Skip to main content

Issues in Differential Diagnosis: Considering Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, and Posttraumatic Stress Disorder

  • Chapter
  • First Online:
Handbook of Child and Adolescent Anxiety Disorders

Abstract

This chapter discussed the issues in differentially diagnosing generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. The chapter starts with a discussion of methods to conduct accurate diagnoses and continues by describing the essential features of each of the three disorders. Similar features across disorders are outlined and discussed. Implications and recommendations are highlighted.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 299.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 379.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Aktar, E., Nikolic, M., & Bögels, S. M. (2017). Environmental transmission of generalized anxiety disorder from parents to children: Worries, experiential avoidance, and intolerance of uncertainty. Dialogues of Clinical Neuroscience, 19(2), 137–147.

    Article  Google Scholar 

  • Alisic, E., Zalta, A. K., Van Wesel, F., Larsen, S. E., Hafstad, G. S., Hassanpour, K., & Smid, G. E. (2014). Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: Meta-analysis. The British Journal of Psychiatry, 204(5), 335–340.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.

    Book  Google Scholar 

  • Anholt, G. E., Aderka, I. M., Van Balkom, A. J. L. M., Smit, J. H., Schruers, K., Van Der Wee, N. J. A., et al. (2014). Age of onset in obsessive–compulsive disorder: Admixture analysis with a large sample. Psychological Medicine, 44(1), 185–194.

    Article  PubMed  Google Scholar 

  • Bailey, B. N., Delaney-Black, V., Hannigan, J. H., Ager, J., Sokol, R. J., & Covington, C. Y. (2005). Somatic complaints in children and community violence exposure. Journal of Developmental & Behavioral Pediatrics, 26(5), 341–348.

    Article  Google Scholar 

  • Balázs, J., Miklósi, M., Keresztény, Á., Hoven, C. W., Carli, V., Wasserman, C., et al. (2013). Adolescent subthreshold-depression and anxiety: Psychopathology, functional impairment and increased suicide risk. Journal of Child Psychology and Psychiatry, 54(6), 670–677.

    Article  PubMed  Google Scholar 

  • Barrett, P. M., & Healy, L. (2003). An examination of the cognitive processes involved in childhood obsessive-compulsive disorder. Behaviour Research and Therapy, 41, 285–299.

    Article  PubMed  Google Scholar 

  • Barzilay, R., Patrick, A., Calkins, M. E., Moore, T. M., Gur, R. C., & Gur, R. E. (2019). Association between early-life trauma and obsessive-compulsive symptoms in community youth. Depression & Anxiety, 36(7), 586–595.

    Article  PubMed  Google Scholar 

  • Beesdo, K., Knappe, S., & Pine, D. S. (2009). Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V. Psychiatric Clinics, 32(3), 483–524.

    PubMed  Google Scholar 

  • Beesdo, K., Pine, D. S., Lieb, R., & Wittchen, H. U. (2010). Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder. Archives of General Psychiatry, 67(1), 47–57.

    Article  PubMed  Google Scholar 

  • Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study. Journal of the American Academy of Child & Adolescent Psychiatry, 38(10), 1230–1236.

    Article  Google Scholar 

  • Borkovec, T. D., Robinson, E., Pruzinsky, T., & DePree, J. A. (1983). Preliminary exploration of worry: Some characteristics and processes. Behaviour Research and Therapy, 21(1), 9–16.

    Article  PubMed  Google Scholar 

  • Borkovec, T. D., Alcaine, O., & Behar, E. W. E. L. Y. N. (2004). Avoidance theory of worry and generalized anxiety disorder. Generalized anxiety disorder: Advances in research and practice.

    Google Scholar 

  • Bokszczanin, A. (2007). PTSD symptoms in children and adolescents 28 months after a flood: Age and gender differences. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 20(3), 347–351.

    Google Scholar 

  • Bokszczanin, A. (2008). Parental support, family conflict, and overprotectiveness: Predicting PTSD symptom levels of adolescents 28 months after a natural disaster. Anxiety, Stress, & Coping, 21(4), 325–335.

    Google Scholar 

  • Brakoulias, V., & Starcevic, V. (2011). The characterization of beliefs in obsessive–compulsive disorder. Psychiatric Quarterly, 82(2), 151–161.

