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Anxiety Disorders During Childhood and Adolescence: Origins and Treatment
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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“Although it was once believed that rates of SAD peak in adolescence, prospective longitudinal studies are mixed in this regard and reveal elevation across both childhood and adolescence [38].”
In the citing paper
“have a major impact on their academic, social, and family functioning (Rapee et al., 2009 )”
From Child- and Parent-Report Measures of Behavioral Avoidance (CAMS/CAMP): Portuguese Validation in Clinical and Non-Clinical Samples. (2024) · cites this paper as Rapee et al., 2009
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Anxiety in Early Adolescents During the Covid-19 Pandemic
Dorčić, T. M., Živčić–Bećirević, I., & Smojver‐Ažić, S. (2023) · European Journal of Psychology Open · doi:10.1024/2673-8627/a000035 · Cited by 5
Zimmermann, K. S., Richardson, R., & Baker, K. (2023) · Neurobiology of Learning and Memory · doi:10.1016/j.nlm.2023.107847 · Cited by 6
“Childhood and adolescence are considered the “ core risk phase ” for emergence of anxiety disorders, and the majority of people diagnosed with these disorders experience their first symptoms during these developmental periods (Beesdo et al., 2009; Rapee et al., 2009).”
BackgroundDumont, É., Parent, S., Ryan, N. C., Jacques, S., Freeston, M. H., Zelazo, P. D., & Séguin, J. R. (2024) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-024-01175-z · Cited by 7
“Specific phobias and separation anxiety disorders usually emerge in early to mid-childhood, whereas social anxiety disorders emerge later in early to mid-adolescence (Rapee et al., 2009).”
Chen, H., Wang, Q., Zhu, J., Zhu, Y., Yang, F., Hui, J., Tang, X., & Zhang, T. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.01.029 · Cited by 6
Hardway, C. L., Kagan, J., Snidman, N. C., & Pincus, D. B. (2013) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-013-9362-5 · Cited by 6
“Indeed, ongoing economic hardship is associated with an increased risk of developing a childhood anxiety disorder (Rapee et al. 2009).”
BackgroundEarly Intervention and Prevention of Anxiety and Depression
Bayer, J. K., & Beatson, R. M. (2013) · Cited by 5
Young Children's Peer Relations: Links with Early Developing Anxiety and Depression
Coplan, R. J. (2014) · Cited by 5
Thabet, A. A. M., Abu-Khusah, A. A., & Vostanis, P. (2014) · The Arab Journal of Psychiatry · doi:10.12816/0004116 · Cited by 5
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Predescu, E., Asztalos, A. B., & Șipoș, R. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.82083 · Cited by 5
“At least one third of the children and adolescents diagnosed with anxiety disorders meet the criteria for two or more anxiety disorders [32].”
BackgroundA Measure of Safety Behaviors for Use with Young People: Subtle Avoidance Measure for Youth
Chapman, C., & Rapee, R. (2020) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2020.1716364 · Cited by 5
“In addition, given the high prevalence of comorbidity among young anxious populations (Rapee et al., 2009), relying on separate measures of safety behaviors that are relevant to specific forms of fear limits their clinical and theoretical utility.”
BackgroundSelf-citationDoes irritability predict attention biases toward threat among clinically anxious youth?
Elvin, O. M., Waters, A. M., & Modecki, K. L. (2022) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-022-01954-3 · Cited by 6
“Children with anxiety disorders experience impairments across social, academic and family life [2].”
BackgroundCognitive Behavioural Therapy in Children and Adolescents
Suganya, M., Prabakar, S., & Rao, U. M. (2022) · Research Journal of Pharmacy and Technology · doi:10.52711/0974-360x.2022.00222 · Cited by 7
Urao, Y., Yoshida, M., Sato, Y., & Shimizu, E. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-04326-y · Cited by 12
The Effect of Pre-Service Teachers’ Family Adaptation on Anxiety: A Moderated Mediating Effect
Li, X., Guan, X., Wang, J., Zhang, Y., Ma, M., Pu, T., Jobe, M. C., & Ahmed, M. Z. (2023) · Sustainability · doi:10.3390/su151410796 · Cited by 5
“Additional research suggests that 2–15% of children and adolescents experience clinical manifestations of anxiety [2] and that they may also suffer from poor internalizing problems [3], or show high susceptibility to more serious mental and physical health problems in the process [4].”
BackgroundMaternal Acceptance Moderates Fear Ratings and Avoidance Behavior in Children
Shimshoni, Y., Silverman, W. K., Byrne, S., & Lebowitz, E. R. (2017) · Child Psychiatry & Human Development · doi:10.1007/s10578-017-0765-5 · Cited by 5
“Reducing avoidance behavior is a major target of cognitive-behavioral therapy (CBT), the front-line evidence based psychosocial treatment for child anxiety [1, 39].”
