Introduction
Childhood, as the initial stage of growing up, is the period of greatest sensitivity to various unfavorable factors due to the strength of the primary impressions and the low resistance of the child’s nervous system. The impact of these factors on the body and its condition is largely mediated by anxious experiences. In this regard, of particular interest are scholarly studies devoted to the analysis of the problem of childhood anxiety as a stable personality trait to the perception of a wide range of circumstances. This anxiety may be characterized as a reaction or response to a threat, and its intensity may not correspond to the objective danger (Morales et al., 2017). Anxiety has a pronounced age specificity, manifested in the forms of compensation and protection, but at different stages, for instance, infancy, preschool, school, and further ages, distinctive manifestations can be observed (Huberty, 2004). Therefore, the assessment of childhood anxiety is an important research field to identify the corresponding prerequisites and effects that are caused by different circumstances.
This work is a literature review that not only systematizes the findings of the causes of anxiety in children but also provides arguments from various authors about how to help the target population. As the sources involved, relevant peer-reviewed articles are used, as well as credible manuals and books. The need to consider childhood anxiety differentially as a situational phenomenon, taking into account personal characteristics and dynamics, explains the practical value of this review. The reason for the emergence of the psychological problem under consideration is always the child’s internal conflict caused by various factors, and the task of competent specialists is to identify specific prerequisites timely and address them through effective interventions.
Background of Studying Childhood Anxiety
In the psychological literature, one can find different definitions of the concept of anxiety, but in the case of such a diagnosis in a child, special criteria are taken into account. According to Huberty (2004), who cites the common term, anxiety “is apprehension or excessive fear about real or imagined circumstances” (p. 1). With regard to the child population, the author argues that anxiety manifests itself distinctively as children grow up, and although many of them tend to reflect on their fears and worries, not everyone experiences psychological discomfort, which is a sign of a possible disorder (Huberty, 2004). Numerous stress factors that a person experiences in childhood become the reasons for the development of anxiety states that can subsequently develop into severe mental problems. Moreover, the situation is aggravated by the high frequency of this issue. As Allen et al. (2020) argue, “anxiety disorders are the most prevalent mental health conditions among US youth, with more than 30% experiencing an anxiety disorder by the time they reach age 18 years” (p. 887). Therefore, addressing the problem through the comprehensive analysis of its causes and manifestations is a critical task.
Causes and Effects
In the academic environment devoted to the analysis of childhood anxiety, much attention is paid to the reasons for the development of this syndrome. Madigan et al. (2018) identify the basic prerequisites for the conditions and mention biological, psychological, and social causes as the main stimuli that can influence the onset of anxiety disorder in children. To date, a large amount of scholarly work has been accumulated concerning the analysis of physiological and psychophysiological changes in the body with a high level of anxiety. It should be noted, however, that despite the variety of this type of studies, they are mainly aimed at reviewing the characteristics of an adult.
Studies of childhood anxiety are performed less frequently, and they are predominantly psychological in nature. At the same time, according to Hollocks et al. (2019), functional disorders observed in anxious adults are not similar to those observed in children. In many works that investigate the emergence and development of childhood anxiety, a psychodynamic approach is carried out (Halfon, 2021). Those researchers who share it proceed from the fact that already at an early age, the individual characteristics of the child’s higher nervous activity are clearly manifested, which are based on the processes of excitation and inhibition and their various combinations (Halfon, 2021; Ruffalo, 2019). In this context, as Halfon (2021) states, anxiety is considered an innate psychodynamic characteristic manifested due to the weakness of the nervous system and the chaotic nature of nervous processes. This allows talking about the influence of physiological characteristics of development on the psychological state of the child.
