Child/adolescent anxiety and related behavioral health conditions can take many different forms. It is not always obvious to the child or the family that one is experiencing anxiety symptoms. It can be helpful, as a first step in moving past anxiety, to take an assessment obtain an objective picture of current symptoms.

The Pediatric Symptom Checklist-17 (PSC-17) is a psychosocial screen designed to facilitate the recognition of cognitive, emotional, and behavioral problems so that appropriate interventions can be initiated as early as possible.

Pediatric Symptom Checklist (PSC-17)

These symptoms may look like other mental health problems.  It is best for child/adolescent to meet with a mental healthcare provider who can rule out other emotional and physical causes of these symptoms and to provide you with a formal diagnosis.  

Depression involves a persistent feeling of sadness and loss of interest. Depression affects how you feel, think and behave, and can lead to a variety of emotional and physical problems.

Key Depression Symptoms:

• Feelings of sadness, tearfulness, emptiness or hopelessness
• Angry outbursts, irritability or frustration, even over small matters
• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
• Sleep disturbances, including insomnia or sleeping too much
• Tiredness and lack of energy, so even small tasks take extra effort
• Reduced appetite and weight loss or increased cravings for food and weight gain
• Anxiety, agitation or restlessness
• Slowed thinking, speaking or body movements
• Feelings of worthlessness or guilt, fixating on past failures or self-blame
• Trouble thinking, concentrating, making decisions and remembering things
• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
• Unexplained physical problems, such as back pain or headaches
• Symptoms cause clinically significant emotional distress and/or functional impairment

These symptoms may look like other mental health problems.  It is best for child/adolescent to meet with a mental healthcare provider who can rule out other emotional and physical causes of these symptoms and to provide you with a formal diagnosis.  

The Patient Health Questionnaire (PHQ-9) is a helpful tool is differentiating the symptoms of depression from the symptoms of anxiety.   

Adolescent Patient Health Questionnaire (PHQ-A)

Generalized anxiety disorder involves excessive and uncontrollable worry that causes intense emotional distress.

Key Symptoms of GAD:

• Persistent, frequent worry difficulty controlling worry
• Worries about areas in life such as finances, health, relationships, being late, etc
• Worry causes emotional distress or function impairment Access

GAD is often experienced  as the presence of excessive anxiety and worry about a variety of every day topics, events, or activities. The excess worry occurs more often than not for at least six months, and is experienced as uncontrollable

These symptoms may look like other mental health problems.  It is best for child/adolescent to meet with a mental healthcare provider who can rule out other emotional and physical causes of these symptoms and to provide you with a formal diagnosis.  

• Screen for Child Anxiety Related Disorders

IED is characterized by recurrent behavioral outbursts representing a failure to control aggressive impulses. Children and adolescents with IED have low frustration tolerances and are disproportionately enraged by small annoyances.

Key symptoms of IED:

• Verbal aggression (e.g., temper tantrums, tirades, verbal arguments, fights)
• Physical aggression toward property, animals or other individuals
• Some children and adolescents with IED will engage in verbal aggression or physical aggression that results in damage or destruction of property or in physical injury.
• The magnitude of aggression expressed during the recurrent outbursts is  out of proportion to the provocation or to any precipitating psychosocial stressors.
• The recurrent outbursts are not premeditated, nor are they committed to achieve a tangible objective such as money, power, or intimidation.  
• The child or adolescent senses increasing tension prior to committing the act and experiences pleasure, gratification or relief during or following the act.
• The impulsive aggressive outbursts have a rapid onset and typically last for less than 30 minutes.

These symptoms may look like other mental health problems.  It is best for child/adolescent to meet with a mental healthcare provider who can rule out other emotional and physical causes of these symptoms and to provide you with a formal diagnosis.  

OCD is characterized by frequent, disturbing intrusive thoughts, feelings, ideas, or sensations (obsessions) and accompanying behaviors that one feels compelled to engage in (compulsions). Compulsions can be either external (washing hands) or internal (counting or praying). One engages in compulsions to get rid of obsessive thoughts, but this only provides temporary relief. 

Key Symptoms of OCD:

• Frequent disturbing intrusive thoughts, feeling, ideas or sensations (obsessions)
• Repeated behaviors that one feels compelled to engage in an attempt to reduce or manage anxiety symptoms (compulsions)
• Obsessions and compulsions cause emotional distress and/or impairment in functioning

These symptoms may look like other mental health problems.  It is best for child/adolescent to meet with a mental healthcare provider who can rule out other emotional and physical causes of these symptoms and to provide you with a formal diagnosis.  

Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS)

All children and adolescents will occasionally disobey, argue with parents and defy authority.  Children and teens are more likely experiencing ODD than “normal” striving for independence and autonomy when these oppositional behaviors  interfere with learning, school adjustment and disrupt child’s relationships with peers and family members.   

Key symptoms of ODD include:

• Having frequent temper tantrums
• Arguing a lot with adults
• Refusing to do what an adult asks
• Always questioning rules and refusing to follow rules
• Doing things to annoy or upset others, including adults
• Blaming others for the child’s own misbehaviors or mistakes
• Being easily annoyed by others
• Often having an angry attitude
• Speaking harshly or unkindly
• Seeking revenge or being vindictive

These symptoms may look like other mental health problems.  It is best for child/adolescent to meet with a mental healthcare provider who can rule out other emotional and physical causes of these symptoms and to provide you with a formal diagnosis.  

• Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following:

1. 1. Deficits in using communication for social purposes
   2. Impairment of the ability to change communication to match context
   3. Difficulties for following rules for conversation (taking turns, use of verbal/nonverbal signs to regulate interaction)
   4. Difficulties understanding what is not explicitly states

• The deficits result in functional limitations in effective communication, social participation, social relationships, and academic achievement.
• The onset of the symptoms is in the early development period, but may not fully manifest until social communication demands exceed limited capabilities.
• The symptoms are not attributable to another medical or neurological condition or to low abilities in the domains of word structure and grammar, and are not better explained by autism spectrum disorder, intellectual disability, or developmental delay.

Research findings suggest persons with PDD can be placed in one of three very different subgroups:

1. A high-functioning group (around 25 percent) whose symptoms largely overlap with that of Asperger syndrome, but who differ in terms of having a lag in language development and mild cognitive impairment. (Asperger syndrome does not generally involve speech delay or cognitive impairment).
2. A second group (around 25 percent) whose symptoms more closely resemble those of autistic disorder, but do not fully meet all its diagnostic signs and symptoms.
3. A third group (around 50 percent) who meet all the diagnostic criteria for autistic disorder, but whose stereotypical and repetitive behaviors are noticeably mild.

Social Anxiety (social phobia) is characterized by overwhelming worry and excessive self-consciousness in everyday situations.

Key Social Anxiety Symptoms:

• Anxiety triggered by situations where one may feel judged or criticized by others.
• Fear of acting in a socially inappropriate way that would lead to negative evaluation or embarrassment.
• Avoidance of social situations where judgment or scrutiny may occur
• Fear of judgment causes clinically significant emotional distress or impairment in functioning.
• Specific social anxiety presentations are public speaking anxiety and selective mutism

These symptoms may look like other mental health problems.  It is best for child/adolescent to meet with a mental healthcare provider who can rule out other emotional and physical causes of these symptoms and to provide you with a formal diagnosis.