Prevention of anxiety disorders

Introduction Anxiety disorders are common and associated with significant impairment in family, peer and academic domains. They typically emerge in childhood or adolescence (Kessler et al., 2005), take a chronic and recurrent course if left untreated (Last et al., 1996), and increase the risk for mental health problems including other anxiety disorders, depression and substance abuse (Bittner et al., 2007). In addition, anxiety disorders are associated with poor long-term outcomes including reduced career choices, alcohol abuse, increased use of health services and suicide (Norton et al., 1996; Roy-Byrne & Katon, 1997). While treatment for anxiety is effective for 50–60% of children, many continue to experience considerable difficulties; some drop out of treatment prematurely and others experience a recurrence of symptoms in the longer term (James et al., 2005; Last et al., 1996). The substantial personal, societal and financial cost of anxiety disorders highlights the importance of identification of children at risk, improved access to health services, and prevention and early intervention for anxiety (Barrett & Pahl, 2006). Ideally, interventions should be provided before difficulties have progressed to the point where child anxiety and maladaptive patterns of family interaction have become rigid and difficult to treat (Dadds et al., 1997).