Memory and language impairments are associated with anxiety disorder severity in childhood

Abstract Introduction Children with anxiety disorders have been suggested to possess deficits in verbal fluency, shifting and attention, with inconsistent results regarding working memory and its subcomponents. This study extends previous findings by analyzing the performance of children with anxiety disorders in a wide range of neuropsychological functions. Methods We evaluated 54 children with a primary diagnosis of an anxiety disorder according to diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) using subtests of a neuropsychological battery. The severity of anxiety disorders was assessed using the Pediatric Anxiety Rating Scale (PARS). We calculated the frequency of neuropsychological impairments (-1.5 standard deviation of the normative sample). Comparisons between groups were performed based on the severity of anxiety symptoms, as well as in the presence of one vs. more diagnoses of anxiety disorder. Results We found higher impairment in visuospatial working memory (23.1%), semantic memory (27.8%), oral language (35.4%) and word writing (44.4%) in anxious children. Moreover, children with higher anxiety severity presented lower performance in visuospatial working memory, inferential processing, word reading, writing comprehension, copied writing, and semantic verbal fluency (d = 0.49 to 0.96 [Cohen's d]). The higher the number of anxiety diagnoses, the lower the performance in episodic memory and oral and written language (d = 0.56 to 0.77). Conclusion Our data suggested the presence of memory (visuospatial working memory and semantic memory) and language deficits (oral and writing) in some children with an anxiety disorder. Severity and number of anxiety diagnoses were associated with lower performance in memory and language domains in childhood.

Trastorno de ansiedad por separación / Separation anxiety disorder and developmental separation anxiety

Anxiety disorders constitute the most common psychiatric diseases in children. These disorders predict an increase in the risk of later anxiety disorders, mayor depression and hospitalization for psychiatric pathology. The primary feature of Separation Anxiety Disorder is developmentally inappropriate anxiety sufficient to cause clinically significant distress or impairment when faced with separation from home or major attachment figures. Drugs that selectively inhibit serotonin reuptake, psychotherapy and parent education constitute effective treatments for children and adolescents with anxiety disorders. Pediatricians and other health care professionals are in a unique position to assist families in understanding the etiology, prevention and treatment of separation anxiety disorder. Early identification in pediatric primary care and effective management may help improve outcome. The objective of our review is to analyze clinical and therapeutic aspects of the Separation Anxiety Disorder and its differences with Separation Anxiety as an expression of the evolutionary emotional development in children.

Los trastornos por ansiedad son cuadros clínicos psiquiátricos frecuentes y predicen un riesgo aumentado de presentar posteriormente trastornos ansiosos y depresivos, además de hospitalizaciones por causa psiquiátrica. El trastorno por ansiedad de separación tiene como característica principal ansiedad excesiva e inapropiada para el desarrollo del niño, concerniente a su separación respecto de las personas con quienes está vinculado. El uso de fármacos, psicoterapia y apoyo parental son medidas terapéuticas eficaces. Los pediatras pueden ser los primeros profesionales que tomen contacto clínico con los niños y realicen la primera aproximación diagnóstica y terapéutica. El propósito de nuestra revisión es analizar aspectos clínicos y terapéuticos del trastorno de ansiedad por separación y sus diferencias con la ansiedad de separación propia del desarrollo emocional del niño.

Factores de riesgo psicológico en el trastorno límite de personalidad / Psychological risk factors in borderline personality disorder

En este trabajo se revisan los factores de riesgo psicológico en los trastornos límite de personalidad. Se concluye que el desarrollo de la psicopatología de estos trastornos no puede ser explicada por un único factor psicológico de riesgo o por un grupo de factores psicológicos de riesgo. Probablemente hay muchas vías que conducen el trastorno límite de personalidad. Las historias de tráuma tienen un papel relevante en un subgrupo de pacientes, mientras que otros factores de riesgo psicológico pueden ser más importantes en otros casos