How Common Are Anxiety Symptoms in German Preschool Children?

What you need to know

• German preschool children showed similar types of anxiety symptoms as children in other countries, but at lower overall levels.
• About 17-19% of children had anxiety levels that may warrant further assessment.
• Children in foster care had lower social anxiety but higher obsessive-compulsive symptoms compared to children living with biological parents.
• The Preschool Anxiety Scale appears to be a useful tool for assessing anxiety in young German children.

Understanding Anxiety in Young Children

Anxiety is a normal part of child development, but excessive anxiety can become problematic. Some anxiety, like separation anxiety between 12-18 months, is developmentally appropriate. However, persistent, intense anxiety that interferes with daily life may indicate an anxiety disorder.

Anxiety disorders are the most common mental health issues in children and adolescents. Studies estimate that 10-20% of preschool-aged children experience anxiety disorders. However, it can be challenging to distinguish normal fears from problematic anxiety in very young children.

To better understand anxiety in German preschoolers, this study used the Preschool Anxiety Scale (PAS) to assess symptoms in 489 children living with biological parents and 88 children in foster care.

The Preschool Anxiety Scale

The PAS is a 28-item questionnaire completed by parents to measure anxiety symptoms in children ages 2-6 years old. It assesses five types of anxiety:

1. Generalized anxiety
2. Social anxiety
3. Obsessive-compulsive symptoms
4. Physical injury fears
5. Separation anxiety

Parents rate how often their child exhibits various anxiety-related behaviors on a scale from 0 (not true at all) to 4 (very often true). Higher scores indicate more anxiety symptoms.

Key Findings on Anxiety in German Preschoolers

Overall Anxiety Levels

German preschoolers showed lower overall anxiety levels compared to children in other countries where the PAS has been used. However, the types of anxiety symptoms were similar across countries.

The most common anxiety symptom reported was reluctance to go to sleep without a parent or to sleep away from home. Other common fears included:

• Fear of insects/spiders
• Fear of thunderstorms
• Fear of meeting unfamiliar people
• Fear of dogs
• Fear of the dark

Clinically Relevant Anxiety

Using cutoff scores suggested by the PAS developers:

• 17% of children living with biological parents had anxiety levels that may warrant further assessment
• 19% of children in foster care had anxiety levels that may warrant further assessment

This aligns with previous estimates that 10-20% of preschoolers experience clinically significant anxiety.

Differences in Foster Care Children

Compared to children living with biological parents, those in foster care showed:

• Significantly lower social anxiety scores
• Higher obsessive-compulsive symptom scores

The researchers hypothesize that lower social anxiety in foster children may relate to indiscriminate friendliness sometimes seen in children who have experienced early neglect. The higher obsessive-compulsive symptoms may relate to past trauma or instability.

Age and Gender Differences

Unlike some previous studies, this research found that younger children (age 2) tended to have lower anxiety scores than older preschoolers. There were minimal gender differences, though girls scored slightly higher on separation anxiety.

Factor Structure of Anxiety Symptoms

The study confirmed that preschool anxiety symptoms cluster into five related but distinct categories, as measured by the PAS:

1. Separation anxiety
2. Social anxiety
3. Obsessive-compulsive symptoms
4. Generalized anxiety
5. Physical injury fears

This suggests that even in young children, different types of anxiety can be distinguished. However, there was also evidence for a higher-order general anxiety factor explaining the correlations between the five anxiety types.

Implications for Assessing Anxiety in Young Children

This research supports the use of the Preschool Anxiety Scale as a valuable tool for measuring anxiety symptoms in German preschoolers. The PAS appears to capture developmentally normal fears as well as potentially problematic anxiety.

However, the authors note some limitations:

• Parent reports may be biased, especially if the parent has mental health issues themselves
• It’s unclear if the PAS is appropriate for 2-year-olds, as some parents had difficulty rating certain items for very young children
• Cultural differences may impact anxiety ratings, so comparisons across countries should be made cautiously

Conclusions

• German preschoolers show similar anxiety symptoms to children in other countries, but at generally lower levels.
• About 17-19% of German preschoolers may have anxiety levels warranting further assessment.
• Children in foster care show a different anxiety profile, with less social anxiety but more obsessive-compulsive symptoms.
• The Preschool Anxiety Scale appears to be a useful screening tool for identifying potentially problematic anxiety in young German children.

Understanding typical and atypical anxiety in early childhood is crucial for identifying children who may need additional support or intervention. Further research on the development and assessment of anxiety in preschoolers, including those in foster care, can help improve early detection and treatment of anxiety disorders.