This multifaceted volume is based on the papers presented at an international conference on child and adolescent anxiety disorders, and it covers a broad range of approaches and perspectives. The 16 chapters range from the more theoretical (on affective—cognitive mechanisms, behavioural inhibition, neuropsychiatry and attachment theory) to the more clinically oriented (phenomenology and assessment, epidemiology, and both pharmacological and psychosocial interventions).

A historical introduction raises the interesting idea that child and adolescent anxiety disorders may be viewed as forerunners of later pathologies. Esquirol viewed anxiety as a sign of vulnerability — a ground on which psychopathology can develop. It is refreshing to think that a lifecourse view on psychopathology was alive many years ago.

For the psychologically minded, a comprehensive chapter on affective—cognitive processes leaves unanswered the question of causation, as most work on cognition in child and adolescent anxiety is characterised by lack of consistency in methods and theory. This shortcoming highlights the need for further observational and experimental studies that can go beyond the self-report questionnaire, to inform on affective—cognitive mechanisms.

For the neurobiologically inclined, the detailed chapter on neuropsychiatry is interesting, although the range of studies and quality of evidence provide no clear message regarding neuropsychiatric underpinnings. The developmental view, although largely based on animal models, is nevertheless refreshing, particularly the significance of early maternal deprivation, which can promote changes in the hypothalamo-pituitary axis that persist into childhood, and can influence stress reactivity and affect regulation in later life. Such evidence might lead to the fruitful integration of psychodynamic ideas, developmental psychopathology and neurobiological perspectives.

From a treatment perspective, psychosocial approaches are reviewed. Most evidence relates to cognitive—behavioural therapies (CBT), and the intriguing finding that educational support is as efficacious as elements of CBT raises the unanswered question of what it is about psychosocial treatments that is effective. Pharmacological approaches are also assessed; here I was concerned at the detailed discussion of the prescription of medications such as benzodiazepines for children, despite the absence of controlled trials supporting their use.

Clinicians will be satisfied with the review chapters on a developmental approach to assessment. Issues for future research are raised, again stressing the need for greater attention to the assessment of ‘cognition’ in anxiety and calling for more experimental studies to inform on affective—cognitive processes such as attention and memory biases in anxiety disorders.

Yule's fluent chapter on post-traumatic stress disorder (PTSD) provides a fascinating update and is complemented by a chapter on preventive approaches to anxiety disorders that focuses on PTSD as an example of prevention.

The most important message arising from this book is that anxiety disorders are common, start early in life and are more persistent than previously recognised. Although there are few follow-up studies, it is concluded that “ child and adolescent anxiety disorders, with or without depression, raise the risk of adjustment problems and anxiety disorders later in life”. Its comprehensive coverage of both theoretical and clinical issues make this recent volume in the Cambridge Child and Adolescent Psychiatry series a valuable addition to departmental libraries and to the personal reference shelves of both clinicians and researchers.