    Article  PubMed  Google Scholar 

  • Burstein, M., Beesdo-Baum, K., He, J. P., & Merikangas, K. R. (2014). Threshold and subthreshold generalized anxiety disorder among US adolescents: Prevalence, sociodemographic, and clinical characteristics. Psychological Medicine, 44(11), 2351–2362.

    Article  PubMed  PubMed Central  Google Scholar 

  • Campo, J. V., Jansen-McWilliams, L., Comer, D. M., & Kelleher, K. J. (1999). Somatization in pediatric primary care: Association with psychopathology, functional impairment, and use of services. Journal of the American Academy of Child & Adolescent Psychiatry, 38(9), 1093–1101.

    Article  Google Scholar 

  • Carleton, R. N. (2016). Into the unknown: A review and synthesis of contemporary models involving uncertainty. Journal of Anxiety Disorders, 39, 30–43.

    Article  PubMed  Google Scholar 

  • Caspi, A., & Moffitt, T. E. (2018). All for one and one for all: Mental disorders in one dimension. American Journal of Psychiatry, 175(9), 831–844.

    Article  PubMed  Google Scholar 

  • Chabane, N., Delorme, R., Millet, B., Mouren, M. C., Leboyer, M., & Pauls, D. (2005). Early-onset obsessive-compulsive disorder: A subgroup with a specific clinical and familial pattern? Journal of Child Psychology and Psychiatry, 46(8), 881–887.

    Article  PubMed  Google Scholar 

  • Choudhury, M. S., Pimentel, S. S., & Kendall, P. C. (2003). Childhood anxiety disorders: Parent–child (dis) agreement using a structured interview for the DSM-IV. Journal of the American Academy of Child & Adolescent Psychiatry, 42(8), 957–964.

    Article  Google Scholar 

  • Cole, J. L., & Warman, D. M. (2019). An examination of continuum beliefs versus biogenetic beliefs in reducing stigma toward violent intrusive thoughts in OCD. Journal of Obsessive-Compulsive and Related Disorders, 23, 100478.

    Article  Google Scholar 

  • Coles, M. E., Mennin, D. S., & Heimberg, R. G. (2001). Distinguishing obsessive features and worries: The role of thought–action fusion. Behaviour Research and Therapy, 39(8), 947–959.

    Article  PubMed  Google Scholar 

  • Comer, J. S., & Kendall, P. C. (2004). A symptom-level examination of parent–child agreement in the diagnosis of anxious youths. Journal of the American Academy of Child & Adolescent Psychiatry, 43(7), 878–886.

    Article  Google Scholar 

  • Comer, J. S., & Kendall, P. C. (2007). Terrorism: The psychological impact on youth. Clinical Psychology: Science and Practice, 14(3), 179–212.

    Google Scholar 

  • Comer, J. S., Kendall, P. C., Franklin, M. E., Hudson, J. L., & Pimentel, S. S. (2004). Obsessing/worrying about the overlap between obsessive–compulsive disorder and generalized anxiety disorder in youth. Clinical Psychology Review, 24(6), 663–683.

    Article  PubMed  Google Scholar 

  • Costello, E. J., & Angold, A. (1995). Epidemiology. In J. S. March (Ed.), Anxiety disorders in children and adolescents (pp. 109–124). Guilford.

    Google Scholar 

  • Creswell, C., Waite, P., & Hudson, J. (2020). Practitioner Review: Anxiety disorders in children and young people–assessment and treatment. Journal of Child Psychology and Psychiatry, 61(6), 628–643.

    Google Scholar 

  • Crawley, S. A., Caporino, N. E., Birmaher, B., Ginsburg, G., Piacentini, J., Albano, A. M., et al. (2014). Somatic complaints in anxious youth. Child Psychiatry & Human Development, 45(4), 398–407.

    Article  Google Scholar 

  • Cummings, C., Caporino, N., & Kendall, P. C. (2014). Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychological Bulletin, 140, 816–845.

    Article  PubMed  Google Scholar 

  • De Los Reyes, A. (2011). Introduction to the special section: More than measurement error: Discovering meaning behind informant discrepancies in clinical assessments of children and adolescents. Journal of Clinical Child and Adolescent Psychology, 40, 1–9.

    Article  Google Scholar 

  • De Los Reyes, A., & Kazdin, A. E. (2005). Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations for further study. Psychological Bulletin, 131(4), 483.

