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As noted above, anxiety is common in children with ADHD. However, a child with an anxiety disorder can present with symptoms which mimic ADHD. These children may appear to be excessively oppositional in their behaviors. One clue to an anxiety disturbance may be the failure of a child thought to have ADHD to standard pharmacologic approaches.

Diagnostic criteria for Generalized Anxiety Disorder can be summarized as:

1. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months about a number of events or activities (school, work, etc.)

2. The person finds it difficult to control the worry

3. The anxiety and worry are associated with (only 1 item required in children):

  • Restlessness
  • Easy fatigability
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Sleep disturbance (difficulty falling asleep or sustaining sleep)

4. The anxiety causes clinically significant distress or impairment

5. The disturbance is not due to effects of a substance or medical condition and does not occur exclusively during a mood disorder or pervasive developmental disorder.