The Developmental Psychopathology of Anxiety

527 Pages·2001·8.9 MB·English

by  Michael W. Vasey

The Developmental Psychopathology of Anxiety
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The Developmental
Psychopathology
of Anxiety
MICHAEL W. VASEY
MARK R. DADDS
Editors
OXFORD
UNIVERSITY PRESS
2001
OXPORD
UNIVERSITY PRESS
Oxford New York
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Copyright © 2001 by Oxford University Press, Inc.
Published by Oxford University Press, Inc.,
198 Madison Avenue, New York, New York 10016
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of Oxford University Press.
Library of Congress Cataloging-in-Publication Data
Vasey, Michael W.
The developmental psychopathology of anxiety / edited by Michael W. Vasey and
Mark R. Dadds.
p. cm.
Includes bibliographical references and index.
ISBN 0-19-512363-8
1. Anxiety in children. 2. Anxiety—Etiology. I. Dadds, Mark R. II. Title.
RJ506.A58 V37 2000
618.92'85223-dc21 00-020480
1 3 5 7 9 8 6 42
Printed in the United States of America
on acid-free paper
To Paula, Katie, Libby, and my parents:
For their patience, support, and the many things
I have learned in their company.
M.W.V.
To my very special family (Paula, Ana, and Tom),
my students, and the many children and families
I have worked with clinically:
AH have taught me so much.
M.R.D.
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PREFACE
Before the 1980s, childhood anxiety problems received surprisingly little
attention from researchers and clinicians relative to the large amounts of
attention devoted to externalizing problems of childhood, such as aggression
and hyperactivity. To a large extent, this relative neglect reflected the view
that childhood anxiety problems, along with other internalizing problems,
were typically transient developmental phenomena that had little importance
for children's long-term adjustment. However, subsequent to DSM-III's
introduction of several childhood anxiety disorder categories into the
psychiatric nomenclature, interest in clinical forms of childhood anxiety
has increased substantially.
Surprisingly, although this growth in interest has coincided with the
advent of the developmental psychopathology perspective, comprehensive
and integrative discussions of the developmental psychopathology of anxiety
remain rare. Understanding of the pathways by which childhood anxiety
disorders develop requires consideration of a wide array of developmental
influences and, more important, their potential for complex, reciprocal inter-
actions over time (i.e., transactions). Work that considers such issues has
begun to appear but, reflecting the broad range of factors that seem likely to
contribute to such disorders, it remains widely scattered across disparate
literatures within similarly diverse fields, including developmental psycho-
logy, clinical psychology, and psychiatry. Further, although a number of
excellent books on childhood anxiety and its disorders have appeared in
the past few years, they have generally devoted more space to descriptive,
assessment, and treatment issues than to considering issues related to the
developmental psychopathology of anxiety. To foster understanding of
such issues, we felt that a book was needed that reviews and integrates
current research and theory on the major factors that may predispose to,
protect against, precipitate, maintain, or ameliorate anxiety disorders in
childhood and the developmental variations that may exist in those factors
and in their operation as well as in the manifestations and prevalence of
anxiety disorders in childhood, and across the lifespan.
In keeping with the overall aims of the volume, contributors were encour-
aged to consider the tenets of the developmental psychopathology perspec-
tive (see chapter 1) when preparing their chapters. Because the study of many
of the issues and factors considered in this volume remains in its infancy, we
urged contributors to go beyond the extant data and speculate regarding the
implications of a developmental perspective for a given factor or its potential
viii Preface
for transactional relations to other factors. The result is a series of very
creative contributions that we are confident will stimulate further theoretical
and empirical efforts regarding these important issues and which will be of
interest to researchers and clinicians alike.
The book is divided into three parts. Part I contains two chapters which
lay the foundations for the remainder of the book. In chapter 1, we review the
major tenets of the developmental psychopathology perspective and, based
upon them, we offer a conceptual framework for conceptualizing the
development of childhood anxiety disorders. In chapter 2, Weiss and Last
review the research on age, sex, and developmental variations in the major
childhood anxiety disorders. As they note, research on anxiety disorders
across the lifespan requires clear understanding of the different forms
taken by such disorders at different points in the lifespan. Further, any
adequate theory of the developmental psychopathology of anxiety must
explain the patterns of change seen in the prevalence rates and manifestations
of anxiety disorders across the lifespan. Such changes are central phenomena
