Anxiety Disorders In Adolescents Research Articles

청소년의 범불안장애 수준에 따른 식생활 행태 및 관련 요인 분석: 제16차-제18차 (2020년-2022년) 청소년건강행태조사를 이용하여

The purpose of this study is to investigate the association between dietary behavior and related factors according to the generalized anxiety disorder (GAD) in adolescents. The results of analyzing demographic characteristics according to the GAD showed that gender, age, BMI, type of school, residence type, father's nationality, smoking and drinking experience, perceived health status, perception of body shape, economic status, academic achievement, physical activity, sedentary time and smartphone usage time were related to the GAD (p<0.01). The results of analyzing dietary behavior according to the GAD showed that the frequency of water intake, sweetened beverage intake, fast food intake, fruit intake and breakfast intake were related to the GAD (p<0.001). The results of analyzing depression and suicidality according to the GAD showed that depression, suicidal ideation, planning, and attempts were all related to the GAD (p<0.001). Even after adjusting for factors corresponding to demographic characteristics, it was confirmed that the level of GAD had a significant effect on depression and suicidality. This study is significant in that it provided basic data on adolescent mental health problems by analyzing dietary behavior and related factors according to the level of GAD.

THE EFFECT OF VIRTUAL THERAPY ON ANXIETY DISORDERS IN ADOLESCENTS

Objective study This is For The influence of virtual therapy on anxiety disorders in adolescents . Method used in study This is method study qualitative as for type research used studies case, usage studies case because researcher can understand in a way deep context, process, and complexity moderate phenomenon studied while the research location was Malang City . Results study this explain that virtual therapy has an effect in reducing the level of anxiety among teenagers in Malang City. Virtual therapy allows teens to remain in a space they consider safe, such as their bedroom, which can increase their openness and comfort in undergoing the therapeutic process. The results of these field findings provide information that reducing the level of anxiety among teenagers in Malang City requires collaboration between various parties, including educational institutions, government and society.

Effects of Cannabidiol in Adolescent and Young Adult Depressive and Anxiety Disorders: A Systematic Review of Clinical and Preclinical Research.

Adolescents and young adults may use cannabidiol (CBD) products in an attempt to reduce depression and anxiety symptoms, despite little research examining this use. This systematic review evaluated preclinical and clinical research on the effects of CBD on depressive and anxiety disorders in adolescence and young adulthood. To provide context, we discuss CBD's mechanism of action and neurodevelopmental effects. PubMed was searched for articles published through June 2022. Preclinical or clinical CBD administration studies with N > 1 that examined depressive and/or anxiety disorders were eligible. Initially, 224 publications were identified. After excluding duplicates and applying eligibility criteria, 6 preclinical (depression: n≈133; anxiety: n≈161) and 4 clinical (anxiety: n=113) articles remained. Due to the low number of studies, results were synthesized qualitatively. The Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence were used to rate each study's evidence. The preclinical effects of CBD on depression-like behavior appear to differ by sex, early life stress, and duration of use. Despite no evidence that CBD exerts anxiolytic effects in preclinical adolescent models, CBD may reduce anxiety symptoms in human adolescents and young adults with anxiety disorders. The existing evidence suggests that CBD may reduce symptoms of anxiety in adolescents and young adults. However, the evidence is sparse and limited by variations in samples and CBD dosing duration. Further research is needed to understand the potential benefits and/or harms of CBD for depression and anxiety disorders in this population. Implications for clinical practice and research are discussed.

Pediatric anxiety disorders: Basic concepts for primary care.

