Anxiety Presentation - Katy Independent School District

Report
Dr. Kristie Moore
October 30, 2014
Super Series
Shafer Elementary
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A mood state characterized by strong negative emotion and
bodily symptoms of tension in anticipation of future danger or
misfortune
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Moderate amounts of anxiety are adaptive; we act more
effectively and cope with potentially dangerous situations
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Excessive, uncontrollable anxiety can be debilitating
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Anxiety involves 3 interrelated anxiety response systems:
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Physical system:
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Cognitive system:
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The brain sends messages to the sympathetic nervous system, which produces
the fight/flight response and activates important chemicals
Activation often leads to subjective feelings of apprehension, nervousness,
difficulty concentrating, and panic
Behavioral system:
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Aggression and a desire to escape the threatening situation
Avoidance perpetuates anxiety
Increased heart rate
 Fatigue
 Nausea
 Upset stomach
 Dizziness
 Blurred vision
 Dry mouth
 Vomiting
 Sweating
 Numbness
 Muscle tension
 Heart palpitations
 Increased respirations
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Thoughts of being scared or hurt
 Thoughts or images of monsters or wild animals
 Self-critical thoughts
 Thoughts of incompetence or inadequacy
 Forgetfulness or blacking out
 Thoughts of appearing foolish
 Thoughts of bodily injury
 Images of harm to loved ones
 Thoughts of going crazy
 Thoughts of contaminations
 Difficulty concentrating
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Avoidance
Crying or screaming
Nail biting
Trembling voice
Stuttering
Trembling lip
Swallowing
Immobility
Twitching
Thumb sucking
Avoidance of eye contact
Physical proximity
Clenched jaw
Fidgeting
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Anxiety:
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Fear:
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Future-oriented mood state, which may occur in
absence of realistic danger; characterized by feelings
of apprehension and lack of control over upcoming
events
Present-oriented emotional reaction to current
danger, characterized by strong escape tendencies
and surge in sympathetic nervous system
Panic:
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Group of physical symptoms of fight/flight response
that unexpectedly occur in the absence of obvious
danger or threat
 Moderate
fear and anxiety are adaptive, and
emotions and rituals that increase feelings of
control are common
 Normal
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fears
Fears that are normal at one age can be
debilitating a few years later
Whether a specific fear is normal also depends
on its effect on the child and how long it lasts
The number and types of fears change over time,
with a general age-related decline in numbers
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Normal anxieties
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Anxieties are common during childhood and
adolescence
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The most common are separation anxiety, test
anxiety, excessive concern about competence,
excessive need for reassurance, and anxiety about
harm to a parent
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Girls display more anxiety than boys, but symptoms
are similar
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Some specific anxieties decrease with age, but
nervous and anxious symptoms often do not and may
remain stable over time
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Normal worries
Children of all ages worry
Worry serves a function in normal development and
moderate worry can help children prepare for the
future
 Children with anxiety disorders do not necessarily
worry more, but they worry more intensely than other
children
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Normal rituals and repetitive behavior
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Ritualistic and repetitive activity is common; it helps
children gain control and mastery of their
environment
Many common childhood routines involve repetitive
behaviors and doing things “just right”
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Disturbance in how information is perceived and processed
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Intelligence and academic achievement: despite normal
intelligence, deficits are seen in memory, attention, and
speech or language
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Threat-related attentional biases: selective attention to
potentially threatening/dangerous information
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High levels of anxiety can interfere with academic
performance; those with generalized social anxiety may drop
out of school prematurely
Anxious vigilance or hypervigilance permits the child to avoid
potentially threatening events
Cognitive errors and biases
Perceptions of threats activate danger-confirming thoughts
 See themselves as having less control over anxiety-related
events than other children
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Somatic complaints, such as stomachaches or
headaches, are more common in children with
GAD, PD and SAD than in those with a specific
phobia
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More frequent in adolescents than in younger children
and in children who display school refusal
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90% have sleep-related problems, including
nocturnal panic (abrupt waking in a state of
extreme anxiety similar to daytime panic
attack), insomnia, and nightmares
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High rates of anxiety in adolescence are related
to reduced accidents and accidental deaths in
early adulthood, and higher rates of nonaccidental death later in life
 Anxious
children display low social
performance and high social anxiety
 See
themselves as shy and socially
withdrawn, and report low self-esteem,
loneliness, and difficulty initiating and
maintaining friendships
 Deficits
in understanding emotion and in
differentiating between thoughts and
feelings
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Attention and seek help if a child exhibits any of the following characteristics:
Exhibits some type of worry every single day
Seems worried often about events beyond their control
Tries to avoid particular situations or events
Preoccupied with pleasing everyone
Changes in behavior including clinginess or moodiness
Development of nervous habits such as nail biting or tics
Suddenly starts getting into trouble at school
Obsessed with schoolwork having to be perfect
Fears going to school
Worries excessively about his or her own safety or the safety of loved ones
Complains often about headaches, stomachaches, fatigue, or muscles aching
Sleep problems including insomnia or daytime sleepiness
Wants to be near parents at all times
Can’t concentrate on simple tasks
Gets scared easily
Rarely seems calm or relaxed
Fidgets often, can’t sit still
Frequently in a bad mood
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Biological Factors
Genetics
 Neurotransmitters – serotonin & dopamine
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Environmental Factors
In response to loss, change in the family, abuse,
transitions,
 Lack of downtime
 Academic pressure
 Social disruptions
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Family/Individual Factors
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Modeling anxiety from others in the family
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General Anxiety Disorder – General anxiety disorder (GAD) is the diagnosis when a child
experiences anxiety, but the cause cannot be determined. General anxiety disorder can last
a few months or several years.