to be explained, and they also offer important clues regarding the factors that
may contribute to the development of anxiety disorders and how they may
differ across age groups.
Part II is devoted to the major factors that may play predisposing, pro-
tective, maintaining, and ameliorating roles in the development of childhood
anxiety disorders and the processes by which they may play such roles. To
begin the part, Eley provides in chapter 3 a comprehensive review of the
rapidly growing behavioral genetics research literature concerning childhood
anxiety. She concludes that there is a significant genetic risk for anxiety in
childhood, and this risk appears to be common to depressive symptoms as
well. Intriguingly, she also reports that there is strong evidence for shared
environmental influences in childhood anxiety, a finding that stands in stark
contrast to the consistent failure to find such influences in studies of adults.
Lonigan and Phillips (chapter 4) provide a comprehensive review of
temperamental influences related to childhood anxiety. In this context, they
articulate an innovative theory of temperamental vulnerability in which risk
for anxiety is related not to a single dimension of temperament but, instead,
to the interaction of two dimensions which operate in complex transaction
with a host of other influences.
In chapter 5, Reiss, Silverman, and Weems review the theory and
evidence underlying the construct of anxiety sensitivity and discuss its role
as a risk factor for childhood and adult anxiety disorders. Worthy of parti-
cular note is their discussion of exciting preliminary evidence that increasing
levels of anxiety sensitivity in childhood are associated with heightened risk
for the development of panic disorders.
In chapter 6, Chorpita reviews evidence for an association between early
control experiences and risk for anxiety disorders across the lifespan.
According to the theory offered by Chorpita, the risk and protective influences
attributable to such experiences are mediated by a variety of transactionally
related factors, which include psychological, social, and biological variables.
Preface ix
In chapter 7, Gunnar offers a critical analysis of evidence for a theory
which argues that biological factors play an important role in the onset and
maintenance of anxiety disorders. Specifically, she considers the hypothesis
that increased release of glucocorticoids and neuropeptides during fear
increases the excitability of fear circuits and plays a role in the organization
of pathological anxiety in humans and animals.
In chapter 8, Thompson considers risk for childhood anxiety disorders
from the perspectives of emotion regulation and attachment theory. In
doing so, he offers valuable insights regarding the development of anxiety
regulation strategies and capacities in both normal and excessively anxious
children.
Menzies and Harris review in chapter 9 the evidence for nonassociative
influences in the etiology of childhood phobias. They conclude that, although
associative conditioning influences play a role in the etiology of many
phobias, such influences are clearly lacking in many other cases. Non-
associative theory suggests that those other cases often represent failures to
master pre-existing fears owning to temperamental and parental influences.
In chapter 10, Dadds, Davey, and Field provide an overview of modern
respondent conditioning theory and then offer an innovative discussion of
such associative conditioning processes from a developmental perspective.
Because cognition figures strongly in current conceptualizations of respon-
dent conditioning, there are numerous ways in which cognitive development
may be relevant to understanding the operation of such processes in child-
hood and their relevance for understanding the etiology, maintenance, and
amelioration of childhood anxiety disorders.
Paralleling the discussion by Dadds and colleagues, Ollendick, Vasey,
and King discuss in chapter 11 the potential roles played by operant con-
ditioning influences in the etiology, maintenance, and amelioration of child-
hood anxiety disorders. They argue that the influence of many environmental
factors on childhood anxiety can be understood in operant conditioning
terms.
In chapter 12, Vasey and MacLeod review evidence for information-pro-
cessing biases related to childhood anxiety. They conclude that it is now
beyond doubt that anxious children show an attentional bias in favor of
threat-relevant stimuli, and more sparse evidence suggests that such children
additionally show a variety of other cognitive biases. However, important
questions remain to be answered regarding the development of such
biases. In the context of biased attentional processes, Vasey and MacLeod
consider several developmental models which must be examined in future
research.
In chapter 13, Dadds and Roth consider family processes in the develop-
ment of childhood anxiety problems. They review evidence for a variety
of family-based influences, and conclude by offering an integrative model
that draws attention to the interconnected influence of child temperament,
parent-child attachment, and family-based social learning processes when
anxiety-prone children are exposed to challenging situations.