    Article  Google Scholar 

  • de Silva, P., & Marks, M. (1999). The role of traumatic experiences in the genesis of obsessive–compulsive disorder. Behaviour Research and Therapy, 37(10), 941–951.

    Google Scholar 

  • de Silva, P., & Marks, M. (2001). Traumatic experiences, post-traumatic stress disorder and obsessive-compulsive disorder. International Review of Psychiatry, 13(3), 172–180.

    Article  Google Scholar 

  • Donovan, C. L., Holmes, M. C., & Farrell, L. J. (2016). Investigation of the cognitive variables associated with worry in children with generalised anxiety disorder and their parents. Journal of Affective Disorders, 192, 1–7.

    Article  PubMed  Google Scholar 

  • Douglass, H. M., Moffitt, T. E., Dar, R., McGee, R. O. B., & Silva, P. (1995). Obsessive-compulsive disorder in a birth cohort of 18-year-olds: Prevalence and predictors. Journal of the American Academy of Child & Adolescent Psychiatry, 34(11), 1424–1431.

    Article  Google Scholar 

  • Drabick, D. A. (2009). Can a developmental psychopathology perspective facilitate a paradigm shift toward a mixed categorical–dimensional classification system? Clinical Psychology: Science and Practice, 16(1), 41–49.

    PubMed  Google Scholar 

  • Ehlers, A., Hackmann, A., & Michael, T. (2004). Intrusive re-experiencing in post-traumatic stress disorder: Phenomenology, theory, and therapy. Memory, 12(4), 403–415.

    Article  PubMed  Google Scholar 

  • Eisen, A. R., & Engler, L. B. (1995). Chronic anxiety. Clinical handbook of anxiety disorders in children and adolescents, 223–250.

    Google Scholar 

  • Elwood, L. S., Hahn, K. S., Olatunji, B. O., & Williams, N. L. (2009). Cognitive vulnerabilities to the development of PTSD: A review of four vulnerabilities and the proposal of an integrative vulnerability model. Clinical Psychology Review, 29(1), 87–100.

    Article  PubMed  Google Scholar 

  • Escobar, J. I., Canino, G., Rubio-Stipec, M., & Bravo, M. (1992). Somatic symptoms after a natural disaster: A prospective study. The American Journal of Psychiatry, 149, 965–967.

    Article  PubMed  Google Scholar 

  • Farrell, L., & Barrett, P. (2006). Obsessive-compulsive disorder across developmental trajectory: Cognitive processing of threat in children, adolescents and adults. British Journal of Psychology, 97, 95–114.

    Article  PubMed  Google Scholar 

  • Fleischer, N., Crane, M., & Kendall, P. (2020). Assessment of childhood anxiety. In Assessment of childhood disorders. Guilford Publications.

    Google Scholar 

  • Floyd, M., Garfield, A., & LaSota, M. T. (2005). Anxiety sensitivity and worry. Personality and Individual Differences, 38(5), 1223–1229.

    Article  Google Scholar 

  • Foa, E. B., Kozak, M. J., Goodman, W. K., Hollander, E., Jenike, M. A., & Rasmussen, S. (1995). DSM-IV field trial: Obsessive-compulsive disorder. American Journal of Psychiatry, 152, 90–96.

    PubMed  Google Scholar 

  • Foa, E. B., Coles, M., Huppert, J. D., Pasupuleti, R. V., Franklin, M. E., & March, J. (2010). Development and validation of a child version of the obsessive compulsive inventory. Behavior Therapy, 41(1), 121–132.

    Article  PubMed  Google Scholar 

  • Furr, J., Comer, J., Edmunds, J., & Kendall, P. C. (2010). Disasters and youth: A meta-analytic examination of posttraumatic stress. Journal of Consulting and Clinical Psychology, 78, 765–780.

    Article  PubMed  Google Scholar 

  • Geller, D. A. (2006). Obsessive-compulsive and spectrum disorders in children and adolescents. Psychiatric Clinics, 29(2), 353–370.

    PubMed  Google Scholar 

  • Geller, D., Biederman, J., Jones, J., Park, K., Schwartz, S., Shapiro, S., & Coffey, B. (1998). Is juvenile obsessive-compulsive disorder a developmental subtype of the disorder? A review of the pediatric literature. Journal of the American Academy of Child & Adolescent Psychiatry, 37(4), 420–427.

