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  • Print publication year: 2000
  • Online publication date: March 2010

4 - Psychosocial developmental theory in relation to anxiety and its disorders

Summary

We must advance beyond the simple ‘stimulus charting’ of fears in youth if we are to truly understand their significance in development and their long-term impact on adjustment

Ollendick, King & Frary, 1989, p. 26

Introduction

Epidemiological and clinical studies have indicated that the prevalence of the different anxiety disorders is related to age, and that the average age-at-intake and age-at-onset also differ for the various anxiety disorders. At the same time, however, virtually any anxiety disorder may occur in any age cohort. This chapter addresses the question whether the differences both between and within age cohorts may be explained in terms of general theories of psycho-social development.

The following age pattern was observed for nonphobic anxiety disorders (Kashani & Orvaschel, 1990; Last et al., 1987; Westenberg et al., 1999; see also American Psychiatric Association (APA), 1987, 1994): (a) separation anxiety disorder (SAD) occurs most frequently in childhood, (b) overanxious disorder (OAD) ismost characteristic of adolescence and (c) panic disorder (PD) appears most frequent in late adolescence and (young) adulthood. Yet, SAD may also occur in adolescence, and PD may occur even in childhood (Ollendick, 1998). DSM-IV no longer includes OAD, and merged this classification with Generalized Anxiety Disorder (GAD; APA, 1994). However, the core criteria and the clinical features of OAD are highly similar to those in children with GAD (see APA, 1994). Tracey et al. (1997) observed that ‘DSM–IV GAD criteria are identifying the same sample as the DSM–III–R OAD criteria’ (p. 409).