., & Rohde, P. (2018). Incidence, recurrence and comorbidity of anxiety disorders in four major developmental stages. Journal of Affective Disorders, 228, 248–253.

  Article  PubMed  Google Scholar 

• Gaylord-Harden, N. K., Burnside, A., & Tinsley, D. T. (2020). The prevalence and longitudinal patterns of continuous community violence exposure and trauma-related symptoms in adolescent male serious offenders. Journal of Traumatic Stress, 33(4), 541–551.

  Article  PubMed  Google Scholar 

• Ghandour, R. M., Sherman, L. J., Vladutiu, C. J., Ali, M. M., Lynch, S. E., Bitsko, R. H., & Blumberg, S. J. (2019). Prevalence and treatment of depression, anxiety, and conduct problems in US children. The Journal of Pediatrics, 206, 256–267.e3. https://doi.org/10.1016/j.jpeds.2018.09.021

  Article  PubMed  Google Scholar 

• Ginsburg, G. S., Drake, K. L., Tein, J. Y., Teetsel, R., & Riddle, M. A. (2015). Preventing onset of anxiety disorders in offspring of anxious parents: A randomized controlled trial of a family-based intervention. American Journal of Psychiatry, 172(12), 1207–1214.

  Article  PubMed  Google Scholar 

• Gordon-Hollingsworth, A. T., Becker, E. M., Ginsburg, G. S., Keeton, C., Compton, S. N., Birmaher, B. B., et al. (2015). Anxiety disorders in Caucasian and African American children: A comparison of clinical characteristics, treatment process variables, and treatment outcomes. Child Psychiatry & Human Development, 46(5), 643–655.

  Article  Google Scholar 

• Hawes, M. T., Szenczy, A. K., Olino, T. M., Nelson, B. D., & Klein, D. N. (2021). Trajectories of depression, anxiety and pandemic experiences; a longitudinal study of youth in New York during the Spring-Summer of 2020. Psychiatry Research, 298, 113778.

  Article  PubMed  Google Scholar 

• Hays, P. A. (2016). Addressing cultural complexities in practice: A framework for clinicians and counselors (3rd ed.). American Psychological Association.

  Google Scholar 

• Hendriks, S. M., Spijker, J., Licht, C. M., Hardeveld, F., de Graaf, R., Batelaan, N. M., Penninx, B. W., & Beekman, A. T. (2016). Long-term disability in anxiety disorders. BMC Psychiatry, 16(1), 1–8.

  Article  Google Scholar 

• Higa-McMillan, C. K., Francis, S. E., Rith-Najarian, L., & Chorpita, B. F. (2016). Evidence base update: 50 years of research on treatment for child and adolescent anxiety. Journal of Clinical Child and Adolescent Psychology, 45(2), 91–113. https://doi.org/10.1080/15374416.2015.1046177

  Article  PubMed  Google Scholar 

• Jarvis, G. E., Kirmayer, L. J., Gómez-Carrillo, A., Aggarwal, N. K., & Lewis-Fernández, R. (2020). Update on the cultural formulation interview. Focus, 18(1), 40–46.

  Article  PubMed  PubMed Central  Google Scholar 

• Kendall, P. C., Brady, E. U., & Verduin, T. L. (2001). Comorbidity in childhood anxiety disorders and treatment outcome. Journal of the American Academy of Child & Adolescent Psychiatry, 40(7), 787–794.

  Article  Google Scholar 

• Kendall, P. C., Compton, S. N., Walkup, J. T., Birmaher, B., Albano, A. M., Sherrill, J., et al. (2010). Clinical characteristics of anxiety disordered youth. Journal of Anxiety Disorders, 24(3), 360–365.

  Article  PubMed  PubMed Central  Google Scholar 

• Khan, A. N., Bilek, E., Tomlinson, R. C., & Becker-Haimes, E. M. (2021). Treating social anxiety in an era of social distancing: Adapting exposure therapy for youth during COVID-19. Cognitive and Behavioral Practice.

  Google Scholar 

• La Roche, M. (2020). Towards a global and cultural psychology: Theoretical foundations and clinical implications. Cognella.

  Google Scholar 

• Liang, J., Matheson, B. E., & Douglas, J. M. (2016). Mental health diagnostic considerations in racial/ethnic minority youth. Journal of Child and Family Studies, 25(6), 1926–1940.

  Article  PubMed  Google Scholar 

• Lyneham, H. J., Street, A. K., Abbott, M. J., & Rapee, R. M. (2008). Psychometric properties of the school anxiety scale—Teacher report (SAS-TR). Journal of Anxiety Disorders, 22(2), 292–300.

