Cited by 821Child and Adolescent Psychosocial and Emotional DevelopmentAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild Therapy and Development

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Anxiety Disorders During Childhood and Adolescence: Origins and Treatment

Rapee, Ronald M., Schniering, Carolyn A., Hudson, Jennifer L.·2009·Annual Review of Clinical Psychology

DOI 10.1146/annurev.clinpsy.032408.153628

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Abstract

The present review summarizes our current knowledge of the development and management of anxiety in children and adolescents. Consideration is given to limitations of this knowledge and directions for future research. The review begins with coverage of the development and demographic correlates of anxiety in young people and then moves to systematic discussion of some of the key etiological factors, including genetics, temperament, parenting, and individual experiences. The second part of the review describes current treatment strategies and efficacy as well as factors thought to influence treatment outcome, including treatment features, child factors, and parent factors. The review concludes with brief coverage of some more recent developments in treatment including alternative models of delivery and prevention strategies.

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“In the recent years, several twin studies have indicated that genetic influences play a major role in the etiology of adolescent and childhood anxiety, often explaining between 30% and 40% of the phenotypic variation in the population (for reviews see: Gregory & Eley, 2007; Rapee et al., 2009; Rice & Thapar, 2009).”
BackgroundResultInfluential
Cognitive behavioral therapy for children and adolescents with anxiety disorders
Stiede, J. T., Trent, E. S., Viana, A. G., Guzick, A. G., Storch, E. A., & Hershfield, J. (2023) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2022.12.001 · Cited by 25
Anxiety Disorder in Children: Review
Al‐Beltagi, M. (2016) · Journal of Paediatric Care Insight · doi:10.24218/jpci.2016.05 · Cited by 24
“Therefore, anxious children cannot be characterized by family size, parental marital status, educational attainment or intelligence [49].”
Fearful Temperament and the Risk for Child and Adolescent Anxiety: The Role of Attention Biases and Effortful Control
Liu, R., & Bell, M. A. (2019) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-019-00306-z · Cited by 37
“…indicated that compared with non-clinical control group, anxious adolescents (age 12-17 years) directed their first fixation away from negative facial emotions (anger, disgust, fear, sadness), which occurred too quickly to be controlled by the top-down regulatory system (Gamble & Rapee, 2009).”
Background
Examining the contribution of student anxiety and opposition-defiance to the internal dynamics of affective, Cognitive and Behavioural Engagement in Math
Archambault, I., Pascal, S., Olivier, É., Dupéré, V., Janosz, M., Parent, S., & Pagani, L. S. (2022) · Learning and Instruction · doi:10.1016/j.learninstruc.2022.101593 · Cited by 29
Attention bias to emotional information in children as a function of maternal emotional disorders and maternal attention biases
Waters, A. M., Forrest, K., Peters, R.-M., Bradley, B. P., & Mogg, K. (2014) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2014.10.002 · Cited by 25
Sex differences in interpretation bias in adolescents
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“If interpretation biases are found to play a role in enhancing the vulnerability of adolescents to anxiety and mood disorders, a greater understanding the etiology of such biases, including the emergence of content specificity, could improve sex- and age-specific interventions and treatments (Rapee et al., 2009; Saute…”
Background
The effect of targeting tolerance of children’s negative emotions among anxious parents of children with anxiety disorders: A pilot randomised controlled trial
Hiller, R. M., Apetroaia, A., Clarke, K., Hughes, Z. D., Orchard, F., Parkinson, M., & Creswell, C. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.05.009 · Cited by 25
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Muris, P. (2011) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2012.642864 · Cited by 24
“Since the pioneering work by Kendall [22], a host of randomized controlled outcome studies have appeared in the literature, all indicating that CBT is effective in treating anxiety disorders in children and adolescents (see for reviews: [3,23]).”
BackgroundInfluential