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Phobias – Children sometimes suffer from a specific phobia. These children greatly fear a
particular object, animal or certain situation. When a child encounters his or her phobia,
they often exhibit symptoms such as shaking, difficulty breathing, heart palpitations, and
an upset stomach.
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Panic Attacks – Panic attacks are also called as agoraphobia. Children suffering from panic
attacks have repeated episodes of shaking, dizziness, chest pains, and intense feelings of
fear. They often avoid certain situations for fear of having a panic attack.
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Social Anxiety – Children with social anxiety only have symptoms when in social settings.
They fear unwanted attention from anyone, including friends.
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Obsessive Compulsive Disorder – Children with obsessive compulsive disorder (OCD) are
consumed by a specific obsession. They perform repetitive rituals as a coping mechanism.
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Post Traumatic Stress Disorder – When a child experiences a traumatic event, he or she
may suffer from post traumatic stress disorder (PTSD). The child cannot stop thinking about
the stressful event. Certain people or situations that remind the child of the traumatic
event will make the child feel very anxious.
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Many self-help books that you can purchase online and review with your
children
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There are also many helpful online home treatments that can help young
children cope with their anxiety disorders.
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More severe cases may involve therapy which typically includes:
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Cognitive Behavior Therapy (CBT) is a type of talk therapy that is administered by a
trained mental health professional. He or she will talk to your child about his or her
anxiety and teach them strategies for reducing the anxiety. The therapist will teach
your child coping skills and strategies to help them relax in anxious situations.
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Acceptance and Commitment Therapy (ACT) teaches a child to live in the present
and not worry about things that happened in the past or might happen in the future.
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Dialectical Behavioral Therapy (DBT) teaches children to maintain control of him or
herself. It teaches the child what to do when experiencing negative feelings or
anxiety.
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Medications: There are different prescription medications that can help with
symptoms of anxiety disorder. Most doctors won’t prescribe medicine unless the child
is also receiving some type of therapy. It’s important to understand that medications
don’t cure anxiety. They just relieve the symptoms as long as the patient is taking the
medicine. Coping strategies to deal with anxiety and stress are more valuable than
medications.
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Be aware of your child’s different moods and feelings. Know what upsets your child. Expect the
child to be anxious in certain situations.
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When your child becomes anxious, talk to him or her in a calming voice. Offer distractions. When
you feel that your child is becoming anxious, try to get them involved in an activity they enjoy.
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Realize that it is very difficult for the child to control his or her anxiety. Praise the child when he
or she handles anxiety appropriately.
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Don’t punish the child for anxious behavior.
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Try to maintain a consistent routine. Let the child know if something out of the ordinary will occur
in his or her day. Stick to a regular bedtime and mealtimes.
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Limit your child’s exposure to violent or scary books, video games, and movies.
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Listen to your child. It can be comforting to a child to know that they can talk to you about their
feelings without judgment.
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Encourage your child to be active. Exercise releases mood-boosting endorphins.
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Encourage healthy habits. Make sure your child is getting his or her daily allowance of vitamins and
nutrients. Make sure your child is getting enough sleep. Unhealthy eating and sleep deprivation
can cause stress.
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Make sure your child has quiet downtime to decompress.
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Do help your child break down large tasks into smaller tasks.
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Do role play social situations with your child and model appropriate behavior.
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Do praise your child for handling stressful situations appropriately.
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Do give your child chores so he or she can feel like an important contribution to the
family.
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Do let your child know that feeling anxious sometimes is ok.
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Do encourage your child to talk about his or her feelings.
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Do take time for yourself. Having a child with anxiety disorder can be stressful, and
parents need time away for their own well being.
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Do keep your own personal fears to yourself. You don’t want to give your child
something new to worry about.
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Do have a sense of humor around your child. Show your child how to laugh at life.
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Do be consistent with your spouse about how to handle your child’s anxiety. Children
with anxiety disorders need consistency. It makes them feel safe.
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Don’t keep your child from normal activities.
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Don’t do everything for your child. He or she
must learn to be independent.
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Don’t overly reassure your child that everything
will be ok.
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Don’t confuse other types of inappropriate
behavior with your child’s anxiety. Children need
to know that there are consequences for
inappropriate behavior that they can control.

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