On the other hand, this is essential to take into account the peculiarities of the social environment as a significant factor that determines, among other things, the child’s psychological development. Fox et al. (2018) note that if the genetic factor is leading in the formation of temperament, it will manifest itself along with the environmental influence. This view determines the biosocial approach to the consideration of the causes of childhood anxiety, which are rooted in both natural, genetic factors in the development of the child’s psyche and in social ones, which are revealed in conditions of socialization. According to Lebowitz et al. (2020), the question of the social causes of childhood anxiety is among the most frequently studied. Several factors can be distinguished, and their unfavorable development is determined by most researchers as the possible causes of the onset and consolidation of anxiety as a stable personality trait in a child.
Family Upbringing
In many scholarly works, the factors of family upbringing, primarily the mother-child relationship, are identified as the central cause of anxiety. Therefore, the data about the features of parent-child interactions, which are specific from the standpoint of the emergence of persistent anxiety in children, is important. For instance, Mehta (2016) mentions the factor of children’s inappropriateness to their parents’ prestigious aspirations, singled out as significant for younger schoolchildren’s anxiety. In addition, family influences are predominantly related to children of preschool and primary school age. The analysis of the influence of family characteristics and upbringing on anxiety in middle-school children and adolescents is different since, as Kranzler et al. (2016) note, the psyche of older children is more mature, and other criteria for assessment are necessary. Nevertheless, as the findings on this issue show, anxious children and adolescents feel less confident, reliable, and protected in the family than their peers with a normal level of anxiety. This explains the need to address the problem of relationships between children and parents to exclude one of the possible risk factors for the development of anxiety disorders.
Academic Performance
Another significant social factor to take into account when considering the issue of anxiety in children is the child’s success at school. A number of studies have shown no link between anxiety and performance as measured by current grades (Namkung et al., 2019; Marsh et al., 2017). It is revealed, however, when analyzing the child’s subjective perception of one’s academic performance (Marsh et al., 2017). In schoolchildren with a normal level of personal anxiety, satisfaction with academic performance depends mainly on the grade obtained. Anxious children are more likely to be dissatisfied with their academic performance, regardless of grades (Marsh et al., 2017). All this points to the importance of academic performance as a factor influencing at least the maintenance and intensification of anxiety, but this impact is indirect.
The issue of academic performance is closely related to how the student’s relationship with teachers develops. Teachers’ rudeness and tactless behavior towards schoolchildren are often seen as the primary causes of childhood anxiety. Such anxiety is described in academic literature under the name of didactogenic neurosis that, as Rosina (2020) argues, “is associated with the child’s attitude to the learning process itself” (p. 26). The analysis of relevant findings has shown that conflicting relationships with the teacher turn out to be the most destructive for those children who already have anxiety or are in a state of anxious readiness, that is, they feel helpless, lacking protection, opportunities for resistance (Rosina, 2020). Therefore, this is critical to consider the factor of academic performance as a potential driver of the development of anxiety disorders.
Peer Relationships
Another social factor in the formation of anxiety in children is relationships with peers. Some children tend to view the peer group as unreliable, dominant, or rejecting, which, in turn, negatively affects the child’s self-esteem and stimulates increased anxiety (Sette et al., 2016). At the same time, anxiety often acts as the main motive for communication, giving rise to increased dependence of a highly anxious child on peers (Sette et al., 2016). While lacking strong friendships, children try to build peer relationships, but due to individual factors, such as distinctive cultural, social, or other criteria, other children may be reluctant to communicate. When faced with this attitude, the child can become withdrawn and insecure, and these behavioral traits correlate directly with anxiety. Some children often cannot establish contact with peers themselves, and to overcome the fear of communication, they can commit wrong actions, for instance, submit to the dominance of more mentally stable peers. Thus, one can note that this is not so much the features of unfavorable communication with peers that affect the emergence and consolidation of anxiety but, conversely, that anxiety determines the characteristics of such communication.
