Dysregulation, Catastrophic Reactions, and the Anxiety Disorders - 17/03/21

Doi : 10.1016/j.chc.2020.10.011

John T. Walkup, MD ^a,^⁎ , Susan J. Friedland, MD ^b, Tara S. Peris, PhD ^c, Jeffrey R. Strawn, MD ^d
^a Ann and Robert H. Lurie Children's Hospital of Chicago, 220 East Illinois Street, Box 10, Chicago, IL 60611, USA
^b Ann and Robert H. Lurie Children’s Hospital of Chicago & Northwestern University Feinberg School of Medicine, Town and Country Pediatrics, 1460 North Halstead Street, Suite 402, Chicago, IL 60642, USA
^c UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, Room 67-439, Los Angeles, CA 90095, USA
^d College of Medicine, University of Cincinnati, 260 Stetson Street, Suite 3200, Cincinnati, OH 45267, USA

^∗Corresponding author.

Résumé

Normal developmental activities (eg, going to school, raising a hand in class, and managing typical life uncertainties) are ‘triggers’ for children and adolescents with anxiety disorders. To cope, children with anxiety avoid; however, when avoidance of developmentally appropriate activities is not possible, catastrophic responses can ensue. If these catastrophic reactions result in successful avoidance, they are likely to recur leading to a generalized pattern of dysregulated behavior. Interventions include treating anxiety disorder symptoms to remission. For parents the goal is to challenge their child to engage in important developmental activities, reward positive coping and avoid reinforcing avoidance behavior.

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Keywords : Anxiety disorders, Catastrophic reaction, Functional analysis, Avoidance, Accommodation, Suicidal behavior