  Article  PubMed  Google Scholar 

• Margherio, S. M., Evans, S. W., & Owens, J. S. (2019). Universal screening in middle and high schools: Who falls through the cracks? School Psychology, 34(6), 591.

  Article  PubMed  Google Scholar 

• Marmorstein, N. R. (2007). Relationships between anxiety and externalizing disorders in youth: The influences of age and gender. Journal of Anxiety Disorders, 21(3), 420–432.

  Article  PubMed  Google Scholar 

• McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G. (2011). Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. Journal of Psychiatric Research, 45(8), 1027–1035.

  Article  PubMed  PubMed Central  Google Scholar 

• Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., et al. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989.

  Article  PubMed  PubMed Central  Google Scholar 

• Moreno, O., & Corona, R. (2021). Considerations to Youth’s psychopathology and mental healthcare disparities research through the intersections of dominant and non-dominant identities. Research on Child and Adolescent Psychopathology, 49(1), 19–23.

  Article  PubMed  Google Scholar 

• Mychailyszyn, M. P., Mendez, J. L., & Kendall, P. C. (2010). Anxiety disorders and school functioning in youth: Comparisons by diagnosis and comorbidity. School Psychology Review, 39, 106–121.

  Article  Google Scholar 

• Mychailyszyn, M. P., Beidas, R. S., Benjamin, C. L., Edmunds, J. M., Podell, J. L., Cohen, J. S., & Kendall, P. C. (2011). Assessing and treating child anxiety in schools. Psychology in the Schools, 48(3), 223–232. https://doi.org/10.1002/pits.20548

  Article  PubMed  PubMed Central  Google Scholar 

• Nail, J. E., Christofferson, J., Ginsburg, G. S., Drake, K., Kendall, P. C., McCracken, J. T., et al. (2015). Academic impairment and impact of treatments among youth with anxiety disorders. Child & Youth Care Forum, 44(3), 327–342. Springer US.

  Article  Google Scholar 

• Pearl, S. B., & Norton, P. J. (2017). Transdiagnostic versus diagnosis specific cognitive behavioural therapies for anxiety: A meta-analysis. Journal of Anxiety Disorders, 46, 11–24.

  Article  PubMed  Google Scholar 

• Putwain, D., & Daly, A. L. (2014). Test anxiety prevalence and gender differences in a sample of English secondary school students. Educational Studies, 40(5), 554–570.

  Article  Google Scholar 

• Sanchez, A. L., Comer, J. S., & LaRoche, M. (2021). Enhancing the responsiveness of family-based CBT through culturally informed case conceptualization and treatment planning. Cognitive and Behavioral Practice.

  Google Scholar 

• Silverman W. K., & Albano A. M. (2004). Anxiety Disorders Interview Schedule for DSM–IV, Child version: Clinician manual. New York, NY: Graywind Publications, New York: Oxford University Press.

  Google Scholar 

• Sosoo, E. E., Bernard, D. L., & Neblett, E. W., Jr. (2020). The influence of internalized racism on the relationship between discrimination and anxiety. Cultural Diversity and Ethnic Minority Psychology, 26(4), 570.

  Article  PubMed  Google Scholar 

• Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour research and therapy, 36(5), 545–566. https://doi.org/10.1016/s0005-7967(98)00034-5

• Spinazzola, J., Ford, J., Zucker, M., van der Kolk, B., Silva, S., Smith, S., & Blaustein, M. (2005). National survey of complex trauma exposure, outcome and intervention for children and adolescents. Psychiatric Annals, 35(5), 433–439.

  Article  Google Scholar 

• Toppelberg, C. O., Tabors, P., Coggins, A., Lum, K., & Burger, C. (2005). Differential diagnosis of selective mutism in bilingual children. Journal of the American Academy of Child and Adolescent Psychiatry, 44(6), 592.

  Article  PubMed  PubMed Central  Google Scholar 

• Wolk, C. B., Kendall, P. C., & Beidas, R. S. (2015). Cognitive-behavioral therapy for child anxiety confers long-term protection from suicidality. Journal of the American Academy of Child and Adolescent Psychiatry, 54(3), 175–179. https://doi.org/10.1016/j.jaac.2014.12.004

  Article  PubMed  Google Scholar 

• Zigarelli, J. C., Jones, J. M., Palomino, C. I., & Kawamura, R. (2016). Culturally responsive cognitive behavioral therapy: Making the case for integrating cultural factors in evidence-based treatment. Clinical Case Studies, 15(6), 427–442.

  Article  Google Scholar 

Download references