Health Provider Checklist for Adolescent and Young Adult Males

Mental Health

Anxiety Disorders

Key Points

  • Anxiety disorders include disorders that share features of excessive fear and anxiety and related behavioral disturbances.
  • DSM-5 defines anxiety disorders as generalized anxiety disorder, panic disorder, social phobia and specific phobia.  Symptoms of many of these disorders begin in childhood or adolescence.
  • A large, national survey of adolescent mental health reported that about 8 percent of teens ages 13-18 have an anxiety disorder, with symptoms commonly emerging around age 6.  However, of these teens, only 18 percent received mental health care.
  • Males are more likely to fear dating, have oppositional defiant disorder or conduct disorder, and use alcohol and illicit drugs to relieve symptoms of the disorder.
  • Obtaining information about anxiety symptoms from multiple informants including the youths and adults (parents and/or teachers) is essential because of variable agreement among informants (American Academy of Child and Adolescent Psychiatry).

Questions to ask young male patients about Anxiety Disorders

Questions to ask young male patients about Trauma and Stressor Related Disorders

Overview

Anxiety disorders are among the most prevalent mental health conditions affecting youth.  Anxiety disorders include disorders that share features of excessive fear and anxiety and related behavioral disturbances. Fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat.1 DSM-5 defines anxiety disorders as generalized anxiety disorder, panic disorder, social phobia and specific phobia.  Symptoms of many of these disorders begin in childhood or adolescence.

A large, national survey of adolescent mental health reported that about 8 percent of teens ages 13-18 have an anxiety disorder, with symptoms commonly emerging around age 6. However, of these teens, only 18 percent received mental health care.2

Imaging studies show that children with anxiety disorders have atypical activity in specific brain areas, compared with other people. For example: In one, very small study, anxious adolescents exposed to an anxiety-provoking situation showed heightened activity in brain structures associated with fear processing and emotion regulation, when compared with normal controls. Another small study found that youth with generalized anxiety disorder had unchecked activity in the brain’s fear center, when looking at angry faces so quickly that they are hardly aware of seeing them.3

Brain scans of teens sizing each other up reveal an emotion circuit activating more in girls as they grow older, but not in boys. This finding highlights how emotion circuitry diverges in the male and female brain during a developmental stage in which girls are at increased risk for developing mood and anxiety disorders. The Child/Adolescent Anxiety Multimodal Study (CAMS), in addition to other studies on treating childhood anxiety disorders, found that high-quality cognitive behavioral therapy (CBT), given with or without medication, can effectively treat anxiety disorders in children. One small study even found that a behavioral therapy designed to treat social phobia in children was more effective than an antidepressant medication.4

Females with social anxiety disorder report a greater number of social fears and comorbid depressive, bipolar, and anxiety disorders, whereas males are more likely to fear dating, have oppositional defiant disorder or conduct disorder, and use alcohol and illicit drugs to relieve symptoms of the disorder. Paruresis (inability to urinate in the presence of others) is more common in males.5 Adolescents, particularly males, may be less willing than adults to openly discuss agoraphobic fears and avoidance.6 With agoraphobia, females have different patterns of comorbid disorders than males. Consistent with gender differences in the prevalence of mental disorders, males have higher rates of comorbid substance use disorders.7


1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. 2013. P 189.

2 National Institutes of Health. Anxiety Disorders in Children and Adolescents.

3 Ibid

4 Ibid

5 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. 2013. P 206.

6 Ibid, P 220.

7 Ibid, P 220.