Category: Anxiety Disorder

The “Diagnostic and statistical manual” (2013) specifies that an individual must exhibit excessive anxiety or worry toward certain events or activities in order to have General Anxiety Disorder (GAD). Adrian demonstrates excessive anxiety and worry for a number of events and activities such as job performance, her children’s well being, and her relationships with men. With regard to her children, Adrian often became very anxious that they might have been harmed or killed if they were out in the neighbourhood playing, and she had not heard from them in a while. This level of worrying is excessive as it is irrational to assume they have been killed in this situation, therefore this study meets the first requirement in the diagnostic criteria. As stated in the case study, “Her worries were also uncontrollable: when a worry came into her mind, she was unable to dismiss it.” This satisfies the diagnostic requirement that the individual must find it difficult to control the worry. (“Diagnostic and statistical manual”, 2013) Additionally, Adrian’s anxiety and worry were accompanied by other symptoms including irritability, problems in getting and staying asleep, frequent muscle tension and headaches, and a feeling of being keyed up or on edge.

She also displayed lapses in concentration and memory. Amid periods of increased worry, Adrian would be more forgetful because her mind had not been focused on her work (e.g., she would often forget what her supervisor had told her). Therefore, Adrian’s symptoms meet the diagnostic criteria, as Adrian’s anxiety and worry are associated with 3 or more of the symptoms listed for Generalized Anxiety Disorder in the DSM-5. The DSM-5 states that the symptoms must cause clinically significant distress in social, occupational or other important areas of functioning. (“Diagnostic and statistical manual”, 2013) Adrian reported distress in her social life by claiming that her children often complained that she was always in a bad mood. She knew that she was spending little time with her friends and had noticed that the men she dated never seem to call her back. Adrian affirmed that being assertive, participating in meetings, dating and public speaking were situations that she tended to endure with moderately high levels of anxiety and distress. Likewise, the symptoms also display clinically significant distress in occupational areas of functioning. She spent many extra hours at the office, arriving 30 minutes early every day to plan out her day to the best of her ability. It took her a relatively long time to complete tasks or make decisions. Adrian would become more anxious and worried at work when her supervisor was around because she feared that her job performance would be negatively evaluated. Her preoccupation with the possibility of being negatively evaluated made her less attentive, leaving her susceptible to make mistakes. There is insufficient evidence suggesting that the disturbance is attributable to the physiological effects of a substance or other medical condition. (“Diagnostic and statistical manual”, 2013) Furthermore, the disturbance doesn’t appear to be better explained by another disorder. (“Diagnostic and statistical manual”, 2013) Therefore, this case study meets all the diagnostic criteria and Generalized Anxiety Disorder appears to be the most plausible diagnosis.

I believe that there is insufficient information provided in this case study to validate the diagnosis of an additional disorder. Research suggests that family history increases the possibility that a person will develop GAD. (“Learn More About General Anxiety”, n.d.) The first-degree relatives of someone with GAD are more vulnerable to develop anxiety and mood disorders, specifically GAD. (Meek, n.d.) Certain patterns of brain function and structure have been found consistently in patients with GAD. GAD patients display elevated amygdala (structure in the brain that processes emotions) activity when processing negative emotions. This heightened amygdala activity can instigate inaccurate perceptions that lead people with GAD to believe a non-threatening interaction or social cue is threatening. (Meek, n.d.) Therefore, it is likely that the disruption in the function or activation of certain parts of the amygdala may be a factor that causes the development of Generalized Anxiety Disorder. (Gregory, 2018) Moreover, an increased quantity of grey matter in specific regions of the brain has been repeatedly found in GAD patients. (Meek, n.d.) The right putamen of the brain shows consistent growth in the volume of grey matter in patients with GAD. Researchers found that an extensive volume of grey matter in the right putamen was positively correlated with mistreatment during childhood. Although correlation doesn’t prove causality, there appears to be a relationship between childhood trauma and the large volume of grey matter seen in many patients with GAD. (Meek, n.d.) Furthermore, an imbalance in neurotransmitters such as dopamine, norepinephrine, and serotonin can have a burden on well-being and stability and is seen in a wide array of GAD patients. (Zimmerman, 2018)