Anxiety disorders in children and adolescents often present in primary care, and many clinicians will need to guide families on treatment. The purpose of this article is to give a brief overview of assessment and treatment principles for clinicians in primary care. Anxiety and its expression are heavily influenced by children's developmental progression and capabilities. Anxiety disorders have multiple underlying etiologies including temperament, environmental exposure to stressors, and childhood trauma. All anxiety disorders are strengthened by an operant process known as escape conditioning. The most effective treatments for child and adolescent anxiety begin with behavioral-based interventions including exposure with response prevention (ERP) and cognitive behavioral therapy (CBT). Medication can be effective in combination with CBT and ERP, or as a standalone treatment when behavioral interventions are not available. Selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors have been evaluated by randomized clinical trials for the treatment of childhood anxiety, but most are not approved by the Food and Drug Administration. When anxiety is severe and functional impairment is high, referral for psychiatric care and multimodal treatment reduces the likelihood of poor outcomes.

Influence of Social Media and Family Environment on Adolescent Anxiety Disorder

Adolescent anxiety disorder is a prevalent psychological disorder that has a substantial impact on the mental health and total development of adolescents. This study reviews and investigates the definition, characteristics, and the two essential etiological components of anxiety disorders in adolescents, namely social media and home environment. This is achieved by describing and analyzing prior research pertaining to anxiety disorders and adolescent mental health. The paper begins by defining adolescent anxiety disorder, noting that it is primarily characterized by excessive concern and tension, which is frequently accompanied by physical discomfort and emotional distress. Adolescents may exhibit social distress, avoidance behaviors, and academic difficulties that impair their daily functioning and learning. As a significant aspect of adolescents' existence, social media has a significant effect on their anxiety levels. Social anxiety, body image anxiety, and other stressors brought on by social media may aggravate anxiety symptoms. Moreover, online violence and negative remarks may have a negative effect on adolescents' mental health. Another crucial etiologic factor is the family environment. Instability, conflict, and tension in the home may increase the risk of adolescents developing anxiety disorders. Anxiety disorders have also been linked to parental styles and economic circumstances. Although numerous scientific studies have been conducted on adolescents and anxiety disorders, additional research is required to shed light on the progression of mental health disorders in adolescents and bring them to the attention of society.

Cognitive and behavioural processes in adolescents with social anxiety disorder

BackgroundA better understanding of the processes that maintain social anxiety disorder (SAD) in adolescents could improve treatment outcomes. This study aimed to establish whether cognitive and behavioural processes known to be important in the maintenance of adult SAD are observed in adolescent populations and whether they are specific to SAD. MethodsWe recruited three groups of adolescents (12-18y): (1) 90 adolescents with a SAD diagnosis, (2) 58 adolescents with an anxiety disorder that was not SAD, and (3) 45 community-based adolescents. Participants completed measures of negative social cognitions, social attitudes, safety behaviours, self-focused attention, and social anxiety, anxiety, and depression symptoms. ResultsThe clinical SAD sample endorsed higher levels of negative social cognitions, attitudes, and safety behaviours compared to both control groups. Self-focused attention was higher in the clinical SAD sample compared to the anxiety clinical control group but not compared to the community control group. ConclusionsThis study provided evidence of SAD-specific mechanisms including negative social cognitions, attitudes and safety behaviours in adolescents. The study did not provide evidence of disorder-specific mechanisms of self-focused attention but this may have been due to methodological limitations. These findings indicate avenues for further research and point to the potential value of Cognitive Therapy for the treatment of adolescent SAD.

Fear conditioning and fear generalization in children and adolescents with anxiety disorders

Overgeneralization of conditioned fear is associated with anxiety disorders (AD). Most results stem from studies done in adult patients, but studies with children are rare, although the median onset of anxiety disorders lies already in childhood. Thus, the goal of the present study was to examine fear learning and generalization in youth participants, aged 10–17 years, with AD (n = 39) compared to healthy controls (HC) (n = 40). A discriminative fear conditioning and generalization paradigm was used. Ratings of arousal, valence, and US expectancy (the probability of an aversive noise following each stimulus) were measured, hypothesizing that children with AD compared to HC would show heightened ratings of arousal and US expectancy, and decreased positive valence ratings, respectively, as well as overgeneralization of fear. The results indicated that children with AD rated all stimuli as more arousing and less pleasant, and demonstrated higher US expectancy ratings to all stimuli when compared to HC. Thus, rather than displaying qualitatively different generalization patterns (e.g., a linear vs. quadratic slope of the gradient), differences between groups were more quantitative (similar, but parallel shifted gradient). Therefore, overgeneralization of conditioned fear does not seem to be a general marker of anxiety disorders in children and adolescents.

