Psychological Medicine

Review Article

The development of anxiety disorders in childhood: an integrative review

L. Murraya1 c1, C. Creswella1 and P. J. Coopera1

a1 Winnicott Research Unit, School of Psychology, University of Reading, Reading, UK


We present an integrative review of the development of child anxiety, drawing on a number of strands of research. Family aggregation and genetic studies indicate raised vulnerability to anxiety in offspring of adults with the disorder (e.g. the temperamental style of behavioural inhibition, or information processing biases). Environmental factors are also important; these include adverse life events and exposure to negative information or modelling. Parents are likely to be key, although not unique, sources of such influences, particularly if they are anxious themselves. Some parenting behaviours associated with child anxiety, such as overprotection, may be elicited by child characteristics, especially in the context of parental anxiety, and these may serve to maintain child disorder. Emerging evidence emphasizes the importance of taking the nature of child and parental anxiety into account, of constructing assessments and interventions that are both disorder specific, and of considering bidirectional influences.

(Received February 28 2008)

(Revised November 18 2008)

(Accepted November 28 2008)

(Online publication February 12 2009)


c1 Address for correspondence: Professor L. Murray, Winnicott Research Unit, School of Psychology, University of Reading, Reading RG6 6AL, UK. (Email: