Vulnerability factors among children at risk for anxiety disorders

Merikangas, Kathleen R.; Avenevoli, Shelli; Dierker, Lisa; Grillon, Christian

doi:10.1016/s0006-3223(99)00172-9

Cited by 190 publications

(168 citation statements)

References 67 publications

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“…The overall pattern of findings provides as much support for positions suggesting that a broad tendency toward mood and anxiety disorders is transmitted as it does for positions suggesting that social anxiety symptoms specifically aggregate within families. [195][196][197] Thus, although shyness does appear to aggregate in families, symptoms of major depression in parents also show strong associations with symptoms of shyness or social anxiety in their offspring. No study has demonstrated specific transmission of social anxiety within families that is independent from this broader liability to mood and anxiety problems.…”

Section: Developmental Issuesmentioning

confidence: 99%

Social anxiety disorder: questions and answers for the DSM-V

et al. 2010

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Background: This review evaluates the DSM-IV criteria of social anxiety disorder (SAD), with a focus on the generalized specifier and alternative specifiers, the considerable overlap between the DSM-IV diagnostic criteria for SAD and avoidant personality disorder, and developmental issues. Method: A literature review was conducted, using the validators provided by the DSM-V Spectrum Study Group. This review presents a number of options and preliminary recommendations to be considered for DSM-V. Results/Conclusions: Little supporting evidence was found for the current specifier, generalized SAD. Rather, the symptoms of individuals with SAD appear to fall along a continuum of severity based on the number of fears. Available evidence suggested the utility of a specifier indicating a ''predominantly performance'' variety of SAD. A specifier based on ''fear of showing anxiety symptoms'' (e.g., blushing) was considered. However, a tendency to show anxiety symptoms is a core fear in SAD, similar to acting or appearing in a certain way. More research is needed before considering subtyping SAD based on core fears. SAD was found to be a valid diagnosis in children and adolescents. Selective mutism could be considered in part as a young child's avoidance response to social fears. Pervasive test anxiety may belong not only to SAD, but also to generalized anxiety disorder. The data are equivocal regarding whether to consider avoidant personality disorder simply a severe form of SAD. Secondary data analyses, field trials, and validity tests are needed to investigate the recommendations and options. Depression and Anxiety 27:168-189, 2010. Key words: DSM-V; social anxiety disorder; social phobia; subtypes; classification; interpersonal; performance; test anxiety; selective mutism; avoidant personality disorder INTRODUCTIONThis review evaluates several issues pertaining to the diagnostic criteria for social phobia or social anxiety disorder (SAD) (Table 1), in light of empirical evidence gathered since DSM-IV. The review was guided by questions posed in the DSM-IV Sourcebook (Vol. 2), chapters titled ''Social phobia'' [1] and ''Social phobia subtypes,''[2] a review conducted as part of the DSM-V Stress Induced and Fear Circuitry Disorders Workgroup Conference, titled ''Social Phobia: Towards DSM V, '' [3] by questions posed by the DSM-V Anxiety, OC Spectrum, Posttraumatic, and Dissociative Disorder Work Group and by issues raised by consulted experts and advisors. The main issues to be addressed are the generalized specifier and its alternatives, the overlap with avoidant personality disorder, and developmental issues including the relationship that SAD shows in childhood with selective mutism (SM) and test anxiety. STATEMENT OF THE ISSUESThis review addresses the following questions, using the validators provided by the DSM-V Task Force: (1) What is the evidence/utility of the DSM-IV generalized specifier? If there is insufficient evidence/utility for a generalized specifier, what is the utility/evidence for alternative sub...

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Section: Developmental Issuesmentioning

confidence: 99%

Social anxiety disorder: questions and answers for the DSM-V

et al. 2010

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“…Children of patients with anxiety and depressive disorders exhibit exaggerated startle (either baseline or only during threat) compared to children with no family history for these disorders, suggesting that startle responsiveness could be a marker of vulnerability for development of clinical anxiety (Grillon et al, 1997;Merikangas et al, 1999;Grillon et al, 1998a) and depression (Grillon et al, 2005b). This latter finding is somewhat surprising as baseline startle appears to be normal, or even reduced, in adults with depression (Kaviani et al, 2004;Perry et al, 2004;Quednow et al, 2006).…”

Section: Startle Abnormalities In Anxiety Disordersmentioning

confidence: 99%

Role of corticotropin releasing factor in anxiety disorders: A translational research perspective

