Adolescence

Adolescence is the stage in a young person’s life between childhood and adulthood where a child moves developmentally from dependency to independence, while becoming more autonomous within their thinking and actions (Geldard et al., 2019). Adolescence is a period of many developmental challenges, including biological, cognitive, psychological and social that may be related to a young person’s personality traits or their surrounding environments (Geldard et al., 2019). For example, adolescents may experience difficulty with aggression, violence, social acceptance and their sexuality (Wise, 2004). In addition, some adolescents may find it difficult to deal with these challenges successfully, leading to an increase in behavioural or emotional consequences (Geldard et al., 2019). As a result, a young person may be susceptible to an increased change in their moods, resulting in some young people experiencing mental health conditions such as anxiety (Wise, 2004).

Anxiety

Anxiety is characterised by feelings of tension, worried thoughts and physical changes (American Psychological Association [APA], 2013b). It is a common neurobiological disorder that affects close to 14% of the population (Beyond Blue, 2022a), with individuals that experience anxiety usually having recurring intrusive thoughts, feelings and concerns (APA, 2013b). In adolescence, anxiety can include the anticipation of real or imagined threats to themselves and the term can be used interchangeably with fear (Fonseca et al., 2011). An individual with anxiety may experience one of four main types of the disorder, including generalised anxiety disorder, social phobia, specific phobia or obsessive-compulsive disorder (Geldard et al., 2019), all having specific impacts on a young person’s relationships (Rapee, 2015).

A young person that has anxiety may experience changes to their behaviour, cognitive responses or physiological responses (Fonseca et al., 2011). Common behaviours can include nervousness, restlessness, poor concentration, irritable moods and fatigue (Geldard et al., 2019). Furthermore, behaviours such as avoiding situations, irrational fears or obsessively concerned about unpleasant and intrusive thoughts may be present in an adolescent with an anxiety disorder (Geldard et al., 2019). These behaviours can have multiple impacts on a young person’s life, including educational outcomes and social situations (Rapee, 2015).

Anxiety can impact an adolescent’s life in many ways. As argued by Ameringen et al. (2003), anxiety can have negative consequences on a broad range of psychosocial variables such as academic performance and social functioning. In addition, anxiety can also lead to school refusal, educational underachievement and difficulty forming appropriate relationships (Ameringen et al., 2003). These behaviours within an adolescent can then lead to problems adjusting to adulthood and successfully functioning outside their environments (Rapee, 2015).

Evidence of Symptoms

Various symptoms contribute to the development of anxiety in adolescents. Symptoms of anxiety are argued to be the most common psychiatric problem among adolescents, causing significant negative impacts on the daily functioning and quality of life of young people (Weeks et al., 2016). Maladaptive cognitive patterns have been examined to contribute to the development and maintenance of anxiety in adolescents, specifically the way a young person processes threatening information or dangerous situations (Weeks et al., 2016). Furthermore, cognitive interpretation of emotional situations can cause excessive catastrophizing, over generalising and personalising of stressful situations in which an adolescent has difficulty processing (Legerstee et al., 2011). In addition, self-blame and rumination have been argued to be positively associated with symptoms of anxiety in adolescents (Legerstee et al., 2011). As such, it can be argued that negative cognitive contexts are observed to be a factor in the presence of anxiety in young people.

Behaviourally, there are various symptoms that can be argued to be observed in adolescents with an anxiety disorder. Inhibited temperaments such as irritability, shyness and fear of unknown situations are behavioural patterns that can be argued to be present in adolescents with an anxiety disorder (Muris et al., 2001). Moreover, interaction with negative environmental influences, such as stressful life experiences, also impacts a teenager’s susceptibility in developing an anxiety disorder (Muris et al., 2001). In addition, a young person’s environment has significant impacts on the presence of anxiety throughout adolescence (Geldard et al., 2019). This is due to factors such as parental expectations, peer acceptance and academic pressure (Rapee, 2015). This connection between the behavioural and social contexts of a young person’s life is argued to be major risk factors in individuals with anxiety (Geldard et al., 2019).