Psychological factors such as childhood trauma can increase the risk of developing GAD. (Meek, n.d.) Recent traumatic or negative events such as divorce, the death of a loved one, changing jobs or schools, or abuse may also prompt the development of GAD. (“Learn More About General Anxiety”, n.d.) Going through notably hard experiences can leave us feeling humiliated, uncertain or isolated, which makes it likely that we may become anxious in situations that remind us of these difficult experiences. (Meek, n.d.) Life events that result in feelings of embarrassment, defeat, deception, and danger are reliable predictors of the development and onset of Generalized Anxiety Disorder. (Meek, n.d.) Additionally, studies have found that a person with a shy or pessimistic personality may be more prone to developing GAD than others. (“Generalized anxiety disorder”, 2017)

Social causes of Generalized Anxiety Disorder appear in numerous forms. Early social learning tends to shape how we handle situations throughout our life. (Meek, n.d.) Caregivers and other important people in our lives inadvertently teach us how to handle demanding, stressful situations through their actions. When they model ineffective methods of stressful management, we tend to follow in their footsteps. These early social learning experiences can influence our development of anxiety. (Meek, n.d.) Additionally, feelings of rejection, abandonment, humiliation, or loneliness can stimulate anxious behaviours. Fearful and dangerous experiences within intimate relationships can impact the augmentation of anxiety (more common in women). Career and work-related stress such as losing a job may also increase anxiety levels. (Meek, n.d.) Moreover, lifestyle choices such as alcohol consumption, tobacco use, caffeine, and use of benzodiazepines can all heighten anxiety levels, which can lead to the onset of GAD. (Gregory, 2018)

Worries can be adaptive or maladaptive. High levels of worry can promote adaptive health behaviours in individuals. (Notebaert et. al, 2014) For example, if someone with elevated levels of worry processes a threat as being dangerous or potentially harmful, then they may take the necessary precautions to reduce/inhibit the effect of the apparent threat. (Notebaert et. al, 2014) A study found that worry could serve as a mechanism to regulate the physiological stimulation associated with anxiety. (Ottaviani et. al, 2014) However, worry becomes a liability when it becomes the default and pathological response to a threat, as seen in patients with GAD. (Ottaviani et. al, 2014) Habitual worrying can be adaptive as well, as worrying can make people take action about serious issues in their lives. (Verplanken & Roy, 2013) As stated by Verplanken & Roy (2013), “Habitual ecological worrying was associated with pro-environmental attitudes and behaviours, and with a personality structure characterized by imagination and an appreciation for new ideas.” This indicates that worrying may open up new windows of creativity and receptivity, along with other strong adaptive qualities.

There are various situations and circumstances in which worry can be a disadvantage. Results of a study suggest that worry may lead to a decrease in selective responding to neutral cues in the environment. (Salters-Pedneault et. al, 2008) The outcomes imply that worry may contribute to feelings of anxiety by weakening adaptive responses to neutral cues and interfering with adaptive behaviours. (Salters-Pedneault et. al, 2008) Another study, which utilized experimentally induced worry, found various physiological drawbacks of GAD. (Fisher, 2015) GAD accounted for impairments in cardiovascular, sympathetic, and parasympathetic systems. Additionally, rigidity of cardiovascular reactivity was seen in individuals with GAD. (Fisher, 2015) At times, individuals can worry so excessively that their daily activities revolve around their worry, especially if their worry started at a young age. This can negatively impact their everyday lives in social, psychological, and prominently, emotional contexts. Worrying, especially at the level of GAD can also result in a seemingly everlasting feeling of apprehension and anxiety because the individual is consumed by their worries and does not possess a means of controlling them. (Zimmerman, 2018) Persons with GAD display high amounts of depression, trait anxiety, severe negative thought intrusions, as well as negative thoughts about worry (Hirsch et. al, 2013) The incompetence to control undesirable thought intrusions related to worry (found in people with GAD) is affiliated with a deficiency in attentional control. (Fox et. al, 2015) Since, adaptive behaviour relies on the ability to filter between relevant and irrelevant information, being able to control attention is a vital asset, one that is not effective in individuals with inflated levels of worry. (Fox et. al, 2015)