Inner Conflict
Inner conflict associated with self-esteem, or self-concept, is often highlighted as one the most important source of anxiety. High anxiety indicates that the child has an unfavorable emotional experience caused by early trauma or other circumstances, and the inability to perceive oneself adequately gives rise to uncertainty (Lang & Connell, 2018). However, as data from studies on the etiology of childhood anxiety show, this is difficult to reliably identify the source of such an experience (Lang & Connell, 2018). A significant influence on its accumulation is exerted by the fact that in assessing their successes and failures, anxious children are guided mainly by external criteria, for instance, others’ approval or disapproval, attention from parents, and other factors. Since such criteria are largely beyond the control of the child, the problem arises, which is accompanied by a constant experience of uncertainty, giving rise to anxiety. Allen et al. (2016) assume that these features of negative emotional experience affect the diffuse, pointless nature of the experience of anxiety. However, regardless of their origin, anxiety disorders affect the fragile child’s psyche negatively and can create severe challenges for normal mental development.
Individual Roots and Causes of Childhood Anxiety
The described factors allow presenting a scheme of the origin of childhood anxiety and its consolidation as a stable personal education at different age stages. In preschoolers and younger schoolchildren, anxiety arises due to the frustration of the need for protection from the immediate environment (Rocha et al., 2019). During these periods, anxiety is not yet a personal formation itself; this is a function of unfavorable relationships with close adults. From pre-adolescence, anxiety is more mediated by the peculiarities of the attitude towards oneself, which during this period are of a contradictory, conflicting nature (Richardson et al., 2021). At the same time, anxiety itself deepens and intensifies this conflict because the resulting doubts, even about real achievements, further increase the negative emotional experience. Therefore, anxiety is consolidated, acquires stable forms of realization in behavior, and becomes a personal property that has its own incentive force. Internal conflict, reflecting contradictions in self-concept, continues to play a central role in the emergence and consolidation of anxiety in the future, and at each stage, it includes those personality aspects that are most significant during each period.
As a result, anxiety has a pronounced age specificity, which is found in its sources, content, and forms of manifestation. According to Elmore and Crouch (2020), the emergence and consolidation of anxiety as a stable formation is associated with the dissatisfaction of the leading needs of the age. For each age period, there are certain areas that cause increased anxiety. In children of early and preschool age, anxiety is generated by separation from loved ones. At the age of 6-7 years, the main role is played by adaptation to school, in younger adolescents – communication with adults (parents and teachers), in older adolescents – communication with peers (Cohen et al., 2018). In general, the child’s subjective distress in these areas, combined with a certain weakness of the psychodynamics of one’s nervous processes, is the reason for the formation and consolidation of personal anxiety in children.
One should note, however, that researchers do not have a consensus on the issue regarding at what age anxiety becomes a stable personality formation. Some authors believe that this can only be talked about by adolescence, and in preschool and primary school age, anxiety is a derivative of a wide range of family disorders (Stuijfzand et al., 2018). According to other authors, anxiety arises already in early childhood, and under unfavorable external circumstances in older preschool age, it develops into anxiety (Comer et al., 2019). However, it is a recognized truth that the formation of anxiety as a stable state is directly associated with the level of the child’s development (Sette et al., 2016). To respond to certain events with an increase in the level of anxiety, the child must have a developed perception to notice the danger, as well as a sufficient level of thinking to come to the conclusion about the inability to prevent this threat.
Despite the difference in approaches, this is worth noting that one of the periods when the number of anxious children increases significantly is primary school age. Rappo et al. (2017) consider a specific type of anxiety that appears during this period due to the entry of children into a new social situation of development – school anxiety. This is a broad concept that includes various aspects of persistent emotional distress, expressed the by excitement in educational situations and the expectation of a negative assessment from teachers and peers.
