Phobic and Anxiety Disorders in Children and Adolescents

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Phobic and Anxiety Disorders in Children and Adolescents

by Amie E. Grills-Taquechel and Thomas H. Ollendick. In book series: Advances in Psychotherapy—Evidence-Based Practice, vol 27. Hogrefe, Cambridge, MA, 2013, 131 pages, $29.80 (paper).

In the hustle and bustle of the clinical care world, it is sometimes difficult to find the time to review the basic tenets of psychiatry. Phobic and Anxiety Disorders in Children and Adolescents does just that. Within the context of anxiety and phobic disorders, it reviews the differential diagnoses, theories, and models of these disorders, diagnostic methods, and treatment. This volume is a well-written overview of the topic. One drawback is that DSMIV-TR terminology is used instead of DSM-5, but for billing purposes, it does provide the corresponding ICD-10 codes.

The first chapter provides an overview of phobic and anxiety disorders as they specifically relate to children. The diagnoses, epidemiology, differential diagnoses, and comorbidities associated with these disorders are described. I found this chapter to be an easy-to-read narrative and a good overall review.

Subsequently, the authors highlight the different theories of why anxiety disorders develop in children and adolescents. The book does not claim to be an exhaustive description of all of the different possibilities but instead provides brief descriptions of the contributing factors including genetic/biological, child/developmental characteristics, and environmental and psychosocial influences. The chapter concludes by bringing all of these factors together to provide integrated models of anxiety. These models provide insight into how and why children become phobic or fearful. They help providers conceptualize the child and assist in developing effective treatment plans.

To properly treat a child with psychiatric issues, it is critical to obtain the correct diagnosis. The third chapter highlights the different tools that are useful in the diagnosis and treatment of anxiety disorders. One important tool mentioned by the authors is kids themselves. They state that even young kids can participate in psychiatric evaluations by answering simple questions about their emotions. The chapter focuses on the different diagnostic instruments available, including broad screening measures, structured and semistructured clinical interviews, observational and behavioral assessments, and rating scales. Detailed tables with examples of each type of assessment are provided for each type of measure. One table lists the scheduled interviews and which diagnoses they assess. This chapter is thorough enough to help even a beginner diagnostician choose appropriate diagnostic tools.

Treatment is the focus of the fourth chapter. The author emphasizes that this section focuses on empirically based treatments. The beginning of the chapter provides a glossary of terms related to treatment. I appreciated this glossary as a way to ensure that the terms mean the same thing to all readers. Treatment modalities are then divided into psychotherapy and psychopharmacology. For each modality, its mechanism of action, methodology, and efficacy are reviewed. The chapter emphasizes combination treatments and looks at their usefulness over single treatments. The effectiveness of psychopharmacologic treatments both individually and in combination with psychotherapy is evaluated. This chapter evaluates the evidence for each treatment, but it does not include details of each medicine (side effects, dosing, etc). The chapter provided an excellent balanced overview of the treatment options.

The book closes with a chapter that combines the didactics of the earlier chapters into a patient vignette—a nice way to conclude the book, as it brings clinical relevance to the forefront.

Felissa Goldstein, MD

Author affiliation: Lee Specialty Clinic, Louisville, Kentucky.

Potential conflicts of interest: None reported.

J Clin Psychiatry 2016;77(6):e760

© Copyright 2016 Physicians Postgraduate Press, Inc.

Volume: 77

Quick Links: Anxiety , Phobic Disorders