A Deep Dive on Diagnostics: Anxiety, OCD, ADHD, and More

Available with English captions and subtitles in Spanish.

A conversation with Lisa W. Coyne, PhD, and Adam Reid, PhD, on diagnosing kids and teens with symptoms of OCD, ADHD, and anxiety.

Getting the Diagnosis Right

Anxiety and OCD can remain unrecognized or can be misdiagnosed, which prevents young people from getting the care they need. Coyne and Reid are experts in the diagnosis and treatment of anxiety and OCD in children and teens. In this session, they explore best practices for diagnosing these conditions, recognizing symptoms, and understanding overlap with other conditions.

Watch now to learn more about:

  • Why an accurate diagnosis is important
  • How health professionals assess and diagnose anxiety, OCD, and other conditions
  • Which conditions can coincide with anxiety and OCD

By the time symptoms of anxiety and OCD become apparent, “they’re usually at the point when they are problematic,” Coyne says. “They’re causing significant distress in a child, significant disruption in a family, and functional impairment across environments like school and with peers.”

In their talk, Coyne and Reid outline the different types of anxiety disorders, including social anxiety, panic disorder, and phobias. They describe how OCD and anxiety are disorders of avoidance, in which those who experience them fear the experience of anxiety itself. Such fear leads to difficulty functioning in all aspects of life.

Coyne points out that correctly diagnosing the type of anxiety a child may be experiencing, and whether OCD is present, points clinicians toward proven, effective treatments, such as cognitive behavior therapy (CBT) and exposure and response prevention (ERP) therapy.

Much of the evidence-based care that is effective for these disorders involves exposure. Exposure therapy is critical because it helps people learn to tolerate the experience of anxiety and live fully.

When it comes to diagnosing anxiety and OCD in young people, it is important for clinicians to use assessment tools specifically designed for children and teens. “Assessment is the roadmap,” Reid says. “If we don’t have a proper assessment of what’s going on, how is treatment supposed to be effective?”

In diagnosing anxiety and OCD in children and teens, clinicians take additional factors into consideration, such as the level of parental accommodation taking place (are parents engaging in behaviors in response to their child’s anxiety?) as well as developmental considerations (behaviors that may be indicative of anxiety at one age may be developmentally typical at another).

The experts point out that symptoms of other mental health conditions, including autism, attention deficit/hyperactivity disorder (ADHD), and eating disorders may be confused with or co-occur with anxiety and OCD. The use of assessment tools, consultation with other mental health professionals, and the ability to keep an open mind are all important factors in making an accurate diagnosis.

“When you get the right diagnosis, that’s validating, it clicks,” Reid says. “You’ll see in the kid or teen: ‘Someone finally gets my experience.’”

Audience Questions

  • What are some of the major challenges in diagnosing anxiety and OCD? Why is it so important to get these diagnoses right?
  • What are some of the most common anxiety disorders in kids and teens?
  • What are some common hallmarks of both anxiety and OCD?
  • How are anxiety and OCD diagnosed?
  • Who tends to do the diagnosing of anxiety and OCD in kids and teens? Is it pediatricians?
  • Are the same diagnostic criteria and assessments used for both adults and children, or are they different?
  • How can different presentations of OCD and misinformation about the condition complicate diagnostic challenges?
  • What should we know about ADHD? How might its symptoms be confused with anxiety or OCD?
  • What are some recommendations for clinicians who want to learn more about anxiety and OCD assessment?
  • How does one know if a child is exhibiting signs of anxiety, OCD, or trauma?
  • In the diagnostic process, how important is it for clinicians to be inquisitive, asking questions beyond the assessments?
  • Should clinicians be open to tweaking diagnoses as they spend more time with a child?
  • What are some common co-occurring conditions that tend to overlap with anxiety and OCD?
  • How can clinicians prioritize what to treat when there are multiple conditions at play?
  • How does online misinformation impact the diagnostic process? What if patients come in already identifying with a specific disorder, or their parents assume they have a particular condition?
  • Can you walk us through an example of the diagnostic challenges around differentiating between an eating disorder and food-related OCD?
  • What should clinicians keep in mind when working to tease out what’s what in a complicated case?
  • When should a clinician consider referring out for extra help?
  • Can you walk us through another example of the confusion that can arise when a child or teen is struggling with mental health challenges?
  • What should we know about the hope that comes with proper care?

The information discussed is intended to be educational and should not be used as a substitute for guidance provided by your health care provider. Please consult with your treatment team before making any changes to your care plan.

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About Dr. Coyne

Lisa W. Coyne, PhD, is a senior clinical consultant at McLean Hospital and an assistant professor of psychology in the Department of Psychiatry, part-time, at Harvard Medical School. She is a licensed clinical psychologist, an internationally recognized acceptance and commitment therapy (ACT) trainer, and the author of numerous books for parents, children, and teens.

About Dr. Reid

Adam Reid, PhD, is the co-owner and director of child and adolescent services at CBTeam in Boston—a specialty behavioral health clinic that treats anxiety and OCD across the lifespan at multiple levels of care. His research interests focus on the improvement and dissemination of evidence-based treatments for OCD.

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