The clinical phenomenology and classification of child and adolescent anxiety

Introduction Anxiety problems have been recognized and discussed throughout the ages under various expressions and from different perspectives. Yet, their study as a specific form of childhood and adolescence psychopathology was largely neglected prior to the second half of the twentieth century. Only during the last 50 years have consistent efforts been made in psychology and psychiatry towards a better understanding of child and adolescent anxiety and its disorders (see Treffers & Silverman, Chapter 1, this volume). The amount of information that has accumulated is now considerable, and shows that anxiety disorders in young people are one of the most common and debilitating forms of psychopathology, constituting a heavy social and economic burden (Bodden, Dirksen, & Bögels, 2008). Children and adolescents with these conditions are at an increased risk of future depression, poor school adjustment, substance abuse, and other problems in adulthood, including anxiety disorders (Kim-Cohen, Caspi, Moffitt, Harrington, Milne, & Poulton, 2003). The conceptualization and diagnosis of these disorders have typically relied on theories, methods, and instruments designed for adults. However, new advances in developmental psychology and psychopathology highlighted the plasticity and individual variation in the patterns of anxiety across life as well as the existence of multiple factors contributing to their continuities and discontinuities (Feng, Shaw, & Silk, 2008; Sweeney & Pine, 2004). This has led to the development of new instruments and strategies, more appropriate to account for the special features of anxiety disorders in children and adolescents.