References

1. Carey, E. (n.d.). Generalized Anxiety Disorder. Retrieved from https://www.healthline.com/health/anxiety/generalized-anxiety-disorder
2. Diagnostic and statistical manual of mental disorders: DSM-5. (2013). doi:https://doi-org.myaccess.library.utoronto.ca/10.1176/appi.books.9780890425596.dsm05
3. Fisher, J. (2015). Necessary versus sufficient causes of impaired physiological functioning in generalized anxiety disorder. Retrieved from https://search-proquest-com.myaccess.library.utoronto.ca/psycinfo/docview/1738488367/abstract/C3AA6F542CC945E0PQ/6?accountid=14771
4. Fox, E., Dutton, K., Yates, A., & Georgiou, A. (2015, July). Attentional control and suppressing negative thought intrusions in pathological worry. Retrieved from https://search-proquest-com.myaccess.library.utoronto.ca/psycinfo/docview/1712601044/F8E053FE7EBA4E3EPQ/9?accountid=14771
5. Generalized anxiety disorder. (2017, October 13). Retrieved from https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/symptoms-causes/syc-20360803
6. Gregory, C. (2018, November 18). Generalized Anxiety Disorder. Retrieved from https://www.psycom.net/bookstore.anxiety.html#causes
7. Hirsch, C., Matthews, A., Lequertier, B., Perman, G., & Hayes, S. (2013, December). Characteristics of worry in Generalized Anxiety Disorder. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743042/
8. Learn More About General Anxiety Disorder. (n.d.). Retrieved from https://www.webmd.com/anxiety-panic/guide/generalized-anxiety-disorder#1-3
9. Meek, W. (n.d.). What Could Cause Generalized Anxiety Disorder? Retrieved from https://www.verywellmind.com/gad-causes-risk-factors-1392982
10. Notebaert, L., Chrystal, J., Clarke, P., Holmes, E., & Macleod, C. (2014, January 8). When We Should Worry More: Using Cognitive Bias Modification to Drive Adaptive Health Behaviour. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3885669/
11. Ottaviani, C., Borlimi, R., Brighetti, G., Casseli, G., & Favareto, E. (2014, September). Worry as an adaptive avoidance strategy in healthy controls but not in pathological worriers. Retrieved from https://search-proquest-com.myaccess.library.utoronto.ca/psycinfo/docview/1560633771/C3AA6F542CC945E0PQ/8?accountid=14771
12. Salters, K. (2006). Inflexibility in state and trait worry: Implications for adaptive functioning. Retrieved from https://search-proquest-com.myaccess.library.utoronto.ca/psycinfo/docview/621583030/C3AA6F542CC945E0PQ/3?accountid=14771
13. Salters-Pedneault, K., Suvak, M., & Roemer, L. (2008, September). An experimental investigation of the effect of worry on responses to a discrimination learning task. Retrieved from https://search-proquest-com.myaccess.library.utoronto.ca/psycinfo/docview/622145989/C3AA6F542CC945E0PQ/7?accountid=14771
14. Verplanken, B., & Roy, D. (2013, September 4). ‘My worries are rational, climate change is not’: Habitual ecological worrying is an adaptive response. Retrieved from https://search-proquest-com.myaccess.library.utoronto.ca/psycinfo/docview/1508433565/F8E053FE7EBA4E3EPQ/8?accountid=14771
15. Zimmermann, K. A. (2018, November 06). Generalized Anxiety Disorder: Causes, Symptoms & Treatment. Retrieved from https://www.livescience.com/45781-generalized-anxiety-disorder.html

According to American Association, anxiety disorder can be explained as a reaction towards tension which could occur and sometimes do bring benefit in certain situations. It helps us to realise its danger and push us to be in a ready mode and focus on the coming danger. This disorder is not the same as the actual feeling which will lead to nervousness or anxiousness and thus will increase the feelings of being scared or fearful. Anxiety disorders are the greatest mental disorders which could reoccur with grown-ups at some point of their life. It is acknowledging anxiety disorder correspond to muscular tension and preventive behaviour. Anxiety disorder need to be looked into in depth for it does prevents a person to live a normal life. There are certain questionable facts of the strength and weakness diagnosis referring DSM5 for the aspect of anxiety disorder.