Data on gender differences that affect the manifestation of anxiety in children also deserve attention as individual criteria. According to the level and intensity of experiencing anxiety, there is a difference in the age dynamics of the state of anxiety in boys and girls (Ip et al., 2019). At preschool and primary school age, boys are more anxious than girls; at 9-11 years old, the intensity of feelings in both genders is equalized, and after 12 years, the general level of anxiety increases in girls while in boys, it slightly decreases (Ip et al., 2019). Nonetheless, girls’ anxiety differs from that of boys, and the older the children, the more significant this difference is (Ip et al., 2019). Girls’ anxiety is more often associated with other people; they are worried about the attitude of others, the possibility of a quarrel or separation from them. Boys are most often worried about violence in its various aspects. They are afraid of physical injury, accidents, and punishment from parents or authorities outside the family, particularly teachers and school principals. Therefore, individual characteristics can be the reasons for the development of anxiety disorders.
While considering the problem of childhood anxiety, this is also crucial to raise the question of its effects on the success of activities. The influence of anxiety on the child’s personality development and behavior can be both negative and, to some extent, positive (Uhl et al., 2019). However, in the latter case, this effect has severe limitations due to the pronounced adaptive nature of this formation. Studies show that up to adolescence, high anxiety has a negative effect on the success of activities, and this condition begins to perform the mobilizing function only in older adolescence since only by this age can it become a motivator (Day, 2016). Therefore, there is little valid evidence for the benefits of anxiety disorders in young children.
High anxiety among children of primary school age underlies many challenges, causing the formation of various negative changes in the functional state. According to Rozenman et al. (2017), severe anxiety reduces the ability to concentrate and impairs the reproduction of information and associative thinking. Its effect can be manifested in an increase in the time interval for the perception and processing of information, in the difficulties of organizing independent activity, and in the challenges of choosing adequate memorization techniques (Rozenman et al., 2017). Thus, a persistently high level of anxiety in childhood leads to a wide range of problems because, due to the fact that a person is in the stage of formation, the influence of a prolonged state of anxiety is strong. The consequences of such an impact may manifest themselves in the impaired development of individual structures and functions and, ultimately, impaired personality formation.
One should note that, in modern scientific literature, there are few works devoted to the comparison between psychological and physiological changes in children with a high level of anxiety. Many studies using clinical diagnostic methods often focus on reviewing children with associated mental problems, for instance, autism spectrum disorder (Rodgers et al., 2016; Vasa et al., 2016). Therefore, the need to improve approaches to the interpretation of child anxiety is due to the importance of identifying the nature of its impact on the child’s body, as well as preventing possible negative consequences timely. This explains the relevance of searching for adequate techniques to help the vulnerable population.
Approaches to Prevent and Address Childhood Anxiety
Working with an anxious child is not easy and, as a rule, takes a long time. Moreover, for the result of targeted interventions to be positive, this is crucial to address the problem from different angles and through the involvement of various stakeholders, including both parents and other adults who are part of the child’s social environment, particularly school teachers. When interacting with anxious children, one should take into account their special attitudes towards success, failure, assessment, and result. As Viana et al. (2019) state, children are sensitive to the outcomes of their activities, and they tend to be afraid and avoid failure and cannot objectively assess results and decide for themselves whether they have done something right but wait for this assessment from adults. Therefore, work with anxious children can be performed in different directions, addressing psycho-emotional development characteristics and, at the same time, considering both psychological aspects and physical factors. As potentially effective methods of influence, adults should pay attention to increasing children’s self-esteem, teaching them the ability to manage themselves in specific, most exciting situations, as well as promoting special relationships at the family level.
Increasing Children’s Self-Esteem
This is impossible to increase the child’s self-esteem in a short time because, in addition to targeted psychological activities, the involved participants in these correction sessions should work in different social circles in which the kid interacts with adults and peers. Adults should refer to the child by name, praise him or her for even minor successes, and highlight their positive results among their peers (Dale et al., 2019). However, the praise is to be sincere because children react sharply to falsehood, and the kid should definitely know what he or she has been praised for and why. These initiatives can help not only enhance the child’s self-esteem but also improve their relationship with peers, who, seeing no clear reasons for bullying, may stop showing hostility. Therefore, improving self-esteem through relevant psychological techniques allows addressing a number of important perspectives.
