When diagnosing pathological anxiety in children one needs to consider the following aspects: development, maturity, society and communication. Behavioral inhibition/extreme shyness/is a permanent temperament trait, often combined with poor recognition of emotional facial expressions.
It is defined by biological markers and reflects a specific susceptibility to neurotic disorders. Children with anxiety suffer from a behavioral inhibition related to persistent fear and show a marked body reaction to stress.
In adolescence such children will be at higher risk of chronic anxiety, depression and substance abuse. A treatment would include a combination of psychotherapy, pharmacotherapy and sociotherapy.