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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.


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