Can We Extrapolate What We Know From the Adult Literature

As the literature on childhood worry is so limited, clinicians and researchers have tended to extrapolate findings from the adult literature. But is this an appropriate action? What aspects of childhood worry can be assumed to be the same in children as in adults, and where must we draw comparisons with care?

As described above, theories that have developed to account for worry in adults have been shown to have substantial relevance for younger worriers. This suggests that at least some aspects of the worry process are similar in adults and children. However, most of this research has been conducted on adolescents, and it is not clear that the same processes are active in younger children. In their review of developmental factors in the worry process, Vasey and Daleiden (1994) give an eloquent description of the developmental factors that are likely to impact on the process of worry in the developing child. However, they also point out that prior to about 8 years of age, the cognitive processes that we currently describe as worry may be too visual to qualify as worry as an adult would recognise it. If this is the case, then different processes may be at work, and adult models must be extrapolated to this population with care.

Briefly, Vasey and Daleiden (1994) suggest that to engage in worry as an adult would understand it, a child needs the ability to anticipate threat, and to elaborate threatening possibilities from a situation. It is not clear at what age this ability develops.

Additionally, according to Vasey and Daleiden (1994), development of self concept seems likely to be important in worry, as worry, particularly in clinical samples, is very self-related. This seems to be true for adults and for children (see above). However, before the age of about 8 years, children tend not to compare their functioning to that of others, but to fixed indicators of achievement, so worry in younger children is likely to be different in this respect to that of adults. Finally, they consider the impact of a child's developing meta-cognitive knowledge upon their capacity to worry. Very little is known about this, but they suggest that a knowledge of which psychological phenomena are 'normal', and which represent a deviation from normality is likely to be limited in young children. This, and an understanding of what can be done to manage worry, is likely to impact on children's response to their worry.

In support of this proposition, Muris, Merckelbach, Meesters et al. (2002) studied 248 children aged 3-14 years. Children were given Piagetian tasks to assess their level of cognitive development. The authors reported that level of cognitive development was positively correlated with an ability to elaborate worries, and with the presence or absence of a personal worry. The authors concluded that cognitive development mediated the relationship between worry and age that has been described.

In summary, much of what is written in this book will apply to children at some stages of development. However, developmental issues must be taken into account, and theories will always warrant further exploration with young populations before conclusions can be drawn.

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