Comorbid anxiety and externalizing disorders usually meant higher dysfunction in families

Comorbidity of Anxiety and Externalizing Disorders

This article explores how growing up in dysfunctional home environments can lead to mental disorders in children.  

University of California, Santa Cruz

Health anxiety refers to excessive concerns regarding one's health. While the DSM-5-TR suggests that the condition primarily begins in adulthood, retrospective reports point to a possible origin in childhood with onset as early as preschool age. 

Health Anxiety in Children 

Health anxiety symptoms within children include, but are not limited to: 
- Worrying about or preoccupation with fears of harboring a severe physical disease
- Bodily preoccupation
- Persistence of preoccupation despite medical evaluation and reassurance 

Health Anxiety Symptoms in Children 

Research suggests that children's health concerns are positively associated with increased levels of physical health problems. One study found that children with impairing functional somatic symptoms (i.e., muscle/joint pain, headaches, fatigue) were reported to have higher levels of health anxiety symptoms compared with children with non-impairing functional somatic symptoms. 

Association between health anxiety and physical health problems in children 

In the DSM-5, the diagnosis of hypochondriasis (i.e., health anxiety) was replaced by two new diagnostic entities. Both diagnoses share high health anxiety as a common criterion. 
- Somatic Symptom Disorder (SSD)
- Illness Anxiety Disorder (IAD) 

DSM-5-TR replaces hypochondriasis

Research points out that the transmission of health anxiety from parent to child is likely a combination of genetics, environment (i.e., parent psychopathology, parent modeling, and reinforcing behaviors), and the interaction of the two factors. Additionally, it was found that parents who have physical health conditions (i.e., functional bowel symptoms) engage in increased treatment seeking for their children with benign symptoms (i.e, sniffles, colds). 

Transmission of health anxiety from parent to child

Health-related worries and behaviors are common in children and adolescents. In a study evaluating health anxiety in children and adolescents, it was found that 15.7% of 14 to 19 year olds reported "clinically hypochondriacal symptoms," and the parents of 2.7% of 5 to 7 year olds reported "considerable" health anxiety symptoms in their children. 

Prevalence of health anxiety in children and adolescents 

A child's cognitive ability to process and understand complex information is more limited and concrete in comparison with adults. This makes it more difficult for children to understand abstract information, such as a "viral"health-related threat. Cognitions typically center on the risk and likelihood of becoming ill with COVID-19, alongside thoughts of how catastrophic this could be (i.e. ultimately death of self/parent).

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