Prevention of child and adolescent anxiety disorders

Anxiety disorders are the most frequently reported mental health concern in child, adolescent, and adult populations (see Costello, Egger, Copeland, Erkanli, & Angold, Chapter 3, this volume) with lifetime prevalence reaching approximately 30% (Kessler, Berglund, Demler, Jin, Merikangas, & Walters, 2005). These disorders exceed the health costs and societal burden of most other physical and mental health problems (Begg, Vos, Barker, Stevenson, & Lopez, 2007; Kessler & Greenburg, 2002). At the individual level, anxiety disorders are associated with immediate distress and impairment (Ialongo, Edelsohn, Werthamer-Larsson, Crockett, & Kellam, 1996; Strauss, Frame, & Forehand, 1987), are a known risk factor in the development of suicidal ideation and of mood and substance use disorders (Hofstra, Van der Ende, & Verhulst, 2000, 2002; Last, Perrin, Hersen, & Kazdin, 1996; Sareen et al., 2005), and are associated with poor long-term outcomes in social, academic, and career domains (Last, Hansen, & Franco, 1997; Weissman et al., 1999). Age of onset for anxiety disorders is typically in childhood or early adolescence (Kessler et al., 2005) and without treatment these disorders persist throughout a person's lifetime (Keller, Lavori, Wunder, Beardslee, Schwartz, & Roth, 1992). Set against this poor prognosis is research showing that the majority of people with anxiety disorders will not receive clinical intervention (Canino et al., 2004; Farmer, Stangl, Burns, Costello, & Angold, 1999).