Certain cognitive and temperamental traits have been shown to contribute to the development of GAD. The two central temperaments that are highly associated with GAD are a withdrawn/inhibited temperament and lack of effortful control (the ability to self-regulate) temperament.13 The anxiety from this dysfunction is maintained through negative reinforcement behaviors (primarily avoidance and escape) when the patient does not have the opportunity to learn new coping techniques.14 Adolescents with GAD also display several cognitive biases, such as increased attention to threat-related stimuli and overestimation of personal risk in various situations, both of which enable anxious feelings and symptoms