Introduction

Progress in the neurobiology of childhood anxiety has recently focused on the effects of rearing and environment in the progression of anxiety states. Convergence of evidence from both child studies of stress and trauma (Pfefferbaum, 1997; Pynoos, Steinberg & Wrath, 1995) as well as primate rearing and deprivation studies (Coplan et al., 1996; Higley, Suomi & Linnoila, 1992) illustrate that the effects of stress in the genesis of anxiety disorder can be profound. Anxiety disorders are now viewed from a developmental perspective (Ollendick, 1998; Rosenberg & Keshavan, 1998) in which an individual's history of exposure to threat and that threat's developmental and cognitive context are interwoven with internal factors (e.g. genetic and neurophysiological) as keys to the individual's ‘stress-response system’. Later in this chapter, neuroanatomical and information processing models of panic and childhood obsessive–compulsive disorders (OCD) are discussed in their developmental context in order to shed light on both the development of anxiety disorder and its frequent association with comorbid conditions, such as attention-deficit hyper-activity disorder (ADHD), in child psychiatry. The implication is clear: anxiety disorders, now viewed across the life span (Ballenger, 1997; Lydiard & Brawman-Mintzer, 1997), require treatments that reflect both the developmental stage and context of anxiety disorder genesis and maintenance.

Our understanding of the neurobiology of anxiety has been propelled by new pharmacological therapeutic tools specific in their impact on certain central nervous system (CNS) receptors within the ‘stress-response system’.