In this paper, one of the most common disorders of childhood and adolescence, social anxiety disorder (SAD), is examined to illustrate the complex and delicate interplay between parent and child factors that can result in normal development gone awry. Our parent-child model of SAD posits a host of variables that converge to occasion the onset and maintenance of this disorder. Specifically, five risk factors--temperamental characteristics of the child, parental anxiety, attachment processes in the parent-child dyad, information processing biases, and parenting practices--will be highlighted. While it is acknowledged that other factors including genetic influences and peer relationships may also be important, they are simply not the focus of this paper. Within these constraints, the implications of our parent-child interaction model for prevention, treatment, research, and practice will be explored.

The purpose of this study was to test whether children and adolescents with anxiety disorders exhibit selective processing of threatening facial expressions in a pictorial version of the emotional Stroop paradigm. Participants named the colours of filters covering images of adults and children displaying either a neutral facial expression or one displaying the emotions of anger, disgust, or happiness. A delay in naming the colour of a filter implies attentional capture by the facial expression. Anxious participants, relative to control participants, exhibited slower colour naming overall, implying greater proneness to distraction by social cues. Children exhibited longer colour-naming latencies as compared to adolescents, perhaps because young children have a limited ability to inhibit attention to distracting stimuli. Adult faces were associated with slower colour naming than were child faces, irrespective of facial expressions in both groups, possibly because adults provide especially salient cues for children and adolescents. Inconsistent with prediction, participants with anxiety disorders were not slower than healthy controls at naming the colours of filters covering threatening expressions (i.e., anger and disgust) relative to filters covering faces depicting happy or neutral expressions.

Lang’s tripartite model posits that three main components characterize a fear response: physiological arousal, cognitive (subjective) distress, and behavioral avoidance. These components may occur in tandem with one another (concordance) or they may vary independently (discordance). The Behavioral Approach Test (BAT) has been used to simultaneously examine the three components of the fear response. In the present study, 73 clinic-referred children and adolescents with a specific phobia participated in a phobia-specific BAT. Results revealed an overall pattern of concordance: correlation analyses revealed the three indices were significantly related to one another in the predicted directions. However, considerable variation was noted such that some children were concordant across the response components while others were not. More specifically, based on levels of physiological arousal and subjective distress, two concordant groups (high arousal-high distress, low arousal-low distress) and one discordant (high arousal-low distress or low arousal-high distress) group of youth were identified. These concordant and discordant groups were then compared on the percentage of behavioral steps completed on the BAT. Analyses revealed that the low arousal-low distress group completed a significantly greater percentage of steps than the high arousal-high distress group, and a marginally greater percentage of steps than the discordant group. Potential group differences associated with age, gender, phobia severity, and phobia type were also explored and no significant differences were detected. Implications for theory and treatment are discussed.

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The anxiety disorders constitute a broad array of syndromes ranging from very circumscribed fears and phobias to pervasive anxiety or worry. According to the most recent editions of the Diagnostic and Statistical Manual of Mental Disorders (4th ed., or DSM-IV; APA, 1994) and the International Statistical Classification of Diseases and Related Health Problems (10th rev., or ICD-10; World Health Organization, 1992), children can be categorized by eight major diagnostic syndromes associated with anxiety: panic disorder with agoraphobia, panic disorder without agoraphobia, agoraphobia without history of panic, specific phobia, social phobia, obsessive-compulsive disorder, posttraumatic stress disorder, and generalized anxiety disorder. In addition, the DSM-IV and ICD-10 specify one anxiety disorder unique to childhoodseparation anxiety disorder. Earlier versions of the DSM included two additional anxiety diagnoses specific to childhood, namely, avoidant disorder and overanxious disorder. In the most recent revision, avoidant disorder and overanxious disorder have been subsumed under the diagnoses of social phobia and generalized anxiety disorder, respectively.In the past 2 decades, epidemiological studies have estimated the prevalence of anxiety disorders (including specific phobias) in general community