After browsing through, there are a few strengths found in DSM 5 which is used in diagnosing anxiety disorder gearing greatly towards usage of neuroscience and therapeutics which further emphasized on grouping of different kind of anxiety disorders. Now it provides greater emphasis on modern scientific method in helping to overcome these disorders. It has been improvised by using electronic information that will help us to understand better the characteristics of each and every one who are going through the stages of anxiety disorders. In directly it helps to see significant changes referring to the problem mentioned for a length of time. It shows detailed behaviour symptoms, cognitive symptoms and physical symptoms of each disorders related to anxiety. Next, usage of developmental direction for the group of this disorders are done according to all different ages for a six months’ period. Each disorder related to anxiety is dealt with comprehensively which touches on the features and symptoms which is needed for evaluation to give further information about the number of people going through this problem at the same time knowing what are the dangers connected with this disorder. This disorder also includes phobia for example specific phobia, panic attacks and social anxiety. The division of anxiety disorder has been changed allowing it to represent and so as to look out of any other anxiety symptoms starting during the younger stage to adulthood stage. DSM5 gives a bit more explanation about the danger, prognostic reasons and biological facts linked to anxiety disorder.

Moreover, new information in DSM5 contains greater focus on ways to reduce the anxiety depending which level the anxiety has cause the person having more suicide risk due to the longer period of sickness. This accurate treatment by monitoring the responds towards the therapy given to the person helps in overcoming anxiety disorder. DSM5 has provided useful knowledge in comprehending the actual cause for the different types of anxiety disorder.

Besides the strength of DSM5, there are also some traces of weakness found in it. The criteria of someone undergoing anxiety disorder stated by DSM5 should show high level of distress and it does not show that the person is undergoing mental disorder unless it is causing them problems in carrying out their routine work every day. It is argued not everyone who experiences anxiety disorder would produce the same symptoms of anxiety such as having panic attack. It should also take into account the symptoms for young children and adult maybe different. DSM5 does not emphasis much on different culture as every culture describes anxiety attack differently and diagnostic process must be included especially for young children and their care givers. Comparing DSM4 and DSM5, generalised anxiety disorder (GAD) symptoms and observation has been reduced significantly. In DSM4 a person needs to show at least three out of six symptoms such as not feeling at ease, fearful and always fidgeting for minimum of three months compared to the changes in DSM5 where a person needs to show only just one out of four symptoms for the duration of only one month. The number of symptoms and the length of observation has been reduced in DSM5 which sometimes does not give an actual picture whether the person is really going through GAD. This may lead to assuming someone who is always worried is having GAD and will be given unnecessary treatment.

Ben’s Case study

Identification of the disorder:

The case presented deals with Ben, a 52 years old man suffering from obsessive-compulsive disorder as well as generalized anxiety disorder, personality disorder and social anxiety disorder. Since Ben has been unmarried his whole life and has always been anxious with girls and he avoids making any social approaches with women. Since he also mentioned that all of the young people in his area dislike him. Thus, Ben is diagnosed with Social anxiety disorder (Social phobia). According to the Social anxiety disorder diagnostic criteria published in DSM-5 (American Psychiatric Association, 2013), 1. The social situations almost always provoke fear or anxiety in individuals with social phobia, 2. The social situations are avoided with intense fear or anxiety, and this is what happens with Ben when he deals with women. Generalized anxiety disorder is the second disorder that Ben is suffering from, one of the diagnostic criteria of generalized anxiety disorder published in DSM-5 (American Psychiatric Association, 2013) is Excessive anxiety and worry, this point can be summarized when Ben became very careful to avoid making mistakes after his incident at work. Ben admits to check all of the locks on his house at night and disconnects his phone to avoid possible threatening phone calls, he also double-checks all of his deliveries after the incident, all of these acts confirms the presence of obsessions and compulsions, which are one of the diagnostic criteria of Obsessive-Compulsive Disorder published in DSM-5 (American Psychiatric Association, 2013). One of the diagnostic criteria of general personality disorder published in DSM-5 (American Psychiatric Association, 2013). is that “c. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning” and this is characterized by Ben’s social interaction during the past few years, He smiles when he is angry and seems upset when everyone is laughing.

Identification of the separate themes:

