Cited by 168Child and Adolescent Psychosocial and Emotional DevelopmentAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMaternal Mental Health During Pregnancy and Postpartum

Research Review: Pediatric Anxiety Disorders—What Have We Learnt in the Last 10 Years?

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Strawn, Jeffrey R., Lu, Lu, Peris, Tara S., Levine, Amir, Walkup, John T.·2021·Journal of Child Psychology and Psychiatry

Abstract

Background: Anxiety disorders first emerge during the critical developmental periods of childhood and adolescence. This review synthesizes recent findings on the prevalence, risk factors, and course of the anxiety disorders; and their neurobiology and treatment. Methods: For this review, searches were conducted using PubMed, PsycINFO, and clinicaltrials.gov . Findings related to the epidemiology, neurobiology, risk factors, and treatment of pediatric anxiety disorders were then summarized. Findings: Anxiety disorders are high prevalence, and early‐onset conditions associated with multiple risk factors including early inhibited temperament, environment stress, and structural and functional abnormalities in the prefrontal‐amygdala circuitry as well as the default mode and salience networks. The anxiety disorders are effectively treated with cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs), and serotonin–norepinephrine reuptake inhibitors (SNRIs). Conclusions: Anxiety disorders are high prevalence, early‐onset conditions associated with a distinct neurobiological fingerprint, and are consistently responsive to treatment. Questions remain regarding who is at risk of developing anxiety disorders as well as the way in which neurobiology predicts treatment response.

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  • The interaction between ADHD and AD is widely debated in the literature, since they have independent transmission patterns, represent different expressions of the same genetic risk factor, and share some neurodevelopmental brain abnormalities.

    “The interaction between ADHD and AD is widely debated in the literature, since they have independent transmission patterns, represent different expressions of the same genetic risk factor [48,111], and share some neurodevelopmental brain abnormalities [106,112,113,114].”

    From ADHD Children Take More Time to Inhibit Automatic Responses: A Comparison with Anxiety Disorders Using NEPSY-II (2025) · cites this paper as [114]

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  • The age of onset of anxiety disorders usually occurs in childhood or adolescence.

    “with the age of onset usually occurring in childhood or adolescence [9–11]”

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  1. [36]Compton SN, Walkup JT, Albano AM, Piacentini JC, Birmaher B, Sherrill JT, … March JS (2010). Child/Adolescent Anxiety Multimodal Study (CAMS): rationale, design, and methods. Child and Adolescent Psychiatry and Mental Health, 4, 1 10.1186/1753-2000-4-1 20051130 PMC2818613 · DOI
  2. [137]Strawn JR, Mills JA, Sauley BA, & Welge JA (2018). The Impact of Antidepressant Dose and Class on Treatment Response in Pediatric Anxiety Disorders: A Meta-Analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 57(4). 10.1016/j.jaac.2018.01.015 PMC5877120 29588049 · DOI · Paper page
  3. [139]Strawn JR, Prakash A, Zhang Q, Pangallo BA, Stroud CE, Cai N, & Findling RL (2015). A randomized, placebo-controlled study of duloxetine for the treatment of children and adolescents with generalized anxiety disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54(4), 283– 93. 10.1016/j.jaac.2015.01.008 25791145 · DOI
  4. [155]Wang Z, Whiteside SPH, Sim L, Farah W, Morrow AS, Alsawas M, … Murad MH (2017). Comparative Effectiveness and Safety of Cognitive Behavioral Therapy and Pharmacotherapy for Childhood Anxiety Disorders: A Systematic Review and Meta-analysis. JAMA Pediatrics 10.1001/jamapediatrics.2017.3036 PMC5710373 28859190 · DOI · Paper page

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Authors
Strawn, J. R., Lu, L., Peris, T. S., Levine, A., & Walkup, J. T.
Affiliations
  • University of Cincinnati (US)
  • West China Medical Center of Sichuan University (CN)
  • University of California, Los Angeles (US)
  • New York State Psychiatric Institute (US)
  • Lurie Children's Hospital (US)
Corresponding author
Strawn, Jeffrey R.
Venue
Journal of Child Psychology and Psychiatry
Publisher
Wiley
Published
2020-06-05
Volume
62
Issue
2
Pages
114-139
ISSN
  • 0021-9630 (ISSN-L)
  • 1469-7610
OpenAlex
W3034047654
Cited by
168
References
195
Citations by year
2026: 36 · 2025: 29 · 2024: 37 · 2023: 28 · 2022: 20 · 2021: 14 · 2020: 4
FWCI
1.29
Type
journal article
Language
en
Open access
Locations
  • Journal of Child Psychology and Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD098757)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords
childhood anxiety disorders, prevalence, risk factors, neurobiology, default mode network, salience network, cognitive behavioral therapy, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, treatment response, inhibited temperament, environmental stress
MeSH terms
Adolescent, Anxiety Disorders, Child, Humans, Serotonin, Temperament, Cognitive Behavioral Therapy, Selective Serotonin Reuptake Inhibitors

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