    Article  Google Scholar 

  • Gillett, C. B., Bilek, E. L., Hanna, G. L., & Fitzgerald, K. D. (2018). Intolerance of uncertainty in youth with obsessive-compulsive disorder and generalized anxiety disorder: A transdiagnostic construct with implications for phenomenology and treatment. Clinical Psychology Review, 60, 100–108.

    Article  PubMed  Google Scholar 

  • Ginsburg, G. S., Riddle, M. A., & Davies, M. (2006). Somatic symptoms in children and adolescents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 45(10), 1179–1187.

    Article  Google Scholar 

  • Ginsburg, G. S., Becker-Haimes, E. M., Keeton, C., Kendall, P. C., Iyengar, S., Sakolsky, D., et al. (2018). Results from the child/adolescent anxiety multimodal extended long-term study (CAMELS): Primary anxiety outcomes. Journal of the American Academy of Child & Adolescent Psychiatry, 57(7), 471–480.

    Article  Google Scholar 

  • Gobble, R., Swenny, C., & Fishbein, M. (2004). The impact of the September 11, 2001 terrorist attacks and aftermath on the incidence of recurrent abdominal pain syndrome in children. Clinical Pediatrics, 43(3), 275–277.

    Article  PubMed  Google Scholar 

  • Goodman, W. K., Price, L. H., Rasmussen, S. A., Riddle, M. A., & Rapoport, J. L. (1991). Children’s Yale-Brown obsessive compulsive scale (CY-BOCS). Department of Psychiatry, Yale University School of Medicine.

    Google Scholar 

  • Goodwin, G. M. (2015). The overlap between anxiety, depression, and obsessive-compulsive disorder. Dialogues in Clinical Neuroscience, 17(3), 249.

    Article  PubMed  PubMed Central  Google Scholar 

  • Goldstein, A. J., & Chambless, D. L. (1978). A reanalysis of agoraphobia. Behavior therapy.

    Google Scholar 

  • Hanna, G. L. (1995). Demographic and clinical features of obsessive-compulsive disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34(1), 19–27.

    Article  PubMed  Google Scholar 

  • Hearn, C. S., Donovan, C. L., Spence, S. H., March, S., & Holmes, M. C. (2017). What’s the worry with social anxiety? Comparing cognitive processes in children with generalized anxiety disorder and social anxiety disorder. Child Psychiatry & Human Development, 48(5), 786–795.

    Article  Google Scholar 

  • Hensley, L., & Varela, R. E. (2008). PTSD symptoms and somatic complaints following Hurricane Katrina: The roles of trait anxiety and anxiety sensitivity. Journal of Clinical Child and Adolescent Psychology, 37, 542–552.

    Article  PubMed  Google Scholar 

  • Hofflich, S. A., Hughes, A. A., & Kendall, P. C. (2006). Somatic complaints and childhood anxiety disorders. International Journal of Clinical and Health Psychology, 6(2), 229–242.

    Google Scholar 

  • Hong, R. Y. (2007). Worry and rumination: Differential associations with anxious and depressive symptoms and coping behavior. Behaviour research and therapy, 45(2), 277–290.

    Google Scholar 

  • Hughes, A. A., Hedtke, K. A., & Kendall, P. C. (2008). Family functioning in families of children with anxiety disorders. Journal of Family Psychology, 22(2), 325.

    Google Scholar 

  • Hudson, J. L., & Rapee, R. M. (2004). From anxious temperament to disorder: An etiological model. In R. G. Hheimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 51–74). Guilford.

    Google Scholar 

  • Huppert, J. D., Moser, J. S., Gershuny, B. S., Riggs, D. S., Spokas, M., Filip, J., et al. (2005). The relationship between obsessive–compulsive and posttraumatic stress symptoms in clinical and non-clinical samples. Journal of Anxiety Disorders, 19(1), 127–136.

    Article  PubMed  Google Scholar 

  • Ivarsson, T., & Valderhaug, R. (2006). Symptom patterns in children and adolescents with obsessive–compulsive disorder (OCD). Behaviour Research and Therapy, 44(8), 1105–1116.

    Article  PubMed  Google Scholar 

  • Janowitz, D., Grabe, H. J., Ruhrmann, S., Ettelt, S., Buhtz, F., Hochrein, A., et al. (2009). Early onset of obsessive–compulsive disorder and associated comorbidity. Depression and Anxiety, 26(11), 1012–1017.

