Which factors help distinguish school-related anxiety from a primary anxiety disorder during evaluation?

• A. Child's age alone.
• B. Presence of academic problems alone.
• C. Context of symptoms, onset, triggers, and impairment across settings, plus duration.
• D. Symptoms that occur only at home.

Answer: (C)

Evaluating whether anxiety is tied to school or represents a broader disorder hinges on pattern and duration across settings. The best approach is to look at where and when symptoms occur, what triggers them, how long they’ve been present, and how much they impair functioning. If the anxiety is closely tied to school contexts—happening during tests, classroom participation, or social interactions at school—and is limited to those settings with impairment mostly at school and during school-related demands, that points to school-related anxiety. A primary anxiety disorder, by contrast, tends to show symptoms across multiple settings (not just at school), across various triggers and people, persists over a substantial period, and causes impairment in overall functioning, including at home, with peers, and in other activities. Reports from parents and teachers, plus a careful look at duration and cross-setting impact, help distinguish the two. Age alone isn’t decisive, and academic problems can accompany either situation, while symptoms confined to home don’t by themselves establish a primary disorder without considering cross-setting patterns and durability.