Intervention of innovative reform in medical education on students’ anxiety disorders

BackgroundGeneralized Anxiety Disorder (GAD) is a common mental illness among adolescents, characterized by generalized and persistent anxiety, lack of clear targets, nervousness, and even involvement of the respiratory and digestive systems. Cognitive behavioral therapy has an improvement effect on anxiety disorders. This research was conducted to provide treatment interventions for students with anxiety disorders.Subjects and MethodsFirstly, 90 adolescent anxiety disorder patients aged 13-22 from a certain hospital were selected. Next, they were randomly divided into a control group and an observation group. The control group received routine drug treatment, while the observation group received cognitive behavioral therapy on this basis. The final treatment period was 16 weeks, with a round of treatment every 8 weeks. Statistical software SPSS23.0 was used for statistical description, and t-tests were used for measurement data.ResultsAfter a round of 8-week treatment, there was no statistically significant difference in the anxiety symptom scale scores between the two groups (P>0.05). After the second round, the Hamilton Anxiety Scale scores of the observation group were significantly lower than those of the control group (P<0.05); The difference in stress status scores at different times was significantly lower in the observation group than in the control group after the start of the second round (P<0.05). In short, cognitive behavioral therapy has a relieving effect on students’ anxiety disorders.ConclusionsDrug therapy is mostly targeted at adult patients. However for adolescent patients, it is necessary to gradually combine cognitive behavioral therapy to promote the relief of anxiety disorders in students.

Escitalopram and Sertraline Population Pharmacokinetic Analysis in Pediatric Patients.

Escitalopram and sertraline are commonly prescribed for anxiety and depressive disorders in children and adolescents. The pharmacokinetics (PK) of these medications have been evaluated in adults and demonstrate extensive variability, but studies in pediatric patients are limited. Therefore, we performed a population PK analysis for escitalopram and sertraline in children and adolescents to characterize the effects of demographic, clinical, and pharmacogenetic factors on drug exposure. A PK dataset was generated by extracting data from the electronic health record and opportunistic sampling of escitalopram- and sertraline-treated psychiatrically hospitalized pediatric patients aged 5-18 years. A population PK analysis of escitalopram and sertraline was performed using NONMEM. Concentration-time profiles were simulated using MwPharm++ to evaluate how covariates included in the final models influence medication exposure and compared to adult therapeutic reference ranges. The final escitalopram cohort consisted of 315 samples from 288 patients, and the sertraline cohort consisted of 265 samples from 255 patients. A one-compartment model with a proportional residual error model best described the data for both medications. For escitalopram, CYP2C19 phenotype and concomitant CYP2C19 inhibitors affected apparent clearance (CL/F), and normalizing CL/F and apparent volume of distribution (V/F) to body surface area (BSA) improved estimations. The final escitalopram model estimated CL/F and V/F at 14.2 L/h/1.73 m2 and 428 L/1.73 m2, respectively. For sertraline, CYP2C19 phenotype and concomitant CYP2C19 inhibitors influenced CL/F, and empirical allometric scaling of patient body weight on CL/F and V/F was significant. The final sertraline model estimated CL/F and V/F at 124 L/h/70 kg and 4320 L/70 kg, respectively. Normalized trough concentrations (Ctrough) for CYP2C19 poor metabolizers taking escitalopram were 3.98-fold higher compared to normal metabolizers (151.1 ng/mL vs 38.0 ng/mL, p < 0.0001), and normalized Ctrough for CYP2C19 poor metabolizers taking sertraline were 3.23-fold higher compared to normal, rapid, and ultrarapid metabolizers combined (121.7 ng/mL vs 37.68 ng/mL, p < 0.0001). Escitalopram- and sertraline-treated poor metabolizers may benefit from a dose reduction of 50-75% and 25-50%, respectively, to normalize exposure to other phenotypes. To our knowledge, this is the largest population PK analysis of escitalopram and sertraline in pediatric patients. Significant PK variability for both medications was observed and was largely explained by CYP2C19 phenotype. Slower CYP2C19 metabolizers taking escitalopram or sertraline may benefit from dose reductions given increased exposure.

