childhood anxieties: an overview slideshow
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8/8/2019 Childhood Anxieties: An Overview Slideshow
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Childhood Anxiety
Jane F. Gilgun, Ph.D., L ICSW
School of Social Work
University of Minnesota, Twin Cities, USAOctober 2010
Topics
Centrality of Parents
PTSD as an example
Temperament
Types of Childhood Anxieties
Anxieties & The Safety of Secure Relationships
A NEATS Analysis
Central Issue
What are the risks & protectivefactors identified with problematicchild behaviors?
If we can find out, we can buildthem into interventions & policy.
Centrality of Parents
Parents as safe havens
Anxiety in children shows in many ways
Dysregulation: avoidance & disorganized behaviors
Parents as active listeners
Parents may require support to be active listeners
Help children return to normal activities
On-going opportunities for self-expression
Temperament
Genes + experience influences neurobiology
Temperament appears to be neurobiological
Easy
Difficult
Slow to warm up
Types of Anxiety Separation Anxiety
Generalized Anxiety
Specific Phobia
Social Phobia
OCD
Panic
PTSD & Acute Stress
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Interactions of Elementsof the NEATS
NEATS=Neurobiology
Executive Function
Attachment
Trauma
Self-Regulation
neurobiology
Executivefunction (EF)
attac
enttrau
a
Self-regulation(SR)
Neurobiology
Cascades of risks encoded in brain circuits
Cascades of resilience encoded in brain circuits
Neurobiologyof Childhood Anxiety
In general
Brain scans show over-active amydala
anxieties show overactivation in some other areas ofbrain & underactivation in others
OCD
issue with serotonin-transmitter gene People may respond to SSRIs (selective serotonin
reuptake inhibitors)
Executive Function By definition, anxiety an issue with EF
People with anxieties may know their fears areirrational
Especially in early childhood some irrational fearsare normative
Persistence
Circumstances
Do children mirror parents?
Attachment
Sensitive, responsive parenting associated withresilience in neurobiologically vunerablechildren (Jaffe, 2007)
Reduction in internalizing and externalizingbehaviors in children by age 5 found in mutuallyresponsive orientations between mothers andyoung children (Calkins et al, 2007)
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Trauma
Many anxieties result from trauma
PTSD & Acute Stress Symptoms
Phobias may be related to trauma
Possibly other anxiety issues result from trauma incombination with predispositions
Genetic
Parental/family influences
Self-Regulation Almost by definition, the anxiety disorders are issues
with SR
Required to cope with anxieties: supportivefamilies/safe havens
Regulating Anxiety
Medication
Therapy
Psychoeducation
Support groups
Meditation
Aerobic exercise
Avoid caffeine & over-the-counter cold medications
A NEATS Analysis of Cognitive
Behavioral Therapy & Medications
Neurobiology
Meds: direct effect
CBT: New behaviors/cognitions: indirect effects
Executive Function
Meds: appear restore balance
CBT: Learn new behaviors & ways of thinking
A NEATS Analysis of Cognitive
Behavioral Therapy & Medications
Neurobiology
Meds: direct effect
CBT: New behaviors/cognitions: indirect effects
Executive Function
Meds: appear restore balance
CBT: Learn new behaviors & ways of thinking
Attachment
Meds: may affect emotional availability
CBT: group, family, & therapist relationships
A NEATS Analysis
of CBT, EMDR, & Meds Trauma
Meds: may make traumatic memories more/lessaccessible
CBT: deals directly with the trauma
EMDR may be an important adjunct
Self-Regulation
Meds: may contribute to reduced heart rate, breathing,& may allow for activation of circuits in the prefrontalcortex (PFC)
CBT: goal is SR
EMDR: by dealing directly with the underlying issues ofanxiety increases activation of circuits in the PFC
May be a form of exposure therapy is a safe setting
References Calkins, Susan D., Alysia A. Blandon, Amanda P.Williford, &
Susan P. Keane (2007). Biol ogical, behavioral, and relationallevels of resilience in the context of risk for early childhoodbehavior problems. Development and Psychopathology, 19, 675700.
Jaffe,Sara R. (2007). Sensitive, stimulating caregiving predictscognitive and behavioral resilience in neurodevelopmentally at-risk infants. Development and Psychopathology, 19, 631-647.
Masten, Ann S., KarinM. Best, & Norman Garmezy (l991).Resilience and development: Contributions from the study ofchildren who overcome adversity. Development andPsychopathology, 2, 425-444.