Mapping the frequency and severity of anxiety behaviors in preschool-aged children

Although anxiety can be early-emerging, impairing, and persistent, behaviors relevant to anxiety mirror typical development in early childhood. To better understand the spectrum of typical to problematic behavior, this study characterizes the range of frequency and severity of separation and social anxiety behaviors and associated impairment in preschool-aged children using a novel daily diary method. Primary caregivers of 291 3-5-year-old children reported the frequency of children's daily separation and social anxiety behaviors and related impairment for 14 days. Frequencies of each separation and social anxiety behavior were computed and item response theory analyses revealed the specific frequencies at which the behavior was considered psychometrically severe/rare. Patterns varied across items; for example, worry that caregiver would not return and shyness with familiar adults had to occur at least 3-4 times over 14 days for the behavior to be considered severe/rare, whereas shyness around peers and new people were not severe at any frequency. In addition, behaviors were associated with impairment. To our knowledge, these data are the first to delineate empirical, dimensional information about the frequency and severity of anxiety behaviors and associated impairment in early childhood. Such data could be useful for clinical practice to enhance empirically-driven assessment of anxiety.