    Article  PubMed  Google Scholar 

  • Jensen, P. S., & Mrazek, D. A. (2006). Research and Clinical Perspectives in Defining and Assessing Mental Disorders in Children and Adolescents. In P. S. Jensen, P. Knapp, & D. A. Mrazek, Toward a new diagnostic system for child psychopathology: Moving beyond the DSM (pp. 11–37). Guilford Press.

    Google Scholar 

  • Kagan, E., Frank, H., & Kendall, P. C. (2018). Accommodation in youths’ mental health: Evidence and issues. Current Directions in Psychological Science, 27, 227–232.

    Article  Google Scholar 

  • Kendall, P. C., Suveg, C., & Kingery, J. N. (2006). Facilitating the dissemination and application of cognitive-behavioral therapy for anxiety in youth. Journal of Cognitive Psychotherapy, 20(3), 243–245.

    Google Scholar 

  • Kendall, P. C., Brady, E. U., & Verduin, T. L. (2001). Comorbidity in childhood anxiety disorders and treatment outcome. Journal of the American Academy of Child & Adolescent Psychiatry, 40(7), 787–794.

    Article  Google Scholar 

  • Kendall, P. C., Compton, S. N., Walkup, J. T., Birmaher, B., Albano, A. M., Sherrill, J., et al. (2010). Clinical characteristics of anxiety disordered youth. Journal of Anxiety Disorders, 24(3), 360–365.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kendall, P. C., Norris, L., Rabner, J., Crane, M., & Rifkin, L. (2020). Intolerance of uncertainty and parental accommodation: Promising targets for personalized intervention for youth anxiety. Current Psychiatry Reports, 22, 1–8.

    Article  Google Scholar 

  • Kılıç, E. Z., Kılıç, C., & Yılmaz, S. (2008). Is anxiety sensitivity a predictor of PTSD in children and adolescents?. Journal of Psychosomatic Research, 65(1), 81–86.

    Google Scholar 

  • Knapp, A. A., Blumenthal, H., Mischel, E. R., Badour, C. L., & Leen-Feldner, E. W. (2016). Anxiety sensitivity and its factors in relation to generalized anxiety disorder among adolescents. Journal of Abnormal Child Psychology, 44(2), 233–244.

    Article  PubMed  Google Scholar 

  • Krebs, G., & Heyman, I. (2015). Obsessive-compulsive disorder in children and adolescents. Archives of Disease in Childhood, 100(5), 495–499.

    Article  PubMed  Google Scholar 

  • Lafleur, D. L., Petty, C., Mancuso, E., McCarthy, K., Biederman, J., Faro, A., et al. (2011). Traumatic events and obsessive compulsive disorder in children and adolescents: Is there a link? Journal of Anxiety Disorders, 25, 513–519.

    Article  PubMed  Google Scholar 

  • Langlois, F., Freeston, M. H., & Ladouceur, R. (2000a). Differences and similarities between obsessive intrusive thoughts and worry in a non-clinical population: Study 1. Behaviour Research and Therapy, 38(2), 157–173.

    Article  PubMed  Google Scholar 

  • Langlois, F., Freeston, M. H., & Ladouceur, R. (2000b). Differences and similarities between obsessive intrusive thoughts and worry in a non-clinical population: Study 2. Behaviour Research and Therapy, 38(2), 175–189.

    Article  PubMed  Google Scholar 

  • Last, C. G., Hersen, M., Kazdin, A., Orvaschel, H., & Perrin, S. (1991). Anxiety disorders in children and their families. Archives of General Psychiatry, 48(10), 928–934.

    Google Scholar 

  • Last, C. G., Perrin, S., Hersen, M., & Kazdin, A. E. (1992). DSM-III-R anxiety disorders in children: Sociodemographic and clinical characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 1070–1070.

    Article  PubMed  Google Scholar 

  • Lavigne, J. V., Gibbons, R. D., Christoffel, K. K., Arend, R., Rosenbaum, D., Binns, H., et al. (1996). Prevalence rates and correlates of psychiatric disorders among preschool children. Journal of the American Academy of Child & Adolescent Psychiatry, 35(2), 204–214.

