Classification of anxiety disorders in children: what a difference two decades make

Abstract

This article provides a summary of what is currently known about the classification of anxiety disorders in children and adolescents; the issues of reliability and validity, both external and internal validity, are the focus. Anxiety disorders can be reliably diagnosed in children and adolescents when structured and/or semi-structured diagnostic interview schedules are used. Although there is strong evidence for the external validity of the broad category of anxiety disorders, the findings are uneven for the specific disorders. Findings relating to external validity also vary depending on the criteria used in the external validation process. Considerably less research has been conducted on internal validity. The little work that has been done generally supports the DSM-IV's internal structure, although this remains an issue that is controversial and requires more research attention. Issues that remain unknown include the reliability of anxiety diagnoses with relative low prevalence in youth, the specificity of effects to anxiety disorders in the external validation process, and factors (e.g. comorbidity) that raise serious concerns about internal validity.