Parent-Adolescent Informant Discrepancies and Clinician Alignment: Implications for the Assessment of Adolescent Social Anxiety Disorder

ABSTRACT The present study had the following aims: 1) Evaluate the degree of discrepancy between parents and their adolescents when reporting social anxiety; 2) Determine if reporting discrepancies between parents and adolescents predict social anxiety severity and impairment ratings following treatment and; 3) Assess if clinician-rated social anxiety severity more strongly aligns with parent- or adolescent-reported social anxiety. Participants included 58 adolescents (12–16 years of age; Mage = 14.29, SD = 1.30; 70.7% female) who participated in a randomized clinical trial. Participants and their parents separately completed the diagnostic interview and self-report measures regarding social anxiety. Results indicate significant parent-adolescent discrepancies regarding the adolescent’s social anxiety; however, parent and adolescent discrepancies were lower on specific feared social situations. Additionally, results demonstrate that correspondence in parent-adolescent reporting was associated with improved treatment outcomes. Lastly, results indicate that clinicians more strongly aligned themselves with parental report of social anxiety.

Implementation and Preliminary Outcomes of an Exposure-Based Summer Camp for Pediatric OCD and Anxiety

Despite the high prevalence of anxiety disorders in children and adolescents and the existence of effective evidence-based treatments for them, access to psychological care remains a major public health concern. Summer camps may provide an effective treatment avenue for youth who might not otherwise have access to care. This study describes the design and implementation of Fear Facers, a semistructured, 5-day, daytime exposure-therapy-based summer camp designed for youth with a primary diagnosis of obsessive-compulsive disorder (OCD), social anxiety, separation anxiety, or a specific phobia. Preliminary data regarding feasibility and patient outcomes is also reported. Among 52 children and adolescents aged 7 to 16 who attended one of six camp sessions between 2018 and 2021, significant reductions in anxiety (d = 0.54) and OCD symptoms (d = 0.57) were observed from pre-camp to immediately post-camp. A subset of campers who were followed for an additional 3 months post-camp (n = 22) showed maintenance of treatment gains. Retention rates for the intervention were high. Our investigation provides further support for the use of a camp-based design for cognitive-behavioral approaches, and may provide a unique setting to maximize elements of inhibitory learning in exposures. We also discuss a number of elements regarding feasibility that need consideration for those hoping to develop similar interventions.

청소년 범불안장애와 식생활과의 연관성 분석:제17차 청소년건강행태조사 원시자료를 이용하여

청소년 범불안장애와 식생활과의 연관성 분석:제17차 청소년건강행태조사 원시자료를 이용하여

The Prevalence of Video Game Addiction and Its Relation to Anxiety, Depression, and Attention Deficit Hyperactivity Disorder (ADHD) in Children and Adolescents in Saudi Arabia: A Cross-Sectional Study.

