2. 1 Welcome Christopher Kaufman, Ph.D. (207) 878-1777 e-mail: info@kaufmanpsychological.org web: kaufmanpsychological.org

3. Understanding and Helping Anxious Students Christopher Kaufman, Ph.D. The Essential Information for Educators and Clinicians

4. A couple of key facts about anxiety disorders in kids.. They affect about 13% of children and teens (anxiety problems are the most prevalent psychiatric condition among children today) Contemporary kids report significantly higher levels of anxiety than same age children did in the 1950’s.

5. Two additional facts.. The bad (or at least pessimistic..) news: Anxiety generally doesn’t go away without treatment – in fact, it tends to worsen over time in the absence of treatment. The good news: Anxiety disorders are among the most successfully treated of psychiatric conditions. More good news: Cognitive-behavioral therapy (CBT) tends to be as or even more effective than medication in treating pediatric and adult anxiety problems

6. Sequence & Timing for Onset of Fears & Anxiety During Normal Development Young Infants – Fear of heights – Loss of support/separation from mom – Sudden, loud and unpredictable stimuli Older Infants (end of first year) – Strange people, novel objects – Separation distress Preschool – Animals, dark, doctors, storms, imaginary creatures/monsters – Most abate/disappear by school years Giuliano, 2011

7. Sequence & Timing for Onset of Fears & Anxiety During Normal Development Elementary to Middle School Years (6 – 12) - Specific fears (bodily harm/injury, physical danger, loss, natural hazards) - School performance - Social performance/relations Adolescence (13 – 20) - Achievement anxiety (test /performance anxiety, fear of failure) - Social acceptance - Fear of blushing, being ‘looked at,’ shaky hands, fainting spells, constricted throat - Death Giuliano, 2011

8. Common Types of Anxiety Disorders Generalized Anxiety Disorder Social Anxiety Disorder (AKA: Social Phobia) Obsessive – Compulsive Disorder (‘OCD’) Panic Disorder Posttraumatic Stress Disorder (PTSD) Specific Phobias

9. Generalized Anxiety Disorder A pattern of frequent, constant worry and anxiety over many different activities and events. AKA: ‘Overanxious Disorder of Childhood’

10. Social Anxiety Disorder A persistent and irrational fear of situations that may involve scrutiny or judgment by others; i.e., school, parties, and other social events.

11. Specific Phobias An extreme fear of a specific object or situation that is out of proportion to the actual danger or threat.

12. Obsessive-Compulsive Disorder OCD is an anxiety disorder in which people have unwanted and repeated thoughts, feelings, ideas, sensations (obsessions), that are often accompanied by compulsive (‘driven’) behaviors.

13. Panic Disorder Panic disorder is a type of anxiety disorder in which someone has repeated attacks of intense fear that something bad will occur when not expected. The person lives in fear that another attack will occur.

14. Posttraumatic Stress Disorder An anxiety disorder occurring after exposure to one or a series of highly traumatizing events.

15. Developmental Diagnostic Trends Most common in children.. Generalized Anxiety Disorder/Overanxious Disorder Specific Phobias School Anxiety Most common in adolescents.. Social Anxiety Disorder (with and without Agoraphobia) Panic Disorders, and OCD become more common

16. Timing/Onset of Anxiety Disorder Specific Animal Phobias (before age 5) Separation Anxiety Disorder (7- 8) Overanxious Disorder/GAD (8 – 9) Social Phobia (11 – 14) Panic Disorder (14+)

17. School Refusal Anxiety-based school refusal affects 2 to 5 percent of school- age children. Children who suffer from school refusal tend to have average or above-average intelligence. It commonly takes place between the ages of five and six and between ten and eleven, and at times of transition, such as entering middle and high school.

18. And now, the primary source of emotional sturm and drang.. The amygdala Be afraid – be very afraid..

19. The amygdala: Our primary source of: FIGHT Flight &

20. 19 The Prefrontal Cortex and Amygdale Amygdala Prefrontal Cortex

21. Daniel Goleman: High and Low Road Emotional Processing Low Road Processing (automatic, prepotent, initiated by the amygdala) High Road Processing (rational, controlled, directed by the PFC) System 1 System 2

22. Amygdale and Reactivity (Feifer, 2009, p. 40) Low amygdala reactivity: A need for greater stimulation and excitement to trigger the amygdala. Tends to be associated outgoing, disinhibited (‘stim –seeking’) behavior. High amygdala reactivity: A need for minimal stimulation of the amygdala to activate the cerebral cortex. Often associated with anxiety disorders in kids!

23. An essential biological basis of fear: AMYGDALAS LEARN By jove, I think I’ve got it!!!

24. Neurotransmitters and Emotional Functioning Serotonin Promotes feelings of calm, emotional stability, and sleep. Dopamine Promotes alertness, focus, and feelings of pleasure and reinforcement Norepinephrine Like Dopamine, it fosters nand energy (also associated with motivation and drive) GABA* Helps induce relaxation and sleep. May balance excitement and inhibition. *gamma-aminobutyric acid

25. Anxiety looks/sounds different in different kids Some internalize it Some externalize it

26. Social Cognitive Theory (SCT) requires educators to.. 1.Understand that kids’ social/behavioral challenges flow from a mismatch between their cognitive capacities/individual constructions of reality and the environments that help shape the constructions. 2.Develop intervention packages that target both the cognitive/personal and environmental contributors!