Ben has reported that he enjoys interacting with people but in the same time he has always been anxious with girls and avoid any social contact with them he also has not been married his whole life, this can indicate Ben’s social anxiety disorder. Social anxiety disorder also known as social phobia is a type of anxiety disorder characterized by excessive fear, anxiety, distress, and self-consciousness in social events (psycom,2018). The other thing that emphasize his social anxiety disorder maintenance is his incident at work, the error he made became known around his work place, and his colleagues teased him for several weeks. According to DSM-5 Onset of social anxiety disorder may follow a stressful or humiliating experience (e.g., being bullied) the people who appreciate Ben’s involvement in the church find him a bit abnormal. According to the cognitive theory, persons with social anxiety disorder tend to overestimate the level of threat in social situation and Expect negative outcomes from interactions with people (Huppert, 2003), these beliefs and expectations are characterized in Ben disconnecting his phone at night to avoid possible threatening phone calls because he thinks that all of the young people in his neighborhood dislike him and they may be planning to break into his house. According to diagnostic and statical manual of mental disorder (DSM-5), the weak elderly, worries about safety may limit their activities. This can be shown in some of the themes that characterize the development and maintenance of general anxiety disorder in Ben, one of them was losing his interest in the walks at night claiming that the streets are too dangerous , and after his incident at work he became very careful to avoid making any mistakes , also he double checks all his deliveries, finally during the past six months Ben admits that he carefully checks all of the locks on his house and disconnect his phone at night. According to the cognitive theory (Wells, 1999), individuals with generalized anxiety disorder develop a sequence of expectations and beliefs about worry, there are Two types of belief which are relevant to the problem: (a) positive beliefs about worry in which the individual believes that worrying serves a protective or coping function, can be characterized by Ben disconnecting his phone at night, and (b) negative beliefs about worry. Some of the themes that characterize the development and maintenance of Obsessive-Compulsive Disorder in Ben is when he checks all of the locks on his house at night and double-checks all of his deliveries after the incident. According to diagnostic and statistical manual of mental disorder (DSM-5), Onset after age 35 years is unusual but does occur. According to the biological perspective (Kelly, 2018) individuals with Obsessive-Compulsive Disorder suffer from repetitive actions called compulsions and irrepressible thoughts called obsessions. According to the behavioral prospective, fear in people with obsessions and compulsions is triggered by fear associated with stimuli (e.g. young adult in the area doesn’t like me) that are unlikely to cause actual harm. Moreover, according to the cognitive perspective, individuals suffering from Obsessive-Compulsive Disorder have an exaggerated sense of personal responsibility (e.g. Ben double-checking all of his deliveries ) and so feel they must carry out their compulsive rituals to avoid adverse consequences, During the past two years, Ben’s colleagues have noticed some changes in him, he always seems unusual also his social communication seemed unsuitable, he smiles when he is angry and seemed upset when everyone else is laughing, one of his coworkers reported that Ben may be using hallucinogenic drugs. Although Ben attended church on regular basis, the people in the church finds him a bit strange. All of these themes characterize the development and maintenance of general personality disorder, according to DSM-5 (p647) ‘personality disorder is a continuing pattern of thinking, feeling, and behaving that is relatively stable over time’. Personality Disorders Institute at Cornell University states that: borderline personality disorder is “more predominant than schizophrenia, autism, and bipolar illness joint”. (Personality Disorders Institute).

Identification of appropriate intervention

Ben’s case reveals that he has signs and symptoms of four disorders, first: Social anxiety disorder, some of the interventions that can help Ben overcome his social phobia are: 1. counselling 2. psychodynamic therapy 3. The treatment should involve confronting the feared stimulus in his real life (Marks, 1975), which is dealing and socializing with women. 4. Develop individual or group social anxiety cognitive behavioral therapy (based on the Clark and Wells model), individual cognitive behavioral therapy for social anxiety disorder according to Clark and Wells model should consist up to fourteen sessions of 90 minutes duration over four months and include education about social anxiety, empirical exercises to determine the adverse effects of self-focused attention and safety-seeking behaviors, CBT involves exposure in vivo and cognitive restructuring with training in relaxation and social and conversational skills training. cognitive behavioral therapy can be in groups or individual. Second disorder is generalized anxiety disorder which can also be treated by cognitive behavioral therapy, according to Combined Treatment for GAD (2017) Patients will be educated about the nature of anxiety and be trained in the recognition and monitoring of situational, physiological, cognitive, and behavioral cues associated with anxious responding. Other therapy options for generalized anxiety disorder and social anxiety disorder are pharmacological intervention. A Study of 75 patients with generalized social anxiety disorder was conducted from 2007 to 2010 and consisted of 16 sessions of individual Cognitive Behavioral Therapy for social anxiety disorder. This study resulted in great reduction of negative emotion ratings, this indicates the effectiveness of Cognitive-Behavioral Therapy for social anxiety. Cognitive Behavioral Therapy can also be used for treating Obsessive-Compulsive Disorder and personality disorder. According to (Treating Personality Disorders – Personality Disorder Treatment Options, n.d.) there are Other therapy options for personality disorder: Dialectical behavior therapy (DBT), Interpersonal therapy (IPT) and Family-focused therapy. In dialectical behavior therapy the psychotherapist assures the patient that their behavior and actions are clear and valid. By the end of the therapy, the patient should be able to change his disruptive or unhealthy behavior to good ones.