Background and objective Video games have become a popular source of entertainment among children and adolescents, not only targeting the young generation but also increasingly popular among older demographics as well. This study aimed to assess the association between video game addiction and depression, anxiety, and attention deficit hyperactivitydisorder (ADHD) among children and adolescents in Saudi Arabia. Materials and methods This was a cross-sectional studyinvolving Saudi adolescents aged 12-16 years. A self-administered online survey was distributed on social media (Twitter, WhatsApp, and Snapchat). The surveyaddressed sociodemographic characteristics (i.e., age, gender, area of residence city, etc.). Arabic versions of the Patient Health Questionnaire-9 (PHQ-9), the seven-item Generalized Anxiety Disorder Scale (PHQ-GAD7), the ADHD Rating Scale-IV (ADHD-RS), and the seven-item GameAddiction Scale(GAS-7) questionnaires were distributed as well, including Arabic terms for depression, anxiety, and ADHD. Results A total of 393 surveys were completed (males: 58.3% vs. females: 41.7%). Of note, 63.1% of the respondents reported playing video games every day with an average of more than five hours of gaming time per day (25.2%). The prevalence of video game addiction was 62.1%. Independent risk factors of video game addiction included being young in age, playing video games every day, playing more than three hours per day, and playing multiplayer games. Furthermore, our findings suggestthat a higher video game addiction score is correlated with higher scores in inattention, anxiety, and depression. Conclusion This study found a high prevalence of video game addiction amongSaudi children and adolescents. Excessivevideo game playing negatively influences mental health and leads to issues including anxiety, depression, and ADHD. Also, younger males with an increased rate of regular playtime were more likely to exhibit video game addiction in comparison to the rest of the population. Further research is required to more comprehensively assess the prevalence rate of video game addiction and its effect on the mental health of the younger generation within the region.

Do single-case experimental designs lead to randomised controlled trials of cognitive behavioural therapy interventions for adolescent anxiety and related disorders recommended in the National Institute of Clinical Excellence guidelines? A systematic review.

Although Cognitive Behavioural Therapy (CBT) is effective for 60% of adolescents with anxiety disorders, only 36% are in remission post-intervention. This indicates that more effective treatments are needed which should be reflected in the NICE guidelines. We hypothesised that Single-case experimental designs (SCEDs) may provide a framework for accelerating the development of novel interventions. The primary purpose of this review was to investigate whether SCEDs are currently followed by randomised controlled trials (RCTs) of CBT intervention for adolescent anxiety disorders named in the NICE guidelines. The secondary objective was to investigate whether using SCEDs prior to RCTs could be a helpful approach. For the primary search of SCEDs five databases were used (PsycINFO, PubMed, PsycArticles, Web of Science and ProQuest). Nineteen articles met eligibility criteria including a total of 107 participants. For the secondary search of RCTs named in the NICE guidelines for adolescent anxiety disorders 53 articles met inclusion criteria and were included in the systematic review. The 19 SCED studies included in the review were conducted with participants with a diverse range of anxiety disorders and across a range of CBT formats. Two of the SCEDs were followed by RCTs, but neither of these were named in the NICE guidelines for anxiety disorders. All of the SCEDs identified were rated as low quality with none meeting the criteria for the highest or second highest quality rating. From the secondary searches, none of the RCTs named in the NICE guide were preceded by SCEDs. It was concluded that currently SCEDs were not followed by RCTs of CBT interventions named in the NICE guidelines for adolescent anxiety disorders. However, it was suggested that SCEDs may provide an important framework for the development of more effective interventions for adolescents with anxiety.

Randomised controlled trial of cultural-adapted and programme-adopted cognitive behavioural therapy for children and adolescents’ anxiety in Japan: protocol for a Multi-, Inter-, and Cross-cultural Clinical Child Study (MIXCS)

IntroductionThe primary objective of the Multi-, Inter-, and Cross-cultural Clinical Child Study (MIXCS) is to evaluate the hypothesis that the effects of cultural-adapted cognitive behavioural therapy (CA-CBT) and programme-adopted cognitive...

Prevention and Treatment of Social Anxiety Disorder in Adolescents: Protocol for a Randomized Controlled Trial of the Online Guided Self-Help Intervention SOPHIE.