The methods of preventing anxiety in children include play and art therapies, which can also increase the level of self-esteem of an anxious kid. The main goal of play therapy is to help the child express any anxious experiences he or she has. The implementation of such assistance through play is the most acceptable since the simulation of situations is the leading activity in preschool age. This method of psychological assistance and self-esteem enhancement allows solving a number of valuable tasks. This includes preventing the appearance of neuropsychiatric disorders in children, developing the ability to regulate their emotions, building trust in adults and peers, getting rid of psychological tension, preventing and correcting deviations in the child’s behavior, as well as developing creative thinking (Zolrahim & Azmoudeh, 2020). These perspectives substantiate the importance of the use of play therapy as a potentially effective intervention technique.
Art therapy is an intervention through the use of art. According to Kostyunina and Drozdikova-Zaripova (2016), in relation to the problem under consideration, this approach is based on helping to free oneself from internal experiences that are characteristic of an anxious child. In the process of art therapy, new forms of self-expression are manifested. They are based on individual systems of motives and presuppose the child’s expression of one’s feelings and experiences in an external form. Such techniques stimulate the desire to understand one’s inner world, the satisfaction of the need for communication with other people, as well as the knowledge of the surrounding world through symbolizing it from a personal standpoint or constructing, for instance, in the form of drawings, stories, or crafts (Rozina, 2020). Various types of art therapy provide an opportunity for self-expression and self-discovery and allow the child to rise to a higher level of their development and self-esteem.
Teaching Children to Manage Their Behavior
As a rule, anxious children do not openly report their problems, and sometimes they even hide them. Therefore, as Swan and Kendall (2016) emphasize, if a child declares to an adult that he or she is not afraid of anything, this does not mean that these words are true. Most likely, this is a manifestation of anxiety the child cannot or does not want to admit. In this case, adults should do their best to involve the kid in a joint discussion of the problem and explain the causes of stress. In kindergarten, adults can discuss with children their feelings and experiences in situations that excite them. In a school environment, by using examples of literary works, teachers can show children that bravery is not a quality of a person who is not afraid of anything but who knows how to overcome one’s fear. Adults can offer pupils to draw their sources of anxiety and talk about them. Such conversations can help anxious children realize that many peers have problems similar to those they thought were characteristic only of them.
Adults who interact with children in families or at school should remember that kids should not be compared to one another. With regard to anxious children, this form of conduct is categorically unacceptable. In addition, when teaching these target audiences to manage behavior, Kalatskaya and Drozdikova-Zaripova (2016) recommend avoiding competition and activities that involve comparing some children with others. This can be traumatic; therefore, the emphasis on coping with anxiety should be presented to the child as an individual skill that they should develop while taking into account the corresponding behavioral motives.
Parents’ Targeted Work
In some families, parents make demands on the child, which he or she cannot meet. As Beato et al. (2017) note, to avoid the fearful attention of adults or their criticism, many kids physically and mentally restrain their internal energy. This, in turn, slows down the normal cognitive development of the child and the realization of his or her creative abilities and interferes with communication with adults and children. To relieve their son or daughter of anxiety, parents should celebrate his or her successes daily by reporting them in the presence of the child to other family members (Beato et al., 2017). This is also useful to reduce the number of remarks and threats so as not to stimulate the emergence and rooting of fears in a fragile child’s psyche. The general emotional atmosphere in the family social environment is important.
Often, children with increased anxiety are demoralized by the first signs of this condition. In many cases, this is crucial to explain to them that these are signs of a person’s readiness to act, and they are experienced by most people (Francis & Roemhild, 2021). It is necessary to teach such children productive work, self-distraction from their fears, and the sense of the right path in their activities not distracted by anxieties of different natures. According to Viana et al. (2017), one of the markers of anxious people’s effective activity is that they are focused not only on its implementation but to a greater extent on how they look. In this regard, this is essential to train them to formulate the goal of their behavior in a given situation, completely distracting from external circumstances. This is also necessary to teach the child the ability to reduce the significance of the situation and understand the sufficiently relative importance of victory or defeat. Parents can use this educational approach as a training technique to help their child learn to control oneself and be ready for more serious challenges in adulthood.
