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Anxiety disorders are among the most prevalent mental health problems in childhood and adolescence. This fully revised new edition is an authoritative guide to the understanding and assessment of anxiety disorders in the young. The first section covers historical and conceptual issues, including cognitive and developmental processes, clinical and theoretical models, phenomenology and classification, and evidence-based assessment. Subsequent sections cover the biology of child and adolescent anxiety, and environmental influences including traumatic events, parenting and the impact of the peer group. The final section addresses prevention and treatment of anxiety. All chapters incorporate new advances in the field, explicitly differentiate between children and adolescents, and incorporate a developmental perspective. Written and edited by an international team of leading experts in the field, this is a key text for researchers, practitioners, students and clinical trainees with interests in child and adolescent anxiety.

Hush little baby, don't say a word; And never mind that noise you heard. It's just the beast under your bed. In the closet, in your head. (Metallica, 1991, track 1) Children are so prone to fear that it has been seen as a normal part of childhood development (see Muris & Field, Chapter 4, this volume). These normal fears are likely to be the precursors of more persistent and severe anxiety (Field & Davey, 2001) because the age of onset of anxiety disorders broadly follows the developmental pattern of non-clinical fears. As reviewed by Muris and Field, infants tend to fear novel stimuli within their immediate environment such as loud noise, objects, and separation from a caretaker (Campbell, 1986), in mid-childhood (6–8 years old) fears are focused towards ghosts and animals, then self-injury in late childhood (Bauer, 1976), and social evaluation in pre-adolescence and adolescence (Westenberg, Drewes, Goedhart, Siebelink, & Treffers, 2004). Similarly, phobias concerning environmental threats (e.g., heights, water) typically originate in infancy (Menzies & Clarke, 1993a, 1993b), then specific phobias emerge in middle childhood (5–6 years) followed by generalized anxiety in late childhood and social anxiety in pre-adolescence (Costello, Egger, Copeland, Erkanli, & Angold, Chapter 3, this volume). This broad correspondence between normal fears and the onset of anxiety disorders raises three questions pertinent to explaining the etiology of anxiety disorders: (1) are these normal fears innate or learnt? (2) What process underlies whether a fear develops into an anxiety disorder? And (3) what variables moderate this process? This chapter attempts to explore these questions by evaluating the contribution of learning processes in the development of both normal fears and anxiety disorders. What are fear and anxiety? Lang, Davis, and Ohman (2000) characterize fear as a reaction to a specific threat, with increasing proximity resulting in escape or avoidance; anxiety, however, is characterized by a more diffuse state with less explicit, more generalized cues and involves increased physiological arousal but without necessarily leading to organized functional behavior. Throughout this chapter, we talk primarily about models of “fear” because it is convenient to describe the mechanisms of acquisition as operating at an individual stimulus level. The difference between whether a child acquires “fear” or “anxiety” lies in the extent to which they have learning experiences about a specific group of related stimuli (fear) or a diffuse array of situations (anxiety). However, the underlying mechanisms are similar. There is also a distinction to be made between the intensity of “normal” fear and anxiety responses and those that characterize anxiety disorders.

This special issue is the culmination of an ESRC seminar series grant awarded to the authors of this editorial. We named the seminar series CATTS (Child Anxiety, Theory and Treatment Seminars) and it took the form of six highly stimulating, one-day seminars on the subject of child anxiety, with participants from clinical and academic backgrounds and from Great Britain, Europe, the USA and Australia. Most of the authors in this publication, and a sister special issue in Cognitions and Emotion (2008), participated in the CATTS series.

Little miss Muffet, sat on a tuffet – Eating her curds and whey. Down came a spider, that sat down beside her and frightened miss Muffet away Children seem particularly prone to fear, so much so that fear has been seen as a normal part of childhood development. It is documented in the research into childhood fear that during infancy children tend to fear stimuli within their immediate environment such as loud noise, objects and separation from a caretaker, but that as the child matures these fears adjust to incorporate anticipatory events and abstract stimuli (Campbell, 1986). Recent work has indicated that general fearfulness decreases as age increases and that this decrease continues at a fairly rapid rate until the beginning of adolescence (Gullone & King, 1997). Mild fears in children often appear and disappear spontaneously and follow a predictable course. For example, Bauer (1976) reported that younger children (4–8 years old) typically fear ghosts and animals whilst older children (10–12 years) are more likely to fear self-injury. These short-lived fears are part of a normal pattern of development, frequently have an obvious adaptive significance, and reflect the everyday experiences of the child. These normative fears are at their highest during the first 11–14 years of life but then stabilize, leaving only pervasive fears and phobias (Draper & James, 1985; Gullone & King, 1997). A phobia is a fear that is out of proportion to the demands of the situation that evokes it, it cannot be rationalized, is involuntary, and leads to avoidance of the situation (Marks, 1969).