Beenen Katherine T, Vosters Jennifer A, Patel Dilip R
Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA.
Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA.
Transl Pediatr. 2025 Jan 24;14(1):127-138. doi: 10.21037/tp-24-258. Epub 2025 Jan 21.
Performance anxiety is characterized by intense feelings of emotional distress before, during, or after performing in front of others. In pediatric patients who participate in organized, competitive athletics, this can manifest with somatic, cognitive, and behavioral symptoms such as activation of the sympathetic nervous system and avoidance behaviors. Performance anxiety may now be classified as a psychiatric disorder if symptoms have been longstanding and cause significant emotional distress and/or functional impairment. Participation in competitive sports can confer many benefits to pediatric patients, but these benefits may go unrealized if performance anxiety is not addressed and leads to attrition from athletics. This review provides up-to-date information on prevalence and risk factors of performance anxiety in young athletes (generally speaking, school-age children, adolescents, and young adults). The clinical presentation, assessment considerations including differential diagnosis, and several standardized measures of performance anxiety are overviewed. We also review comprehensive management of sports performance anxiety in pediatric populations, with an emphasis on psychological interventions. Presently, cognitive behavioral therapy dominates the literature as an effective treatment for this condition, and special considerations in adapting this intervention to pediatric populations are considered. Recent research in the area of mindfulness as an effective intervention for sports performance anxiety is explored. In addition, careful consideration is given to appropriate pharmacological treatment, including propranolol, hydroxyzine, and benzodiazepines.
表现焦虑的特征是在他人面前表演之前、期间或之后出现强烈的情绪困扰感。在参加有组织的竞技运动的儿科患者中，这可能表现为躯体、认知和行为症状，如交感神经系统激活和回避行为。如果症状长期存在并导致严重的情绪困扰和/或功能损害，表现焦虑现在可能被归类为精神障碍。参与竞技运动可以给儿科患者带来许多益处，但如果表现焦虑得不到解决并导致退出运动，这些益处可能无法实现。本综述提供了有关年轻运动员（一般而言，学龄儿童、青少年和年轻人）表现焦虑的患病率和危险因素的最新信息。概述了临床表现、包括鉴别诊断在内的评估注意事项以及几种表现焦虑的标准化测量方法。我们还综述了儿科人群运动表现焦虑的综合管理，重点是心理干预。目前，认知行为疗法作为这种疾病的有效治疗方法在文献中占主导地位，并考虑了将这种干预措施应用于儿科人群时的特殊注意事项。探讨了正念领域作为运动表现焦虑有效干预措施的最新研究。此外，还仔细考虑了适当的药物治疗，包括普萘洛尔、羟嗪和苯二氮䓬类药物。