Parental attention and care are the critical components of raising a child with a healthy psyche and normal mental development. Moreover, parents can be involved in therapy sessions because, as Carnes et al. (2019) argue, “including parents in psychological treatment is a good approach to treatment as it is the parents who have the experience, foresight, and motivation required for successful treatment that children often lack” (p. 184). The more attention a child receives, the less likely they will face fears caused by self-doubt and disapproval from adults and peers. Therefore, parents’ target work is one of the key directions in addressing the problem in question.
Conclusion
Since childhood anxiety is a common phenomenon caused by internal conflicts and negative experiences, the task of adults is to provide timely and competent assistance aimed at addressing the causes of anxiety and preventing the development of more dangerous disorders in the future. At different stages of growing up, a child faces new challenges and may experience negative interactions with peers or other adults. The findings from the involved academic sources show that despite individual manifestations of anxiety, each child can exhibit different responses due to a variety of factors, including demographic characteristics. Help for the vulnerable population should come from a variety of stakeholders and can be based on building children’s self-esteem, teaching them how to deal with negative emotions, and involving parents as the key mediators of the parenting process. Future research on the topic of childhood anxiety may be related to identifying correlations between disturbed mental state and the digital environment because expanding the role of media in modern life is a threat to the child’s psyche, which can stimulate the development of mental disorders caused by the negative effects of online communication.
References
Allen, K. B., Benningfield, M., & Blackford, J. U. (2020). Childhood anxiety – If we know so much, why are we doing so little? JAMA Psychiatry, 77(9), 887-888. Web.
Allen, K. B., Silk, J. S., Meller, S., Tan, P. Z., Ladouceur, C. D., Sheeber, L. B., Forbes, E. E., Dahl, R. E., Siegle, G. J., McMakin, D. L., & Ryan, N. D. (2016). Parental autonomy granting and child perceived control: Effects on the everyday emotional experience of anxious youth. Journal of Child Psychology and Psychiatry, 57(7), 835-842. Web.
Beato, A., Pereira, A. I., & Barros, L. (2017). Parenting strategies to deal with children’s anxiety: Do parents do what they say they do? Child Psychiatry & Human Development, 48(3), 423-433. Web.
Carnes, A., Matthewson, M., & Boer, O. (2019). The contribution of parents in childhood anxiety treatment: A meta‐analytic review. Clinical Psychologist, 23(3), 183-195. Web.
Cohen, J. R., Andrews, A. R., Davis, M. M., & Rudolph, K. D. (2018). Anxiety and depression during childhood and adolescence: Testing theoretical models of continuity and discontinuity. Journal of Abnormal Child Psychology, 46(6), 1295-1308. Web.
Comer, J. S., Hong, N., Poznanski, B., Silva, K., & Wilson, M. (2019). Evidence base update on the treatment of early childhood anxiety and related problems. Journal of Clinical Child & Adolescent Psychology, 48(1), 1-15. Web.
Dale, L. P., Vanderloo, L., Moore, S., & Faulkner, G. (2019). Physical activity and depression, anxiety, and self-esteem in children and youth: An umbrella systematic review. Mental Health and Physical Activity, 16, 66-79. Web.
Day, P. (2016). Motivating teen spirit: Early mental health intervention. British Journal of School Nursing, 11(2), 93-95. Web.
Elmore, A. L., & Crouch, E. (2020). The association of adverse childhood experiences with anxiety and depression for children and youth, 8 to 17 years of age. Academic Pediatrics, 20(5), 600-608. Web.
