Anxiety in elementary-aged children in the US from 2016-2022: An analysis of the National Survey of Children’s Health

Randi Kerr, Del Perkins, Rachel Wilkins, Amy Hendrix-Dicken, Michael Baxter, Micah Hartwell

Research output: Contribution to conferencePosterpeer-review


Introduction: According to the American Academy of Pediatrics, the presentation of anxiety disorders during childhood are multifactorial with genetics, parenting style, and personality being major components. The American Psychologist Academy states there has been a decade-long mental health crisis among children. Common stressors that may have intensified childhood anxiety during this timeframe include food insecurity, homelessness, and school violence. Additionally, during the COVID-19 pandemic, 200,000 US children lost their primary caregiver and parental unemployment peaked at 21.7%, causing additional household stress.

Adolescent anxiety is a predictor of anxiety as an adult. Identifying anxiety at a young age allows for early intervention and decreased morbidity. This investigation analyzed data from the National Survey of Children’s Health (NSCH) to assess rates of parent-reported anxiety and severity in 5-9 year-old children in the United States from 2016 through 2022 and to determine trends in anxiety diagnoses and severity during this timeframe.

Methods: The National Survey of Children's Health (NSCH) is a self-reported household survey that aims to gather annual information on the health of children 0-17 years of age. Using this data, we assessed trends of anxiety with linear regression during this time. We then conducted a regression to assess the difference in association among years using 2016 as the reference year. Finally, we repeated these analyses among children with anxiety disorders using severity of diagnosis (mild/moderate and severe) to determine if a change in symptom severity occurred during this timespan.

Results: The prevalence of anxiety diagnosis from 2016-2022 showed a statistically significant increase trend (Coef: 0.005; SE: 0.001, P < .001). Compared to 2016 where the prevalence of anxiety was at its lowest during this timespan at 4.86%, 2022 was the highest at 6.36%. Additionally, compared to 2016 in which 4.10% of children reported displaying severe symptoms, only 2021 and 2022 showed statistically significant increases compared to this baseline—years where children reporting severe symptoms nearly doubled at 8.21%, and 7.79%, respectively.

Conclusion: In addition to the increasing trend in reported anxiety among 5-9-year-old children, during the post-COVID-19 pandemic years, the percentage of children with severe symptoms has nearly doubled compared to 2016. Potential factors contributing to this could include loss of caregiver, food insecurity, poverty, earlier onset of puberty, and increased social stressors. As healthcare professionals, it is crucial to identify these characteristics early in childhood so that appropriate intervention can be prescribed. The USPSTF recommends anxiety screening in all children ages 8 and older. Cognitive behavioral therapy (CBT) is the treatment of choice for children with mild to moderate anxiety. Children with severe anxiety symptoms may warrant pharmaceutical intervention for appropriate management of symptoms. Early intervention with CBT may help children develop a more positive mindset using evidence-based thinking, reducing overall duration of therapy and decreasing the severity of mental health disorders as the child develops. Further research is needed to identify potential factors that may be leading to the continual increases in the overall prevalence of anxiety and severity of symptoms to identify potential therapeutic strategies.
Original languageAmerican English
StatePublished - 16 Feb 2024
Oklahoma State University Center for Health Sciences Research Week 2024
- Oklahoma State University Center for Health Sciences, Tulsa, United States
Duration: 13 Feb 202417 Feb 2024


Oklahoma State University Center for Health Sciences Research Week 2024
Country/TerritoryUnited States
Internet address


  • anxiety
  • pediatrics
  • elementary


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