InfluentialBehavioral Sleep-Related Problems in Clinically Anxious Children: A Parent-Report Diary Study
Price, T. E., Farrell, L. J., Donovan, C. L., & Waters, A. M. (2019) · Child Psychiatry & Human Development · doi:10.1007/s10578-019-00878-5 · Cited by 6
Forcadell, E., Medrano, L., García-Delgar, B., Fernández‐Martínez, I., Orgilés, M., García, C., Lázaro, L., & Lera‐Miguel, S. (2020) · The Spanish Journal of Psychology · doi:10.1017/sjp.2020.39 · Cited by 5
“To prevent these anxiety disorders becoming chronic and to prevent the development of other psychiatric disorders (Rapee et al., 2009), early diagnosis and intervention are essential.”
BackgroundRichard, R., & Marcotte, D. (2014) · Santé mentale au Québec · doi:10.7202/1023999ar · Cited by 5
“Le deuxième objectif est de comparer les distorsions cognitives des adolescents anxieux et concomitants et de mesurer Sante mentale au Q.38.2.MEP.indd 262 14-02-23 11:40 PM si la présence de distorsions cognitives dépressogènes chez les élèves anxieux de sixième année influence le risque qu’une…”
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Albieri, E., & Visani, D. (2014) · Cross-cultural advancements in positive psychology · doi:10.1007/978-94-017-8669-0_8 · Cited by 5
Service evaluation of the Cool Little Kids parenting program delivered in the community
Jarosz, E., & Bayer, J. K. (2017) · Advances in Mental Health · doi:10.1080/18387357.2017.1418630 · Cited by 5
Assessing Child and Adolescent Internalizing Disorders
Hudson, J. L., Newall, C., Schneider, S. C., & Morris, T. M. (2014) · doi:10.1002/9781118500576.ch7 · Cited by 5
Self-citationAnxiety Disorders in Children and Adolescents
Grills, A. E., Seligman, L. D., & Ollendick, T. H. (2014) · Wiley eBooks · doi:10.1002/9781118775349.ch22 · Cited by 5
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“, 2010) and are associated with significant functional impairment (Rapee et al., 2009; Swan et al., 2018).”
BackgroundBrain Connectivity Variability Influences Anxiety Through the Behavioral Inhibition System
He, R., Zhu, Y. D., Ye, J., Yao, D., Xu, P., Li, F., Jiang, L., & Liang, Y. (2025) · International Journal of Neural Systems · doi:10.1142/s0129065725500558 · Cited by 4
Maçãs-Carvalho, I., Brazão, N., Pereira, M., Canavarro, M. C., & Rijo, D. (2025) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70196 · Cited by 4
Syros, I., Karantzali, A., & Anastassiou‐Hadjicharalambous, X. (2022) · OBM Neurobiology · doi:10.21926/obm.neurobiol.2204146 · Cited by 6
Wise, S., Huang‐Pollock, C. L., & Pérez‐Edgar, K. E. (2023) · Biological Psychology · doi:10.1016/j.biopsycho.2023.108550 · Cited by 4
Chiappini, E. A., Parrish, C., Reynolds, E. K., & Mcguire, J. F. (2021) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.2021.85.3.231 · Cited by 4
Percepción de prácticas parentales y\n\t\t\t\t ansiedad en adolescentes mexicanos
González-Fuentes, M. B., & Andrade-Palos, P. (2021) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) · Cited by 4
Johnson, I. C., Achulo, S., Brevard, K. C., & Ansong, D. (2024) · Societies · doi:10.3390/soc14030038 · Cited by 4
“…with decreased levels of hope [37], increased loneliness [41], challenges in literacy achievement and academic participation [43,46–48], food insecurity [44], internalizing behaviors, such as withdrawal and anxiety [42,49], and externalizing behaviors, such as aggression and defiance [11,14].”
BackgroundNovak, M., Gačal, H., & Šutić, L. (2024) · Journal of Prevention · doi:10.1007/s10935-024-00810-1 · Cited by 4
“Anxiety disorders disrupt normal psychological functioning and are defined by a state of tension, expectation of threat, worry, dis - torted thoughts, and physical symptoms (Rapee et al., 2009 ).”
Coppola, G., Barbaro, M. G. F., Curci, A., Simeone, M., Costantini, A., Goffredo, M., Latrofa, A., Liso, D. D., & Silverman, W. K. (2018) · Child & Youth Care Forum · doi:10.1007/s10566-018-9464-z · Cited by 4
The Role of the Family in Child and Adolescent Psychopathology
Hawes, D. J., Allen, J. L., Essau, C. A., & Fisher, C. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108682053.003 · Cited by 4
Zikopoulou, O., Rapee, R. M., & Simos, G. (2021) · Psychiatry International · doi:10.3390/psychiatryint2020016 · Cited by 5
“This is in line with other studies, supporting that anxiety interferes in many areas of a child’s daily routine [5,44].”