Fox, A. S., Oler, J. A., Birn, R. M., Shackman, A. J., Alexander, A. L., & Kalin, N. H. (2018). Functional connectivity within the primate extended amygdala is heritable and associated with early-life anxious temperament. Journal of Neuroscience, 38(35), 7611-7621. Web.
Francis, S. E., & Roemhild, E. (2021). Assessing parental cognitions about child anxiety: Are parents’ thoughts about child anxiety associated with child anxiety and anxiety sensitivity? Journal of Anxiety Disorders, 80, 102400. Web.
Halfon, S. (2021). Psychodynamic technique and therapeutic alliance in prediction of outcome in psychodynamic child psychotherapy. Journal of Consulting and Clinical Psychology, 89(2), 96-109. Web.
Hollocks, M. J., Lerh, J. W., Magiati, I., Meiser-Stedman, R., & Brugha, T. S. (2019). Anxiety and depression in adults with autism spectrum disorder: A systematic review and meta-analysis. Psychological Medicine, 49(4), 559-572. Web.
Huberty, T. J. (2004). Anxiety and anxiety disorders in children: Information for parents. National Association of School Psychologists, 1-6.
Ip, K. I., Liu, Y., Moser, J., Mannella, K., Hruschak, J., Bilek, E., Muzik, M., Rosenblum, K., & Fitzgerald, K. (2019). Moderation of the relationship between the error-related negativity and anxiety by age and gender in young children: A preliminary investigation. Developmental Cognitive Neuroscience, 39, 100702. Web.
Kalatskaya, N. N., & Drozdikova-Zaripova, A. R. (2016). Ways to help the child cope with anxiety? International Electronic Journal of Mathematics Education, 11(4), 499-511.
Kostyunina, N. Y., & Drozdikova-Zaripova, A. R. (2016). Adolescents’ school anxiety correction by means of mandala art therapy. International Journal of Environmental and Science Education, 11(6), 1105-1116. Web.
Kranzler, A., Young, J. F., Hankin, B. L., Abela, J. R., Elias, M. J., & Selby, E. A. (2016). Emotional awareness: A transdiagnostic predictor of depression and anxiety for children and adolescents. Journal of Clinical Child & Adolescent Psychology, 45(3), 262-269. Web.
Lang, J. M., & Connell, C. M. (2018). The child trauma screen: A follow‐up validation. Journal of Traumatic Stress, 31(4), 540-548. Web.
Lebowitz, E. R., Marin, C., Martino, A., Shimshoni, Y., & Silverman, W. K. (2020). Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized noninferiority study of supportive parenting for anxious childhood emotions. Journal of the American Academy of Child & Adolescent Psychiatry, 59(3), 362-372. Web.
Madigan, S., Oatley, H., Racine, N., Fearon, R. P., Schumacher, L., Akbari, E., Cooke, J. E., & Tarabulsy, G. M. (2018). A meta-analysis of maternal prenatal depression and anxiety on child socioemotional development. Journal of the American Academy of Child & Adolescent Psychiatry, 57(9), 645-657. Web.
Marsh, H. W., Pekrun, R., Parker, P. D., Murayama, K., Guo, J., Dicke, T., & Lichtenfeld, S. (2017). Long-term positive effects of repeating a year in school: Six-year longitudinal study of self-beliefs, anxiety, social relations, school grades, and test scores. Journal of Educational Psychology, 109(3), 425-438. Web.
Mehta, R. (2016). Relationship between parental aspiration and academic anxiety in adolescence. International Research Journal of Management Sociology & Humanity (IRJMSH), 7(2), 27-37.
Morales, S., Taber‐Thomas, B. C., & Pérez‐Edgar, K. E. (2017). Patterns of attention to threat across tasks in behaviorally inhibited children at risk for anxiety. Developmental Science, 20(2), e12391. Web.
Namkung, J. M., Peng, P., & Lin, X. (2019). The relation between mathematics anxiety and mathematics performance among school-aged students: A meta-analysis. Review of Educational Research, 89(3), 459-496. Web.
