Children who experience difficulty at school will most likely experience anxiety or fear that is associated with their performance at school. Also keep in mind that for some children this is the root cause for their behaviour.  Anywhere, between 20 to 30 percent of a population suffers from some form of anxiety-related disorders during their lifetime.

While the physical and psychological manifestations of anxiety and fear can appear similar, they are not.  According to the operational definitions, Anxiety is characterized as a state of being that arises from general and non-specific stimuli that are perceived as being potentially threatening in the future.  This perception often results in apprehension accompanied by increased arousal and vigilance which can be extreme and persists for an extended period of time.  The fear response is stimulated by specific stimuli and results in active-defensive responses that will subside when the fear stimulator is not longer present.  A fear of snakes is not the same as feeling anxiety over failing a grade.

These two behavioural states do share some sub-systems in the brain and also have their own underlying constellation of brain regions that are activated.  Imaging studies have provided evidence to suggest that alteration of brain activity and structure within and between neural circuits plays a critical role in how these two states are expressed.  They are therefore treated with different therapeutic strategies that manipulate this altered brain and focus on the neurological pathways behind these disorders.

Treatment:

Controlling the firing of specific cells and neural circuitry using light-based manipulation of ion channels (optogenetics) is promising.

Manipulating the epigentic code with drugs that interfere with the genetic expression of fear and anxiety is currently being investigated.

Pharmacological interventions that affect the deployment of neurotransmitters are still the most commonly used treatment.

Cognitive Behavioural Therapy and Extinction-based interventions – where the person is exposed to the stimulus that triggers the fear in the absence of the negative outcome, or talking about the general state of anxiousness is the treatment approach. Virtual reality environments have been useful in exposing the person to the environment in a safe manner.  These treatments often fail in children who are not ready or prepared to undertake this approach.

Lifestyle interventions like, diet, exercise, meditation and environmental change are also therapeutic strategies that do work for some children.

One single form of intervention will not be completely successful.  Therefore, a multi-pronged approach that combines current research with early diagnosis and intervention is the most efficient treatment.

When trying to deal with anxiety and fear it is important you understand the neural mechanisms of these states and emotion regulation if you have any hope of helping someone alter their brain functioning and consequently the behaviour associated with it.

(Dias, B., Banerjee, S., Goodman, J., & Ressler, K.  Towards New Approaches to Disorders of Fear and Anxiety. (2014).   Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta GA)

 

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