Dysregulation, Catastrophic Reactions, and the Anxiety Disorders

John T. Walkup*, Susan J. Friedland, Tara S. Peris, Jeffrey R. Strawn

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Normal developmental activities (eg, going to school, raising a hand in class, and managing typical life uncertainties) are ‘triggers’ for children and adolescents with anxiety disorders. To cope, children with anxiety avoid; however, when avoidance of developmentally appropriate activities is not possible, catastrophic responses can ensue. If these catastrophic reactions result in successful avoidance, they are likely to recur leading to a generalized pattern of dysregulated behavior. Interventions include treating anxiety disorder symptoms to remission. For parents the goal is to challenge their child to engage in important developmental activities, reward positive coping and avoid reinforcing avoidance behavior.

Original languageEnglish (US)
Pages (from-to)431-444
Number of pages14
JournalChild and Adolescent Psychiatric Clinics of North America
Issue number2
StatePublished - Apr 2021
Externally publishedYes


  • Accommodation
  • Anxiety disorders
  • Avoidance
  • Catastrophic reaction
  • Functional analysis
  • Suicidal behavior

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health

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