School-based cognitive behavioral interventions for anxious youth: study protocol for a randomized controlled trial
Haugland, B. S. M., Raknes, S., Haaland, A. T., Wergeland, G. J., Bjaastad, J. F., Baste, V., Himle, J., Rapee, R. M., & Hoffart, A. (2017) · Trials · doi:10.1186/s13063-017-1831-9 · Cited by 34
Self-citation
Attention avoidance of the threat conditioned stimulus during extinction increases physiological arousal generalisation and retention
O'Malley, K. R., & Waters, A. M. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.03.001 · Cited by 23
The Metacognitive Model of Anxiety in Children: Towards a Reliable and Valid Measure
White, J. A., & Hudson, J. L. (2015) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9725-1 · Cited by 24
“This is cause for concern, given the associated reduced quality of life for children and families, and increased risk of psychopathology in adulthood (Rapee et al. 2009).”
BackgroundSelf-citation
The Structure of Challenging Parenting Behavior and Associations With Anxiety in Dutch and Australian Children
Majdandžić, M., Lazarus, R. S., Oort, F. J., van der Sluis, C. M., Dodd, H. F., Morris, T. M., de Vente, W., Byrow, Y., Hudson, J. L., & Bögels, S. M. (2017) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2017.1381915 · Cited by 28
“…and the development and maintenance of childhood anxiety disorders (Creswell, Murray, Stacey, & Cooper, 2011), with ﬁ ndings often highlighting the importance of parental overcontrol and rejection (McLeod, Wood, & Weisz, 2007; Murray, Creswell, & Cooper, 2009; Rapee, Schniering, & Hudson, 2009).”
Self-citation
The Transition Experience to Boarding School for Male Aboriginal Secondary School Students from Regional and Remote Communities across Western Australia.
Mander, D. J. (2012) · Australasian Journal of Paramedicine · Cited by 24
Commentary: Bashful Boys and Coy Girls: A Review of Gender Differences in Childhood Shyness
Gazelle, H., Peter, D., & Karkavandi, M. A. (2014) · Sex Roles · doi:10.1007/s11199-014-0361-0 · Cited by 23
Explicating the “Developmental” in Preschool Psychopathology
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Carbon Dots Derived from Os Draconis and Their Anxiolytic Effect
Chen, Y., Xiong, W., Zhang, Y., Bai, X. B., Cheng, G., Zhang, Y., Chen, R., Guo, Y., Kong, H., Zhang, Y., et al. (2022) · International Journal of Nanomedicine · doi:10.2147/ijn.s382112 · Cited by 23
Treatment and Outcomes for Anxiety Disorders Among Children and Adolescents: A Review of Coping Strategies and Parental Behaviors
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Desarrollo de la competencia social y prevención del comportamiento antisocial en niños de 3 años
Fernández-Cabezas, M., Benítez, J.-L., Fernández, E., Justicia, F. J., & Arráez, A. J. (2011) · Journal for the Study of Education and Development Infancia y Aprendizaje · doi:10.1174/021037011797238603 · Cited by 23
“La interiorización de problemas puede provocar trastornos de ansiedad que pueden afectar a las relaciones entre el niño y quienes le rodean (Rapee et al., 2009).”
Background
Is Mindful Parenting a Mechanism that Links Parents’ and Children’s Tendency to Experience Negative Affect to Overprotective and Supportive Behaviors?
Moreira, H., Caiado, B., & Canavarro, M. C. (2020) · Mindfulness · doi:10.1007/s12671-020-01468-6 · Cited by 28
Reliability, Validity, and Clinical Use of the Dominic Interactive: A DSM-Based, Self-Report Screen for School-Aged Children
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Do Parents Enhance Cognitive Behavior Therapy for Youth Anxiety? An Overview of Systematic Reviews Over Time
Byrne, S., Cobham, V., Richardson, M., & Imuta, K. (2023) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-023-00436-5 · Cited by 23
The Test Anxiety Measure for College Students-Short Form: Development and Examination of Its Psychometric Properties
Lowe, P. A. (2020) · Journal of Psychoeducational Assessment · doi:10.1177/0734282920962947 · Cited by 27
Cardiac interoception in infants: Behavioral and neurophysiological measures in various emotional and self‐related contexts
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Psychopathological Factors that can Influence Academic Achievement in early Adolescence: a Three-Year Prospective Study
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Predictors of Treatment Outcomes in Anxious Children Receiving Group Cognitive-Behavioural Therapy: Pretreatment Attention Bias to Threat and Emotional Variability During Exposure Tasks
Waters, A. M., Potter, A., Jamesion, L., Bradley, B. P., & Mogg, K. (2015) · Behaviour Change · doi:10.1017/bec.2015.6 · Cited by 22
