Children and adolescents are often grouped together and treated similarly. Most materials used to assess mental health in minors examine a large age range from five to 18 years old. However, Polly Waite and Cathy Creswell point out that children and adolescents are different in terms of mental and physical development; such factors question a homogenized treatment approach to individuals younger than 18.

According to the latest news from the October 2014 volume of Journal of Affective Disorders, children differ from adolescents in clinical characteristics so much that separate treatment plans are needed. Waite and Creswell compared the clinical characteristics of anxiety disorder assessment between children and adolescents in attempts to redefine treatment plans for each group.

Reassessing Anxiety Disorders in Children and Adolescents

All children and adolescents were recruited from the Berkshire Healthcare NHS Foundation Trust, Child and Adolescent Mental Health Service (CAMHS) Anxiety and Depression Pathway, based at the University of Reading. Waite and Creswell chose 100 children ages six to 12 and 100 adolescents ages 13 to 18. For the purpose of this study, Waite and Creswell classified preteens as children and teenagers as adolescents. However, the researchers acknowledged that developmental changes occur at different ages and sometimes in discrete ways. All individuals had been assessed with an anxiety disorder. Patients with Obsessive-compulsive Disorder (OCD) and complex Post-traumatic Stress Disorder (PTSD) were excluded from the study because neither fall under the category of broad anxiety disorders in the DSM-5.

After collecting general demographic data, all participants were reassessed with the following measures:

  • Anxiety Disorders Interview Schedule for Children (ADIS-C/P): A structured interview designed to assess a patient according to the DSM-IV criterion.
  • Spence Children's Anxiety Scale (SCAS-C/P): A 38-item survey assessing panic attacks, agoraphobia, separation anxiety, physical injury fears, social phobia, generalized anxiety, and obsessive-compulsive symptoms.
  • Short Mood and Feelings Questionnaire (SMFQ-C/P): A 13-item self-report measuring depression.
  • Strength and Difficulties Questionnaire (SDQ-P): A 5-item questionnaire assessing behavioral disturbance and externalizing symptoms.

Caregivers were also assessed in the study. Waite and Creswell used A 21-item self-report called the Depression Anxiety Stress Scales (DASS) to measure levels of emotional burdens in caregivers.

The Diagnostic Differences between Children and Adolescents

The results from the ADIS-C/P assessed 84 percent of both the child and adolescent groups for an anxiety disorder. When it came to properly defining the disorder, the following was found:

  • Children were significantly more likely to be diagnosed with separation anxiety disorder.
  • Adolescents were significantly more likely to be diagnosed with Social Anxiety Disorder (SAD).
  • Adolescents were commonly diagnosed with a comorbid mood disorder.
  • More adolescents with an anxiety disorder were not regularly attending school.
  • Adolescents scored higher on the SMFQ-C/P and SDQ-P.
  • Caregivers of both groups scored similarly.

The observations clearly show a distinction between the age groups. Waite and Creswell suggest that “adapting treatments designed for children to make the materials more 'adolescent-friendly' is unlikely to sufficiently meet the needs of adolescents."

Date of original publication:
Updated on: October 23, 2015

Sources

Science Direct

Polly Waite, Cathy Creswell. Children and adolescents referred for treatment of anxiety disorders: Differences in clinical characteristics. Journal of Affective Disorders, 1 October 2014; DOI: 10.1016/j.jad.2014.06.028

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