The screen problem for children with anxiety
Friday, June 22, 2018
While depictions of violence affect many children differently, those with an anxiety disorder are more likely to experience a negative impact.
"Children who have a preexisting anxiety disorder are at greater risk for reacting more viscerally to violent or frightening images or stories," said Dr. Victor Fornari, director of child and adolescent psychiatry at Zucker Hillside Hospital in Queens, New York City. "Distressing images from these sources can imprint in their memory and cause them to relive them through flashbacks or intrusive thoughts that can interfere with their daily lives."
The role of primary care
Pediatricians can help prevent these ramifications. Dr. Fornari recommends incorporating behavioral health screenings into children’s annual well visits to establish a mental health baseline and identify behavioral health concerns as they develop.
For example, in 2008, Massachusetts mandated that annual well-child visits include pediatric behavioral health screenings. Through the initiative, 355,490 children received screening, with nearly 153,000 children having a previously unlisted behavioral health condition added to their medical chart, according to a study published in Pediatrics.
Screening for anxiety disorders — using rating scales, such as the Generalized Anxiety Disorder 7 (GAD-7), Penn State Worry Questionnaire (PSWQ) or Screen for Child Anxiety Related Emotional Disorders (SCARED) — can identify children who are at greater risk for reacting adversely to scary images or stories.
Should patients experience loss of sleep or nightmares, which may indicate a reaction to something they’ve seen, pediatricians can use the baseline data to assess the severity of the condition and make a referral. The physician can also use the opportunity to advise parents about limiting exposure to violent video games, movies and TV shows.
"These screenings can shed light on early signs of a change in the way a child functions, such as falling grades," Dr. Fornari said. "The earlier a primary care provider identifies young people who are experiencing stress, the earlier we can intervene and prevent problems."
The Child and Adolescent Psychiatry for Primary Care, co-created by Dr. Fornari, is a behavioral health support network of select medical schools and teaching hospitals.
The site offers primary care physicians easy access to referral or consultation resources, plus a library of assessment questionnaires and rating scales, webinars and the opportunity to enroll in a toll-free consultation line.
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