    Article  Google Scholar 

  • Levey, D. F., Gelernter, J., Polimanti, R., Zhou, H., Cheng, Z., Asian, M., et al. (2020). Reproducible genetic risk loci for anxiety: Results from ~200,000 participants in the million veteran program. The American Journal of Psychiatry, 177(3), 223–232.

    Article  PubMed  PubMed Central  Google Scholar 

  • Libby, S., Reynolds, S., Derisley, J., & Clark, S. (2004). Cognitive appraisals in young people with obsessive-compulsive disorder. Journal of Child Psychology and Psychiatry, 45(6), 1076–1084.

    Article  PubMed  Google Scholar 

  • Lipinski, J. F., Jr., & Pope, H. G., Jr. (1994). Do “flashbacks” represent obsessional imagery? Comprehensive Psychiatry, 35(4), 245–247.

    Article  PubMed  Google Scholar 

  • Maser, J. D., Norman, S. B., Zisook, S., Everall, I. P., Stein, M. B., Schettler, P. J., & Judd, L. L. (2009). Psychiatric nosology is ready for a paradigm shift in DSM-V. Clinical Psychology: Science and Practice, 16(1), 24–40.

    Google Scholar 

  • March, J. S., Parker, J. D., Sullivan, K., Stallings, P., & Conners, C. K. (1997). The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. Journal of the American academy of child & adolescent psychiatry, 36(4), 554–565.

    Google Scholar 

  • McEvoy, P. M., Watson, H., Watkins, E. R., & Nathan, P. (2013). The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct. Journal of Affective Disorders, 151(1), 313–320.

    Article  PubMed  Google Scholar 

  • McLaughlin, K. A., Koenen, K. C., Hill, E. D., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 52(8), 815–830.

    Article  Google Scholar 

  • McNally, R. J., English, G. E., & Lipke, H. J. (1993). Assessment of intrusive cognition in PTSD: Use of the modified Stroop paradigm. Journal of Traumatic stress, 6(1), 33–41.

    Google Scholar 

  • Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., et al. (2010). Lifetime prevalence of mental disorders in US adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989.

    Article  Google Scholar 

  • Michael, T., Halligan, S. L., Clark, D. M., & Ehlers, A. (2007). Rumination in posttraumatic stress disorder. Depression and Anxiety, 24(5), 307–317.

    Article  PubMed  Google Scholar 

  • Muris, P., Merckelbach, H., Gadet, B., & Moulaert, V. (2000). Fears, worries, and scary dreams in 4-to 12-year-old children: Their content, developmental pattern, and origins. Journal of Clinical Child Psychology, 29(1), 43–52.

    Article  PubMed  Google Scholar 

  • Muris, P., Roelofs, J., Meesters, C., & Boomsma, P. (2004). Rumination and worry in nonclinical adolescents. Cognitive Therapy and Research, 28(4), 539–554.

    Google Scholar 

  • Nader, K., Kriegler, J. A., Blake, D. D., Pynoos, R. S., Newman, E., & Weather, F. W. (1996). Clinician administered PTSD scale, child and adolescent version (p. 156). National Center for PTSD.

    Google Scholar 

  • Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100(4), 569.

    Article  PubMed  Google Scholar 

  • Ollendick, T. H., & King, N. J. (1998). Empirically supported treatments for children with phobic and anxiety disorders: Current status. Journal of clinical child psychology, 27(2), 156–167.

    Google Scholar 

  • Palitz, S. A., Rifkin, L. S., Norris, L. A., Knepley, M., Fleischer, N. J., Steinberg, L., & Kendall, P. C. (2019). But what will the results be?: Learning to tolerate uncertainty is associated with treatment-produced gains. Journal of Anxiety Disorders, 68, 102146.

    Article  PubMed  Google Scholar 

  • Panganiban, M., Yeow, M., Zugibe, K., & Geisler, S. L. (2019). Recognizing, diagnosing, and treating pediatric generalized anxiety disorder. Journal of the American Academy of PAs, 32(2), 17–21.

    Google Scholar 

  • Pine, D. S. (1997). Childhood anxiety disorders. Current Opinion in Pediatrics, 9, 329–338.

    Article  PubMed  Google Scholar 

  • Read, K. L., Comer, J. S., & Kendall, P. C. (2013). The Intolerance of Uncertainty Scale for Children (IUSC): Discriminating principal anxiety diagnoses and severity. Psychological Assessment, 25(3), 722–729.