BackgroundResultSelf-citationZeevi-Cousin, A., & Lavenda, O. (2023) · Children · doi:10.3390/children10091564 · Cited by 8
“In addition, untreated anxious children grow up to be adults with a high probability of absenteeism in the workplace, unemployment, repeated visits to medical specialists, and more frequent illness [11].”
Ramos, M. L., Zhou, A. M., Lytle, M. N., Myruski, S., Pérez‐Edgar, K. E., & Buss, K. A. (2024) · Developmental Psychobiology · doi:10.1002/dev.22485 · Cited by 4
Gedik, Z., Gökkaya, F., & Sütcü, S. T. (2018) · Uludağ Üniversitesi Fen Edebiyat Fakültesi Sosyal Bilimler Dergisi · doi:10.21550/sosbilder.336670 · Cited by 5
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Trajectory-based methods in clinical psychology: A person centred narrative approach
O’Connor, K. P., Robert, M., Pérodeau, G., & Séguin, M. (2015) · New Ideas in Psychology · doi:10.1016/j.newideapsych.2015.06.001 · Cited by 4
Social Anxiety Disorder in Swedish Adolescents : Prevalence, Victimization a Development
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Davies, M. (2011) · Australasian Psychiatry · doi:10.3109/10398562.2011.583055 · Cited by 4
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Behavioural Inhibition and the Prevention of Internalising Distress in Early Childhood
Rapee, R. M., & Bayer, J. K. (2018) · Springer eBooks · doi:10.1007/978-3-319-98077-5_15 · Cited by 4
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Study Protocol: Temperament, Evolving Emotions, and Neuroscience StudyPreprint
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“Anxiety disorders are the most prevalent psychiatric disorders among youths (Kessler et al., 2005) and have a major impact on their academic, social, and family functioning (Rapee et al., 2009 ).”
Parental Internalizing Symptoms as Predictors of Anxiety Symptoms in Clinic-Referred Children
Fjermestad, K. W., Lium, C., Heiervang, E. R., Havik, O. E., Mowatt Haugland, B. S., Bjelland, I., & Henningsen Wergeland, G. J. (2020) · Scandinavian Journal of Child and Adolescent Psychiatry and Psychology · doi:10.21307/sjcapp-2020-003 · Cited by 6
“Several factors may influence the development and maintenance of anxiety in children, including genetic, physiological, temperamental, parental, and familycontext related risks (2-4).”
Pattern of Anxiety among the Secondary School Adolescents in Ilesa, Nigeria
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“Cognitive behavioural therapy for anxiety disorders in children and adolescents often include psychoeducation, affect recognition, cognitive restructuring, relaxation, and graded exposure (Rapee et al., 2009).”
BackgroundA Family-Based CBT Approach to the Treatment of Anxiety Disorders in Children and Adolescents
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“, 2014) and later risk for other internalizing and externalizing mental health disorders (Rapee et al., 2009; Seligman et al., 2014).”
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“The onset of social anxiety, usually during adolescence, has been linked with adverse developmental outcomes in social, academic, physical and mental health domains [3].”
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“Anxiety is the most prevalent psychiatric disorder among children and adolescents and relates to a series of poorer psychosocial functions (Rapee et al., 2009).”
BackgroundIntergenerational relations in childhood anxiety: A network approach
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“Received: July 23, 2015; Accepted: December 02, 2015; Published: December 07, 2015 Introduction Anxiety disorders are common in adolescents and left untreated can predict anxiety and depression in adulthood [1-3].”
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“Several studies have highlighted the significant consequences of anxiety disorders in children (Donovan & Spence 2000; Rapee et al., 2009; Merikangas et al., 2009).”
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“The growth and development of internalizing symptoms in children affect their functionality in various areas of their lives, such as school and social relationships (Buchanan-Pascall et al., 2018; Cosma et al., 2018; Rapee et al., 2009).”
Wuthrich, V. M., Rapee, R. M., McLellan, L. F., Wignall, A., Jagiello, T., Norberg, M. M., & Belcher, J. (2021) · Child Psychiatry & Human Development · doi:10.1007/s10578-021-01291-7 · Cited by 3
“Anxiety disorders are common mental disorders that affect up to 10% of adolescents, are associated with poor academic, social and family outcomes, and the development of depression, substance use, and other mental health disorders [2].”
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Separation Anxiety Assessment Scale—Parent Version: Spanish Validation (SAAS-P: Spanish Validation)
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Mother-child disagreements on child anxiety: associated factors
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“Further, elevated anxiety impacts functioning and associates with reduced peer interactions, impaired academic and career functioning, and increased family and personal distress and medical complications (Rapee et al., 2009).”
BackgroundMultimodal Markers of Transdiagnostic Childhood Mental Health Impairment
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Metadata
- Authors
- Rapee, R. M., Schniering, C. A., & Hudson, J. L.
- Affiliations
- Macquarie University (AU)
- 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
- 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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