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Child and Adolescent Anxiety

Julia Pemberton

Registered Psychologist
Perth Western Australia

Anxiety is fear, worry or dread that is disproportionate to the circumstances, causing distress and interference with healthy development and functioning. Anxiety affects about 10% of young people aged between 18-24 years. Approximately 50% of people with anxiety experience their first symptoms by the age of 11 years.

A wide range of childhood difficulties are associated with anxiety including school refusal, phobias, general fearfulness or worry, social withdrawal and obsessive-compulsive type symptoms. Separation anxiety and specific phobias are more common in children around 6-9 years of age. Generalized anxiety, obsessive-compulsive disorder, social anxiety and panic disorder are generally seen in middle childhood and adolescence. Depression has a high rate of comorbidity in children, especially adolescents.

Children display and react to anxiety symptoms differently, which often leads to difficulties in diagnosis. Anxiety symptoms in children often present as physical symptoms, which may lead parents to initially seek assistance from their GP. Children often don't articulate their fears, demonstrating their anxiety in a number of behavioural or physical ways.

Common symptoms of anxiety in children and adolescents


  • Avoidance of feared situations
  • Social isolation or withdrawal
  • Freezing or clinging
  • Crying or tantrums
  • Excessive shyness
  • Inability to relax
  • Problems with school, peers or family life


  • Difficulty sleeping
  • Muscle tension
  • Stomach upset, diarrhea
  • Headache
  • Rapid heartbeat
  • Dizziness, shortness of breath or difficulty breathing


  • Persistent worrying and excessive fears
  • Increased irritability


  • Difficulty concentrating and paying attention
  • Easily distracted

Starting school, moving, sudden separation or loss of a parent, pet or family member can trigger the onset of anxiety. Several life stressors may also trigger anxiety. Studies have also shown genes, attachment, family functioning and parenting style can also be associated with anxiety.

Early detection is important in the effective treatment of anxiety. It is particularly important as anxiety often presents at critical stages of development in childhood, adolescence and early adulthood. Studies have shown that cognitive behavioural therapy (CBT) and exposure therapy are effective in reducing anxiety symptoms in children and adolescents. Other helpful strategies include developing social skills and assertiveness, relaxation and mindfulness, problem solving and stress management, psycho-education and parent management skills.

Strategies for parenting anxiety


  • Give excessive reassurance
  • Be too directive or involved when your child attempts activities
  • Allow your child to avoid age-appropriate activities
  • Become impatient


  • Reward brave, non-anxious behaviour
  • Ignore anxious behaviour
  • Prompt coping strategies
  • Model brave, non-anxious behaviour

From "Helping Your Anxious Child: A Step-by-Step Guide for Parents" by RM Rapee, A Wignall, S Spence, V Cobham & H Lyneham

Julia Pemberton
Registered Psychologist
Phone: 0407 772 410

Mt Lawley Counselling
13 Alvan Street Mt Lawley
Western Australia 6050

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