Anxiety disorders in adolescence are associated with impaired academic, financial, social, and health functioning and can lead to significant risk for developing an anxiety disorder (Reardon et al., 2018). When identifying an adolescent with an anxiety disorder, multiple assessments are utilised to accurately ascertain the level and type of symptoms present. Typically, assessment of adolescents requires multiple approaches including multiple measures, multiple informants, multiple settings and multiple time periods (Huberty & Reed, 2012). Furthermore, developmental and family history, interviews, with family and teachers, diagnostic tools and observations are all frequently used to monitor symptoms of anxiety in adolescents (Huberty & Reed, 2012).

Questionnaires, interviews and psychometric data are used as diagnostic tools for identifying anxiety disorders in adolescents (Geldard et al., 2019). One of the most common ways of assessing a young person for an anxiety disorder is the use of questionnaires such as the Spence Children’s Anxiety Scale (SCAS), Revised Children’s Anxiety and Depression Scale (RCADS), Screen for Child Anxiety Related Disorders (SCARED) and the Multidimensional Anxiety Scale for Children (MASC-2; Reardon et al., 2018). These questionaries measure for accuracy, consistency and validity in diagnosing an adolescent with an anxiety disorder. Although arguments demonstrate that these diagnostic tools are ineffective due to time constraints, specificity and the difficulty distinguishing between anxiety and other psychiatric disorders, they are overall effective at identifying a mental health disorder in adolescents (Reardon et al., 2018).

Impact on the Individual and Interactions

Anxiety in an adolescent can be disabling and more pervasive than the anxiety experienced in normal life (Geldard et al., 2019). It can affect a young person’s ability to cope with everyday stressors, and can lead to varying consequences across an individual’s social, environmental and educational lives. Poor academic performance due to the inability to concentrate or excessive fear of failure are associated with anxiety disorders in adolescents (Weeks et al., 2016). In addition, this poor academic performance can then lead to school refusal, impacting their educational and social outcomes (Ameringen et al., 2003). Furthermore, an adolescent with anxiety may also find it difficult to form appropriate relationships, choosing to isolate themselves away from unfamiliar social situations due to their excessive intrusive thoughts (Rapee, 2015). These negative interactions can impact a young person’s ability to cope, leading to problems in adulthood.

Suggested Interventions

The high prevalence and significance of anxiety disorders on individuals highlight the importance of effective early intervention. Educational strategies allow young people to gain control over their behaviours and develop the knowledge to adequately deal with the stressors of life  When providing interventions for students with an anxiety disorder, the focus should be on aspects of an individual’s socio-emotional development (Huberty & Reed, 2012). Furthermore, interventions help to build the capacity of school staff to address the barriers to learning and promote the development of students that are affected by a mental health disorder (Huberty & Reed, 2012). Interventions such as Individual Support Plans are necessary to meet the educational and emotional needs of students with an anxiety disorder (Huberty & Reed, 2012).

Within schools, Individual Support Plans should be developed in order to intervene as early as possible after the onset of behaviour, learning and emotional problems within a classroom setting (Huberty & Reed, 2012). These plans help classroom teachers to monitor for symptoms of anxiety, while providing differentiated interventions within a classroom that help an adolescent to feel connected to their learning (Huberty & Reed, 2012). Furthermore, an Individual Support Plan may help a Guidance Officer to adequately provide the necessary information to classroom teachers to help a student successfully complete set tasks and assessments (Huberty & Reed, 2012). They also enable classroom teachers to monitor for signs of anxiety that a student may have, allowing them to appropriately intervene where necessary (Huberty & Reed, 2012). Therefore, it can be argued that Individual Support Plans are beneficial interventions for students with an anxiety disorder as they help monitor and provide alternate methods of teaching and learning, enabling students to succeed with their educational outcomes (Huberty & Reed, 2012).