Novel mechanism-based treatments for pediatric anxiety and depressive disorders

Genetic Vulnerability to Social Anxiety Disorder

Most anxiety disorders 'run within families': people suffering from an anxiety disorder often have family members who are highly anxious as well. In this chapter, we explore recent work devoted to unraveling the complex interplay between genes and environment in the development of anxiety. We review studies focusing on the genetic vulnerability to develop social anxiety disorder (SAD), as SAD is one of the most prevalent anxiety disorders, with an early onset, a chronic course, and associated with significant life-long impairments. More insight into the development of SAD is thus of uttermost importance.First, we will discuss family studies, twin studies, and large-sized population-based registry studies and explain what these studies can reveal about the genetic vulnerability to develop anxiety. Next, we describe the endophenotype approach; in this context, we will summarize results from the Leiden Family Lab study on Social Anxiety Disorder. Subsequently, we review the relationship between the heritable trait 'behavioral inhibition' and the development of SAD, and highlight the relevance of this work for the development and improvement of preventative and therapeutic interventions for socially anxious youth.

Current and Future Approaches to Pediatric Anxiety Disorder Treatment

This overview critically appraises the literature on the treatment of pediatric anxiety disorders. The two established treatments for these conditions comprise cognitive-behavioral therapy (CBT) and antidepressant medications. Many youths receiving these treatments fail to achieve remission, which creates a need for new treatments. After summarizing the literature on CBT and currently available medications, the authors describe research that lays a foundation for improvements in the treatment of pediatric anxiety disorders. This foundation leverages neuroscientific investigations, also described in the overview, which provide insights on mechanisms of successful treatment.