Mian Nicholas D
Center for Anxiety and Related Disorders, Boston University, 648 Beacon Street, 6th Floor, Boston, MA, 02215, USA,
Clin Child Fam Psychol Rev. 2014 Mar;17(1):85-96. doi: 10.1007/s10567-013-0152-0.
Anxiety disorders in preschool-age children represent an important clinical problem due to high prevalence, substantial impairment, persistence, and associated risk for later emotional problems. Early intervention may mitigate these problems by capitalizing on a strategic developmental period. Elevated neuroplasticity, availability of screening tools, and the potential to modify parenting practices position anxiety as a good candidate for early intervention and preventive efforts. While some novel interventions show promise, the broad success of such programs will largely depend on parent engagement. Since parents are less likely to identify and seek help for anxiety problems compared to other childhood behavior problems, especially in a preventive manner, methods for understanding parents' decisions to participate and enhancing levels of engagement are central to the success of early childhood anxiety prevention and intervention. Understanding these processes is particularly important for families characterized by sociodemographic adversity, which have been underrepresented in anxiety treatment research. This review summarizes the developmental phenomenology of early emerging anxiety symptoms, the rationale for early intervention, and the current state of research on interventions for young, anxious children. The roles of parent engagement and help-seeking processes are emphasized, especially among economically disadvantaged and ethnic minority communities who are acutely at risk. Evidence-based strategies to enhance parent engagement to facilitate the development and dissemination of efficacious programs are offered.
学龄前儿童焦虑症是一个重要的临床问题，因为其患病率高、损害严重、持续存在且有引发后期情绪问题的风险。早期干预可利用关键的发育阶段来缓解这些问题。神经可塑性增强、有筛查工具可用以及有可能改变育儿方式，使得焦虑症成为早期干预和预防工作的一个理想对象。虽然一些新型干预措施显示出前景，但此类项目的广泛成功在很大程度上取决于家长的参与度。与其他儿童行为问题相比，家长识别焦虑问题并寻求帮助的可能性较小，尤其是以预防性方式寻求帮助，因此理解家长参与决策的方式并提高其参与度的方法对于幼儿焦虑症预防和干预的成功至关重要。对于社会人口统计学上处于不利地位的家庭来说，理解这些过程尤为重要，而这些家庭在焦虑症治疗研究中的代表性不足。本综述总结了早期出现的焦虑症状的发展现象学、早期干预的基本原理以及针对焦虑幼儿的干预措施的研究现状。强调了家长参与和寻求帮助过程的作用，尤其是在经济上处于不利地位和少数民族社区中，这些社区面临的风险尤为突出。本文还提供了基于证据的策略，以提高家长参与度，促进有效项目的开发和推广。
