August 4, 2016

Anxiety during childhood: should you be worried?

Worries and anxiety during childhood and adolescence are very common. Most of the time the anxiety that kids experience falls within the normal range. However, up to 1 in 5 children may actually suffer from an anxiety disorder before they reach age 18. Anxiety is common to human experience because it is important for survival, functioning to signal the possibility of threat in the environment. Anxiety's survival value is evident as evolution has maintained it across the animal kingdom. Because of numerous studies, we know a lot about the brain systems that detect danger and signal the alarm associated with anxiety. We believe that this important brain system, when overactive, is responsible for more severe and impairing anxiety.

In some cases, anxiety, worries and fears may make it difficult for kids to fully experience and enjoy life by interfering with important developmental events such as school performance, meeting new friends, family relationships, and trying new things like sports, clubs and activities. Children who experience anxiety that interferes with their daily functioning may benefit from treatment, which may include talk therapy, drug treatment, or a combination of the two.

However, some children may experience a milder form of anxiety that is restricted to mild worries about new experiences, feeling nervous in new situations, feeling shy when meeting new adults and peers, or having some difficulty being alone. In mildly anxious children with more subtle symptoms, the extent to which they may be suffering is not always clear. Furthermore, a subset of these children will go on to develop more significant anxiety and anxiety disorders as they mature.

Because anxiety frequently has its onset early in life, it is important to be able to recognize and distinguish "normal" from more significant anxiety. Our group is focused on understanding how anxiety manifests in children, its underlying brain systems, and the influences of development on anxiety and brain function. Our ultimate goal is to be able to predict which children are at risk for developing more serious anxiety problems. Using imaging to study children's brains will also help us begin to think of new, more effective treatments to prevent children from suffering as adolescents and adults.  

The special case of girls and anxiety

Our current research is focused on studying young girls, beginning in late childhood and following them through early adolescence. We are focused on studying girls with mild to moderate anxiety because they are particularly vulnerable to the emergence of significant anxiety symptoms during adolescence. In fact, during adolescence, girls are twice as likely as boys to struggle with anxiety and depression. Girls will be enrolled in our study beginning at 9-11 years of age, and will be assessed annually using rating scales, clinical interviews and brain imaging. The longitudinal design of our study will allow us to understand the anxiety-related brain changes that occur as girls enter adolescence. Our goal is to be able to develop data that will predict the girls that are likely to develop more serious problems. We are also very interested in the girls that do not develop problems, and plan to use their brain data to help us come up with ideas about new treatments.  

About our research study

My research team at the HealthEmotions Research Institute hopes to enroll about 300 girls ages 9 to 11 who have mild to moderate symptoms of anxiety, which include shyness, worrying, and nervousness.

We will track changes in the girls' brain activity, mood, and behavior for three years. Because our brain scanning uses magnetic resonance imaging (MRI), girls with braces cannot be a part of the study. Girls who are currently receiving treatment for anxiety or other emotional issues, or who have been treated for anxiety in the past are not eligible to participate.

Dr. Lisa Williams, who is leading the study, says girls who are enrolled are excited about the chance to help others from what we learn from our study.