Rappo, G., Alesi, M., & Pepi, A. (2017). The effects of school anxiety on self-esteem and self-handicapping in pupils attending primary school. European Journal of Developmental Psychology, 14(4), 465-476. Web.
Richardson, C. E., Magson, N. R., Fardouly, J., Oar, E. L., Forbes, M. K., Johnco, C. J., & Rapee, R. M. (2021). Longitudinal associations between coping strategies and psychopathology in pre-adolescence. Journal of Youth and Adolescence, 50(6), 1189-1204. Web.
Rocha, M. S., Yaruss, J. S., & Rato, J. R. (2019). Temperament, executive functioning, and anxiety in school-age children who stutter. Frontiers in Psychology, 10, 2244. Web.
Rodgers, J., Wigham, S., McConachie, H., Freeston, M., Honey, E., & Parr, J. R. (2016). Development of the anxiety scale for children with autism spectrum disorder (ASC‐ASD). Autism Research, 9(11), 1205-1215. Web.
Rozenman, M., Vreeland, A., & Piacentini, J. (2017). Thinking anxious, feeling anxious, or both? Cognitive bias moderates the relationship between anxiety disorder status and sympathetic arousal in youth. Journal of Anxiety Disorders, 45, 34-42. Web.
Rozina, I. (2020). Special features of designing a correction program for adolescents who have signs of psychosomatic disorders. European Humanities Studies: State and Society, (3(II)), 19-38. Web.
Ruffalo, M. L. (2019). Understanding schizophrenia: Toward a unified biological and psychodynamic approach. Psychoanalytic Social Work, 26(2), 185-200. Web.
Sette, S., Baumgartner, E., Laghi, F., & Coplan, R. J. (2016). The role of emotion knowledge in the links between shyness and children’s socio‐emotional functioning at preschool. British Journal of Developmental Psychology, 34(4), 471-488. Web.
Stuijfzand, S., Creswell, C., Field, A. P., Pearcey, S., & Dodd, H. (2018). Research review: Is anxiety associated with negative interpretations of ambiguity in children and adolescents? A systematic review and meta‐analysis. Journal of Child Psychology and Psychiatry, 59(11), 1127-1142. Web.
Swan, A. J., & Kendall, P. C. (2016). Fear and missing out: Youth anxiety and functional outcomes. Clinical Psychology: Science and Practice, 23(4), 417-435. Web.
Uhl, K., Halpern, L. F., Tam, C., Fox, J. K., & Ryan, J. L. (2019). Relations of emotion regulation, negative and positive affect to anxiety and depression in middle childhood. Journal of Child and Family Studies, 28(11), 2988-2999. Web.
Vasa, R. A., Mazurek, M. O., Mahajan, R., Bennett, A. E., Bernal, M. P., Nozzolillo, A. A., Arnold, L. E., & Coury, D. L. (2016). Assessment and treatment of anxiety in youth with autism spectrum disorders. Pediatrics, 137(Supplement 2), S115-S123. Web.
Viana, A. G., Kiel, E. J., Alfano, C. A., Dixon, L. J., & Palmer, C. A. (2017). The contribution of temperamental and cognitive factors to childhood anxiety disorder symptoms: A closer look at negative affect, behavioral inhibition, and anxiety sensitivity. Journal of Child and Family Studies, 26(1), 194-204. Web.
Viana, A. G., Trent, E. S., Raines, E. M., Woodward, E. C., Storch, E. A., & Zvolensky, M. J. (2019). Childhood anxiety sensitivity, fear downregulation, and anxious behaviors: Vagal suppression as a moderator of risk. Emotion, 21(2), 430-441. Web.
Zolrahim, R., & Azmoudeh, M. (2020). The effect of cognitive-behavioral play therapy on social anxiety and aggressive behaviors in primary school children. Quarterly Journal of Child Mental Health, 6(4), 231-240. Web.