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Signs and Symptoms of Anxiety

Very few psychological problems cause more distress than anxiety. Often, the symptoms develop over time and the individual may not be aware of the anxiety as an ongoing problem. Anxiety causes a range of psychological as well as physical symptoms. These can vary between individuals, however, psychological symptoms often include:

  • excessive worries
  • exclusive focus on one particular topic
  • lack of concentration
  • irritability
  • restlessness
  • social withdrawal
  • avoidance of locations or individuals
  • hopelessness
  • disturbances to memory and attention
  • negative thinking ("There is no easy way out")

In addition, physical symptoms are possible including

  • feeling hot
  • feeling unsteady
  • heart pounding or racing
  • feeling dizzy
  • hands trembling
  • difficulty in breathing
  • a feeling of choking
  • indigestion
  • lightheadedness
  • hot and cold sweats

Not everybody experiences all of these symptoms and they may change over time. Individuals with phobias (fear of a specific object or situation) may feel anxious when approaching the particular object or situation. Examples of specific phobias are

  • a fear of certain animals
  • concerns about a particular medical procedure (e.g. an injection)
  • a fear of flying (e.g. air travel)
  • being uncomfortable in open places
  • being uncomfortable in narrow/enclosed locations
  • a fear of acceleration (e.g. in an elevator)
  • a fear of public places

Individuals with social anxiety (or phobia) often avoid social groups and situations as well as meeting new people. It is important to distinguish social anxiety from neuro-developmental disorders such as Autism Spectrum Disorder (ASD), including Aspergers, and social (pragmatic) communication disorder. These neuro-developmental disorders make social communication difficult or may delay the devlopment of social skills.

How often do Anxiety Disorders occur?

Anxiety disorders are common in children (and adults), with prevalence estimates ranging from 5% to 25% in different countries (Figueroa, Soutullo, Ono & Saito, 2012; Simon & Boegels, 2009). Anxiety disorders often co-occur with mood disorders and can result in depression or other mental health problems such as substance use. Early onset anxiety disorders (13 years or younger) may follow a chronic course and, hence, an early diagnosis is important.

What are the Causes of Anxiety Disorders?

Cognitive-behavioural models of anxiety disorders suggest that negative automatic thoughts play a significant role. Hence, Cognitive Behavioural Therapy (CBT) strategies have been developed, which include cognitive restructuring, coping self-talk, in vivo exposure, modelling and relaxation training (Muris, Mayer, den Adel, Roos & van Wamelen, 2009). The effectiveness of CBT can be further enhanced through the addition of family therapy, even though this has not been shown in all studies (Muris et al., 2009). The authors report that negative automatic thoughts and anxiety control (the feeling to be in control of symptoms) make unique contributions to treatment outcome. The influence of both automatic thoughts and anxiety control appeared to differ across various types of anxiety disorders (Muris et al., 2009, p.147).

What are the Psychological Treatment Options?

CBT is long established as a method of choice for anxiety and depression in children. Muris et al. (2009, p.147) argue that “negative automatic thoughts play a dominant role in symptoms of separation anxiety disorder”. The individual may make false or immature predictions about what can happen in the absence of care-givers or partners. Alternatively, the individual may rehearse in his or her mind what might happen to attachment figures during periods of absence, which could lead to an indefinite separation. The individual may also “catastrophise”, that is, interpret minor events in the absence of parents or partners as very negative and, as a result, experience intense fear.

Barrett et al. (2001, p.135/6) observed that, when compared with a group without treatment, CBT alone as well as CBT plus family management/treatment showed greater improvement on a variety of measures at a 12-month follow-up. More specifically, “clients that received family training also showed significantly greater improvement than the CBT-only group on a number of measures” (Barrett et al., 2001, p.136).

How does Cognitive Behavioural Therapy work? CBT addresses distorted and unhelpful patterns of thinking that result in anxiety. Based on the assumption that negative thoughts result in negative emotions and that well-adapted positive thoughts result in positive emotions, CBT tries to replace cognitive distortions (unhelpful thinking styles) with well-adjusted thinking patterns. Core elements of CBT are:

  • Cognitive restructuring: Identifying negative thoughts and replacing these by positive thinking styles.
  • Modelling: Practicing successful behaviour for critical situations; plus
  • Relaxation training: This may include calming (breathing) techniques and progressive muscle relaxation. These can be adjusted for young children.



Please note that the Psychology Network is not able to offer crisis services. Therefore, if you or a loved one is thinking or talking about suicide then you will need to seek urgent medical attention or alternatively call a crisis service such as Lifeline on 13 11 14.

For information on fees and a first appointment, please call 1300 798 598 or email admin@psychologynetwork.com.au today.

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.

Barrett, P. M., Duffy, A. L., Dadds, M. R., & Rapee, R. M. (2001). Cognitive-behavioral treatment of anxiety disorders in children: long-term (6-year) follow-up. Journal of Consulting and Clinical Psychology, Vol. 69, 135-141.

Figueroa, A., Soutullo, C., Ono, Y., & Saito, K. (2012). Separation Anxiety. In Rey, J.M. (Ed), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions.

Muris, P., Mayer, B., den Adel, M., Roos, T., & van Wamelen, J. (2009). Predictors of Change Following Cognitive-Behavioral Treatment of Children with Anxiety Problems: A Preliminary Investigation on Negative Automatic Thoughts and Anxiety Control. Child Psychiatry Human Development, Vol. 40, 139-151.

Simon, E. & Boegels, S.M. (2009). Screening for anxiety disorders in children. European Child Adolescent Psychiatry. Vol. 18, 625–634.