    Article  PubMed  Google Scholar 

  • Reiss, S., & McNally, R. J. (1985). Expectancy model of fear. In S. Reiss & R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 107–121). Academic.

    Google Scholar 

  • Runyon, M. K., Deblinger, E., & Steer, R. A. (2013). PTSD symptom cluster profiles of youth who have experienced sexual or physical abuse. Child Abuse & Neglect, 28(1), 84–90.

    Article  Google Scholar 

  • Salkovskis, P. M. (1985). Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23(5), 571–583.

    Article  PubMed  Google Scholar 

  • Salkovskis, P. M. (1989). Cognitive-behavioural factors and the persistence of intrusive thoughts in obsessional problems. Behaviour Research and Therapy, 27(6), 677–682.

    Article  PubMed  Google Scholar 

  • Salkovskis, P. M. (1996). Cognitive-behavioral approaches to the understanding of obsessional problems. In Current controversies in the anxiety disorders (pp. 103–133). Guilford Press.

    Google Scholar 

  • Salloum, A., Johnco, C., Smyth, K. M., Murphy, T. K., & Storch, E. A. (2018). Co-occurring posttraumatic stress disorder and depression among young children. Child Psychiatry & Human Development, 49(3), 452–459.

    Article  Google Scholar 

  • Schmidt, N. B., Keough, M. E., Mitchell, M. A., Reynolds, E. K., MacPherson, L., Zvolensky, M. J., & Lejuez, C. W. (2010). Anxiety sensitivity: Prospective prediction of anxiety among early adolescents. Journal of Anxiety Disorders, 24(5), 503–508.

    Article  PubMed  PubMed Central  Google Scholar 

  • Selles, R. R., Storch, E. A., & Lewin, A. B. (2014). Variations in symptom prevalence and clinical correlates in younger versus older youth with obsessive–compulsive disorder. Child Psychiatry & Human Development, 45(6), 666–674.

    Article  Google Scholar 

  • Shafran, R., Thordarson, D. S., & Rachman, S. (1996). Thought-action fusion in obsessive compulsive disorder. Journal of Anxiety Disorders, 10(5), 379–391.

    Article  Google Scholar 

  • Sheynin, J., Duval, E. R., King, A. P., Angstadt, M., Phan, K. L., Stein, M., … & Liberzon, I. (2018). Resting-state functional connectivity is associated with treatment outcome in PTSD patients. In Society for Neuroscience Annual Meeting (Vol. 505).

    Google Scholar 

  • Silverman, W. K., La Greca, A. M., & Wasserstein, S. (1995). What do children worry about? Worries and their relation to anxiety. Child Development, 66(3), 671–686.

    Article  PubMed  Google Scholar 

  • Silk, J. S., Nath, S. R., Siegel, L. R., & Kendall, P. C. (2000). Conceptualizing mental disorders in children: Where have we been and where are we going?. Development and Psychopathology, 12(4), 713–735.

    Google Scholar 

  • Speckens, A. E., Hackmann, A., Ehlers, A., & Cuthbert, B. (2007). Imagery special issue: Intrusive images and memories of earlier adverse events in patients with obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 38(4), 411–422.

    Article  PubMed  Google Scholar 

  • Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour research and therapy, 36(5), 545–566.

    Google Scholar 

  • Starcevic, V., & Berle, D. (2006). Cognitive specificity of anxiety disorders: A review of selected key constructs. Depression and Anxiety, 23(2), 51–61.

    Article  PubMed  Google Scholar 

  • Steinberg, A. M., Brymer, M. J., Kim, S., Briggs, E. C., Ippen, C. G., Ostrowski, S. A., et al. (2013). Psychometric properties of the UCLA PTSD reaction index: Part I. Journal of Traumatic Stress, 26(1), 1–9.

    Article  PubMed  Google Scholar 

  • Stewart, S. E., Hu, Y. P., Leung, A., Chan, E., Hezel, D. M., Lin, S. Y., et al. (2017). A multisite study of family functioning impairment in pediatric obsessive-compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 56(3), 241–249.

    Article  PubMed  Google Scholar 

  • Stewart, S. E., Geller, D. A., Jenike, M., Pauls, D., Shaw, D., Mullin, B., & Faraone, S. V. (2004). Long‐term outcome of pediatric obsessive–compulsive disorder: a meta‐analysis and qualitative review of the literature. Acta Psychiatrica Scandinavica, 110(1), 4–13.