Social anxiety symptoms are highly prevalent among adolescents and are associated with poor quality of life and low psychosocial functioning. If untreated, social anxiety often persists into adulthood and increases the risk for comorbid disorders. Therefore, early interventions for social anxiety to prevent negative long-term consequences are critical. However, adolescents rarely seek help and often avoid face-to-face psychotherapeutic interventions due to the perceived lack of autonomy and anonymity. Thus, online interventions represent a promising opportunity to reach adolescents who have social anxiety but do not seek help yet. This study aims to evaluate the efficacy, moderators, and mediators of an online intervention developed to reduce social anxiety in adolescents. A total of 222 adolescents aged 11-17 years with subclinical social anxiety (N=166) or with a diagnosis of social anxiety disorder (N=56) are randomly assigned to the online intervention or a care-as-usual control group. The 8-week guided online intervention is based on the Cognitive Model of Social Phobia and evidence-based online interventions for social anxiety adapted to the specific needs of adolescents. The care-as-usual group will be given access to the online intervention after the follow-up assessment. Participants are assessed at baseline, at 4 and 8 weeks post intervention, and at 3-month follow-up assessment on the primary outcome, that is, social anxiety, on secondary outcomes (eg, level of functioning, fear and avoidance, general anxiety, depression, quality of life, self-esteem, and negative effects of the intervention), on potential moderators (eg, therapy motivation, therapy expectancy, and satisfaction with the intervention), and potential mediators (eg, therapeutic alliance and adherence to the intervention). Data will be analyzed based on an intention-to-treat approach and both groups (intervention and care-as-usual) will be compared at each assessment time point. Furthermore, potential mechanisms of change and generalization of intervention effects on daily life are assessed using an ecological momentary assessment procedure that includes items on maintaining mechanisms of social anxiety, social context, and affect. Participants are prompted 3 times a day during the first 8 weeks of the study and again for 2 weeks following the follow-up assessment. Recruitment is ongoing; initial results are expected in 2024. Results are discussed considering the potential of online interventions as a low-threshold prevention and treatment option for adolescents with social anxiety and in light of current advances in dynamic modeling of change processes and mechanisms in early intervention and psychotherapy in adolescents. ClinicalTrials.gov NCT04782102; https://clinicaltrials.gov/ct2/show/NCT04782102. DERR1-10.2196/44346.

Anxiety Disorders in Children and Adolescents with Primary Headache: Diagnosis and Treatment Options

Anxiety Disorders in Children and Adolescents with Primary Headache: Diagnosis and Treatment Options

Hostile and threatening interpretation biases in adolescent inpatients are specific to callous-unemotional traits and social anxiety

Psychopathological syndromes, such as disruptive behavior and anxiety disorders in adolescence, are characterized by distorted cognitions and problematic behavior. Biased interpretations of ambiguous social situations can elicit both aggressive and avoidance behavior. Yet, it is not well understood whether different interpretation biases are specific to different syndromes, or whether they can co-occur. We assessed both hostile and threatening interpretation biases in identical social situations, and proposed that they are uniquely related to callous-unemotional (CU) traits and social anxiety, respectively. We also explored the role of gender and age herein. The sample consisted of 390 inpatients between 10 and 18 years of age with a variety of psychiatric disorders. Hostile and threatening interpretations were assessed with the Ambiguous Social Scenario Task (ASST) consisting of 10 written vignettes. Both CU-traits and social anxiety were assessed with self-report questionnaires. Results showed that, overall, CU-traits were related to more hostile interpretations, whereas social anxiety was related to more threatening interpretations. In addition, in boys, hostile and threatening interpretations correlated significantly positive with each other. Age was not related to interpretation biases. Together, these results generally support the content-specificity of interpretation biases in concepts relevant to disruptive behavior disorders and anxiety disorders, and indicate that different interpretation biases can co-occur specifically in boys.

Does an app designed to reduce repetitive negative thinking decrease depression and anxiety in young people? (RETHINK): a randomized controlled prevention trial