“Overall, treatment outcome rates of 65% of children free of their principal diagnosis and 46% free of all anxiety diagnoses at post-treatment are consistent with outcomes rates from large-scale trials of group-based CBT for anxious children (see Rapee et al., 2009 for a review).”
BackgroundResult
A Longitudinal Study of Inhibited Temperament, Effortful Control, Gender, and Anxiety in Early Childhood
Niditch, L. A., & Varela, R. E. (2018) · Child & Youth Care Forum · doi:10.1007/s10566-018-9447-0 · Cited by 29
“Behavioral inhibition may also lead to child anxiety by eliciting or interacting with other risk factors, for example, through selection and shaping of environments and experiences that confer risk for development of anxiety symptoms (Rapee et al. 2009).”
Background
Continuity and Change in, and Child Predictors of, Caregiver Reported Anxiety Symptoms in Young People with Autism Spectrum Disorder: A Follow-Up Study
Teh, E. J., Chan, D. M.-E., Tan, G. K. J., & Magiati, I. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3136-y · Cited by 26
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Emotion Regulation, Peer Acceptance and Rejection, and Emotional–Behavioral Problems in School-Aged Children
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Family Functioning and Anxiety Symptoms in Adolescents: The Moderating Role of Mindfulness
Watkins, N. K., Salafia, C., & Ohannessian, C. M. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-021-02219-4 · Cited by 21
Person-Centered Maternal Emotion Socialization and Child Temperament: Relations to Children’s Emotion Regulation and Anxiety and Depressive Symptoms
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Developmental and Psychosocial Issues in Cystic Fibrosis
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“Behavioral and cognitive-behavioral interventions are generally considered to be first-line treatments for depression and anxiety in the general population of schoolage children.(44,45) There is a dearth of literature applying these evidence-based treatment protocols to enhance adjustment in the CF population.”
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“, genetic determinants, inhibited temperament, attention bias) and their family environment (e.g., insecure attachment, overprotectiveness, control; Albano et al., 2003; McLeod, Wood, & Weisz, 2007; Rapee et al., 2009).”
BackgroundInfluential
Parent-child interactions in children with asthma and anxiety
Sicouri, G., Sharpe, L., Hudson, J. L., Dudeney, J. E., Jaffé, A., Selvadurai, H. C., & Hunt, C. J. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.08.010 · Cited by 21
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Parental Monitoring and Adolescent Risk Behaviors: The Moderating Role of Adolescent Internalizing Symptoms and Gender
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The dark side of white lies: Parenting by lying in childhood and adolescent anxiety, the mediation of parent-child attachment and gender difference
Liu, M., & Wei, H. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.105635 · Cited by 21
Anxiety Disorders in Children and Adolescents
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Authors: Rapee, R. M., Schniering, C. A., & Hudson, J. L.
Affiliations: Macquarie University (AU)
ORCID: Rapee, Ronald M.
Schniering, Carolyn A.
Hudson, Jennifer L.
Venue: Annual Review of Clinical Psychology
Publisher: Annual Reviews
Published: 2009-04-01
Volume: 5
Issue: 1
Pages: 311-341
ISSN: 1548-5943 (ISSN-L)
1548-5951
DOI: 10.1146/annurev.clinpsy.032408.153628
OpenAlex: W2167192006
Cited by: 821
References: 223
Citations by year: 2026: 18 · 2025: 40 · 2024: 30 · 2023: 38 · 2022: 33 · 2021: 56 · 2020: 49 · 2019: 39 · 2018: 47 · 2017: 79 · 2016: 48 · 2015: 71 · 2014: 79 · 2013: 64 · 2012: 54
FWCI: 5.95
Type: journal article
Language: en
Open access: closed
Locations: Annual Review of Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
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
Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
Keywords: childhood anxiety, adolescent anxiety, anxiety disorders, causes of anxiety, temperament, parenting, treatment outcomes, treatment efficacy, prevention
MeSH terms: Adolescent, Anxiety Disorders, Bibliotherapy, Child, Humans, Life Change Events, Parent-Child Relations, Risk Factors, Temperament, Cognitive Behavioral Therapy, Parenting, Treatment Outcome, Genetic Predisposition to Disease

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Anxiety Disorders During Childhood and Adolescence: Origins and Treatment

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