    Google Scholar 

  • Storch, E. A., Lack, C. W., Merlo, L. J., Geffken, G. R., Jacob, M. L., Murphy, T. K., & Goodman, W. K. (2007). Clinical features of children and adolescents with obsessive-compulsive disorder and hoarding symptoms. Comprehensive Psychiatry, 48(4), 313–318.

    Article  PubMed  Google Scholar 

  • Storch, E. A., Merlo, L. J., Keeley, M. L., Grabill, K., Milsom, V. A., Geffken, G. R., et al. (2008a). Somatic symptoms in children and adolescents with obsessive-compulsive disorder: Associations with clinical characteristics and cognitive-behavioral therapy response. Behavioural and Cognitive Psychotherapy, 36(3), 283–297.

    Article  Google Scholar 

  • Storch, E. A., Murphy, T. K., Lack, C. W., Geffken, G. R., Jacob, M. L., & Goodman, W. K. (2008b). Sleep-related problems in pediatric obsessive-compulsive disorder. Journal of Anxiety Disorders, 22(5), 877–885.

    Article  PubMed  Google Scholar 

  • Tiwari, S., Podell, J. C., Martin, E. D., Mychailyszyn, M. P., Furr, J. M., & Kendall, P. C. (2008). Experiential avoidance in the parenting of anxious youth: Theory, research, and future directions. Cognition and Emotion, 22(3), 480–496.

    Article  Google Scholar 

  • Turner, S. M., Beidel, D. C., & Stanley, M. A. (1992). Are obsessional thoughts and worry different cognitive phenomena? Clinical Psychology Review, 12(2), 257–270.

    Article  Google Scholar 

  • Verduin, T. L., & Kendall, P. C. (2008). Peer perceptions and liking of children with anxiety disorders. Journal of Abnormal Child Psychology, 36(4), 459–469.

    Article  PubMed  Google Scholar 

  • Viana, A. G., Hanna, A. E., Woodward, E. C., Raines, E. M., Paulus, D. J., Berenz, E. C., & Zvolensky, M. J. (2018). Emotional clarity, anxiety sensitivity, and PTSD symptoms among trauma-exposed inpatient adolescents. Child Psychiatry & Human Development, 49(1), 146–154.

    Article  Google Scholar 

  • Villabø, M. A., Gere, M. K., Torgersen, S., March, J. S., & Kendall, P. C. (2012). Diagnostic efficiency of the child and parent versions of the Multidimensional Anxiety Scale for Children (MASC). Journal of Clinical Child and Adolescent Psychology, 41, 75–85.

    Article  PubMed  Google Scholar 

  • Voltas, N., Hernández-Martínez, C., Arija, V., & Canals, J. (2017). The natural course of anxiety symptoms in early adolescence: Factors related to persistence. Anxiety, Stress, & Coping, 30(6), 671–686.

    Article  Google Scholar 

  • Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., et al. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. New England Journal of Medicine, 359(26), 2753–2766.

    Article  PubMed  Google Scholar 

  • Wells, A., & Papageorgiou, C. (1998). Relationships between worry, obsessive–compulsive symptoms and meta-cognitive beliefs. Behaviour Research and Therapy, 36(9), 899–913.

    Article  PubMed  Google Scholar 

  • Wright, K. D., Lebell, M. A. A., & Carleton, R. N. (2016). Intolerance of uncertainty, anxiety sensitivity, health anxiety, and anxiety disorder symptoms in youth. Journal of Anxiety Disorders, 41, 35–42.

    Article  PubMed  Google Scholar 

  • Zohar, A. H., Pauls, D. L., Ratzoni, G., Apter, A., Dycian, A., Binder, M., et al. (1997). Obsessive-compulsive disorder with and without tics in an epidemiological sample of adolescents. American Journal of Psychiatry, 154(2), 274–276.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Philip C. Kendall .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Fleischer, N., Rabner, J., Spandorfer, J., Kendall, P.C. (2023). Issues in Differential Diagnosis: Considering Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, and Posttraumatic Stress Disorder. In: McKay, D., Storch, E.A. (eds) Handbook of Child and Adolescent Anxiety Disorders. Springer, Cham. https://doi.org/10.1007/978-3-031-14080-8_3

Download citation

Publish with us

Policies and ethics