BackgroundThe first onset of common mental health disorders, such as mood and anxiety disorders, mostly lies in adolescence or young adulthood. Hence, effective and scalable prevention programs for this age group are urgently needed. Interventions focusing on repetitive negative thinking (RNT) appear especially promising as RNT is an important transdiagnostic process involved in the development of depression and anxiety disorders. First clinical trials indeed show positive effects of preventative interventions targeting RNT on adult as well as adolescent mental health. Self-help interventions that can be delivered via a mobile phone app may have the advantage of being highly scalable, thus facilitating prevention on a large scale. This trial aims to investigate whether an app-based RNT-focused intervention can reduce depressive and anxiety symptoms in young people at risk for mental health disorders.MethodsThe trial will be conducted in a sample (planned N = 351) of individuals aged 16–22 years with elevated levels of RNT but no current depression or anxiety disorder. In a randomized controlled between-subjects design, two versions of the app-based self-help intervention will be compared to a waiting list control condition. The full RNT-focused intervention encompasses a variety of RNT-reducing strategies, whereas the concreteness training intervention focuses on only one of these strategies, i.e., concrete thinking. The primary outcome (depressive symptoms) and secondary outcomes (anxiety symptoms and RNT) will be measured at pre-intervention, post-intervention (6 weeks after pre-intervention), and follow-up (18 weeks after pre-intervention).DiscussionThis trial aims to find out whether targeting RNT via an app is an effective and feasible way of preventing depression and anxiety disorders in adolescents. Since app-based interventions are highly scalable, this trial might contribute to tackling challenges related to the increasing rates of mental health disorders among young people.Trial registrationhttps://www.drks.de, DRKS00027384. Registered on 21 February 2022—prospectively registered.

Perfectionism, Self-Esteem and DSM-IV-Based Symptoms of Anxiety Disorders in Adolescents

Objectives: The purpose of this study is to examine the relationship between perfectionism and self-esteem and the symptoms of anxiety disorders in adolescent. Study design: Cross-sectional research design was used in this study Place and duration of the study: The study was conducted from private high secondary schools and colleges in Karachi, Pakistan, from February 2019 to March 2020. Subject and Method: 500 students made up the entire sample for the current study. Additionally, the sample includes both male (N=212) and female (N=288) students. The participants' ages ranged from 12 to 18 years old. The mean age of the sample as a whole was 15.44 (SD=1.82), while the mean ages of male and female students were respectively 15.12 (SD=1.89) and 15.68 (SD=1.88). Furthermore, a sample of 254 kids in grades 8 through 10 and 246 college students in grades 11 and 12 was chosen from various schools and colleges. Results: Pearson product moment correlation and linear regression were used to examine the data using statistical software for social sciences (SPSS- Vol. 16.0). The findings demonstrated that perfectionism and anxiety have a strong positive relationship (P.001). Furthermore, a summary of linear regression demonstrates that perfectionism in adolescents predicts the amount of anxiety in adolescents. Perfectionism accounts for around 5.3 percent of the variation in anxiety symptoms in adolescents. Self-esteem and anxiety, on the other hand, have a substantial negative connection (p.001) among adolescents. Low self-esteem in teenagers significantly predicts the level of anxiety in adolescents, according to the results of linear regression. Self-esteem accounts for around 15% of the variation in anxiety symptoms in adolescents. The findings were evaluated in light of prior studies, and new directions for future research were suggested. Practical Implication: The study "Perfectionism, Self-esteem, and DSM-IV-Based Symptoms of Anxiety Disorders in Adolescents" has important implications for those working with anxious adolescents in the Pakistani community. The results suggest that reducing perfectionism and improving self-esteem could help alleviate anxiety symptoms in Pakistani adolescents, and mental health practitioners can use this information to develop culturally sensitive interventions that take into account the unique cultural and social context of Pakistan. Additionally, early detection and intervention of anxiety symptoms is crucial, and raising awareness among parents, teachers, and healthcare professionals in Pakistan could be beneficial. The study's findings could inform the development of effective, culturally sensitive mental health programs and interventions for Pakistani adolescents in the educational system. Overall, this study provides valuable information to assist parents and professionals in supporting adolescents coping with anxiety challenges. Conclusion: The study provides valuable information for parents and professionals to support adolescents coping with anxiety challenges, but it also has some limitations, and important recommendations were made. Keywords Self-esteem, Perfectionism, Anxiety disorder, Adolescents, DSM-IV-TR,