Autonomic arousal and interpretations of physical symptoms in childhood anxiety disorders

• Main Author: Alkozei, Anna
• Published: University of Reading 2014
• Subjects: 618.92
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.632831

Anxiety disorders and social anxiety disorder in particular, are common in childhood and associated with negative short and long term consequences. Psychophysiological theories suggest that anxiety disorders are associated with chronic dysregulation of the autonomic nervous system, as indexed by respiratory sinus arrhythmia (RSA) and heart rate (HR). Findings to date regarding autonomic arousal at rest and in response to stress, among children with (social) anxiety disorder(s) have been inconsistent however, and/or subject to a range of methodological limitations. The first study presented in this thesis aimed to investigate whether children with social anxiety disorder, other anxiety disorders and nonanxious children differ in terms of their autonomic arousal at rest and in response to stress, taking account of various methodological shortcomings of previous studies. Results showed limited evidence for autonomic dysregulation in anxious versus nonanxious children. These findings were contrary to expectations on the basis of psychophysiological models. This may suggest however, that it is how children interpret their physical symptoms that is particularly important in relation to childhood anxiety disorders, and social anxiety disorder in particular. Past research has suggested that negative interpretation of physical symptoms and/or inferring threat from a situation on the basis of one's own physical experience, is associated with high levels of anxiety in children. Furthermore, theories of social anxiety disorder suggest that socially anxious individuals in particular interpret their internal physical symptoms in a negative way which influences their view of themselves as a social object. The second study presented in this thesis investigated these hypotheses among children with social anxiety disorder, other anxiety disorders and nonanxious children, again taking into account methodological limitations of previous studies. Children with social anxiety disorder were more likely than both other groups to assume that physical symptoms are associated with negative consequences, and to view ambiguous situations as anxiety provoking, whether physical information was present or not. The findings highlight that cognitive characteristics may be particular pertinent in the context of social anxiety disorder in childhood, and may be a potential target for treatment.