Children and adolescents with generalized anxiety disorder are commonly described as ‘worriers’ by their parents. They worry excessively about many areas of life functioning, such as schoolwork, family, friends, health and any new or unusual situation. As a general guideline for making this diagnosis, the worry needs to be more days than not for a minimum of six months. These children show a persistent tendency to make negative predictions and to presume that the worst possible outcome will occur. For example, one 12 year old girl was certain that she would perform poorly in a school examination and that this would mean she would never be able to pursue a successful career. These beliefs lead to chronic worry and high anxiety about schoolwork, poor concentration and attention and, in turn, to reduced academic performance.
Children with GAD report difficulties controlling the worry and often seek reassurance or comfort from others. Over time, constant reassurance can further reinforce negative beliefs. Despite a common belief that GAD is manifested only as worry, these children will show considerable avoidance behaviour – for example refusing to try anything new or unusual. Other associated problems include poor concentration, irritability, restlessness, fatigue, sleep disturbance and somatic symptoms such as muscle tension, headaches or stomach aches.
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