Risbrough

Stein

2006

Hormones and Behavior

204

139

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Anxiety disorders are a group of mental disorders that include generalized anxiety disorder (GAD), panic disorder, phobic disorders (e.g., specific phobias, agoraphobia, social phobia) and posttraumatic stress disorder (PTSD). Anxiety disorders are among the most common of all mental disorders and, when coupled with an awareness of the disability and reduced quality of life they convey, they must be recognized as a serious public health problem. Over 20 years of preclinical studies point to a role for the CRF system in anxiety and stress responses. Clinical studies have supported a model of CRF dysfunction in depression and more recently a potential contribution to specific anxiety disorders (i.e., panic disorder and PTSD). Much work remains in both the clinical and preclinical fields to inform models of CRF function and its contribution to anxiety. First, we will review the current findings of CRF and HPA axis abnormalities in anxiety disorders. Second, we will discuss startle reflex measures as a tool for translational research to determine the role of the CRF system in development and maintenance of clinical anxiety. KeywordsCRH; CRF; Posttraumatic stress disorder; Anxiety; Panic disorder; Startle Overview of CRF neuroendocrine effects and its effects on G-protein-coupled receptorsCorticotropin releasing factor (CRF; also termed "CRH" for corticotropin releasing hormone) was first described in Science by Vale et al. (1981). They reported the discovery of a hypothesized hypothalamic factor, CRF, a 41 amino acid peptide which selectively and potently activated pituitary corticotropin (or adrenal corticotropin releasing hormone, ACTH) secretion. They predicted that this peptide could be "a key signal in mediating and integrating an organism's endocrine, visceral and behavioral response to stress" (Vale et al., 1981(Vale et al., p. 1397). More than 20 years of subsequent animal research and clinical studies have confirmed this hypothesis, supporting a role for CRF, and its more recently discovered ligand family Urocortin 1, 2 and 3, in anxiety and stress responses Reyes et al., 2001;Spina et al., 1996). In this review, we will focus on the current state of knowledge of CRF system dysregulation in clinical anxiety and discuss future avenues of translational research on the role of CRF in startle phenotypes observed in some anxiety disorders. CRF mediation of the neuroendocrine response to stressIn response to stress, CRF is released from the median eminence of the hypothalamus, where it subsequently binds to receptors at the anterior pituitary and increases ACTH release into the * Corresponding author. 8950 Villa La Jolla Drive, Suite B-218, La Jolla, CA 92037, USA. E-mail address: mstein@ucsd.edu (M.B. Stein). bloodstream. ACTH consequently acts at the adrenal cortex to facilitate release of glucocorticoids such as cortisol. This system, known as the hypothalamic-pituitary-adrenal axis (HPA), is an important component of the response to stress and has been shown to be dysregulated in both anxiety and de...

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“…For example, parental psychopathology and disruption in the parent-child relationship might predict particularly high risks for psychopathology following exposure to domestic violence. Concerning contributions from parental psychopathology, considerable research examines the association between mood and anxiety disorders in parents and their children, as reviewed elsewhere (Weissman et al, 1997;Merikangas et al, 1999). This literature is not reviewed in the current summary, since few family-based studies have examined directly interactions between parental psychopathology and the psychological effects of traumatic exposure.…”

Section: Stress Trauma and Psychopathology In Children And Adolescentsmentioning

confidence: 99%

Trauma, Proximity, and Developmental Psychopathology: The Effects of War and Terrorism on Children

Pine

Costello

Masten

2005

Neuropsychopharmacol

134

121

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This report summarizes recent literature relevant to the effects of terrorism on children's mental health. The paper addresses three aspects of this topic. In the first section of the paper, data are reviewed concerning the relationships among stress, trauma, and developmental psychopathology. A particular emphasis is placed on associations with indirect forms of trauma, given that terrorism involves high levels of indirect trauma. Second, the paper delineates a set of key principles to be considered when considering ways in which the effects of terrorism on children's mental health can be minimized. Third, data are reviewed from studies in developmental psychobiology. These data are designed to illustrate the mechanisms through which children exhibit unique effects in the wake of traumatic circumstances.

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Vulnerability factors among children at risk for anxiety disorders

Cited by 190 publications

References 67 publications

Social anxiety disorder: questions and answers for the DSM-V

Social anxiety disorder: questions and answers for the DSM-V

Role of corticotropin releasing factor in anxiety disorders: A translational research perspective

Trauma, Proximity, and Developmental Psychopathology: The Effects of War and Terrorism on Children

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