Experiencing anxiety is a part of every human’s life, people have anxiety about their everyday fears and there’s nothing wrong with that. However, there are many cases that occur every day where anxiety disorders are more intense. Individuals with anxiety disorder often tend to fear and shy from everyday interactions. Patients with an anxiety disorder are characterized by the feelings of panic and anxiety that causes them to lose control over their own mind. A lot can play into the reason why people have an anxiety disorder. Specific phobias, stress buildup, and trauma are all ways people can develop anxiety disorders. “A new systematic review of 65 studies from around the world involves a total of 97,333 health care workers and finds that 1 in 5 have experienced depression, anxiety, and/or PTSD during the ongoing COVID-19 pandemic” Yufei Li, 2010. The ongoing pandemic that has swept America by storm and has posed a challenge for nurses who continue to provide help for these COVID patients, with many that fear for their own life.

There are different types of anxiety disorders, including generalized anxiety, panic disorder, and PTSD. All are cases that are categorized in the same group of mental illnesses. One of the most common anxiety disorders is PTSD, which for short stands for, “ Post-traumatic stress disorder”. This disorder occurs mostly with war veterans and is one primary cause of suicides in America. The risk of suicide is elevated for those suffering from these different types of anxiety disorders. The reason for this is because individuals with anxiety disorders experience depression more than the average person, this interferes with everyday activities leading to an impaired life. “Many studies have demonstrated the efficacy of exposure therapy in the treatment of chronic post-traumatic stress disorder (PTSD). Despite the convincing outcome literature, a concern that this treatment may exacerbate symptoms. (Hembree, 2003)” Symptoms of an anxiety disorder include sleep loss, depression, and nausea. Risk factors of this disorder could include drug abuse, mental illnesses, and even suicide. Researchers find that anxiety disorder can be both inherited and or caused by an environmental situation. An example of an environmental situation where an individual has developed anxiety disorder would be like a person who had a traumatizing childhood and shows traits of extreme anxiety. In many cases, exposure to negative experiences in early childhood is the cause of this disorder.

Therapies and treatments that are used to help treat people with an anxiety disorder are mainly put through psychotherapy and different types of medication prescribed by a doctor. Psychotherapy is used to help talk to people about their anxieties, other treatments include prescribed medications like antidepressants which are used to treat depression symptoms found in people with anxiety disorders. Another way people with anxiety disorders could benefit is by joining a support group. Talking with a group of individuals about your problems and hearing about theirs is an efficient way to open up and could help with people that suffer from this type of disorder. Another way to treat anxiety disorder could be as simple as exercising at the gym, this is a good stress management technique and is suggested by researchers.

Anxiety is a common human trait and is normal. While anxiety is common, there are millions of people who suffer from extreme anxiety. When this happens an individual’s ability to function properly on an everyday basis is affected. Researchers and doctors continue to work on finding ways to treat this disorder so that they can bring hope and relief to the ones who are affected by this disorder.

Lieutenant Dan exhibits clear symptoms of anxiety disorder. As expressed on top of, the initial trigger may be a traumatic expertise that he couldn’t overcome. In Lieutenant Dan’s case, this trigger are often argued to be one amongst 2 things. The primary is that he was shot, injured, and then, incapacitated as a results of his fight within the war. As a result of he came therefore about to death and was therefore severely slashed, he might not are able to overcome each the emotional and physical trauma. The second trigger is once he survives his war injuries, he’s forced to measure during a world he doesn’t would like to be in. Ironically, Lt. Dan place such a profound positive reward for dying in battle that he was traumatized by being ripped far from his destiny. Lt. Dan was excited to die within the war as a result of each man in his kinship group has fought and died in every American war. He not dying in the field tore his hope for the sole thing he wished.

The primary scene that best represents his symptoms of anxiety disorder is when Lt. Dan rips Forrest out of Forrest’s bed within the hospital and yells at him for saving his life and blaming him for becoming crippled. He continues to scold Forrest and tells him that “it was his destiny to die in this war.’ this implies that Lt. Dan is re-experiencing this trauma in his head and cannot come back to terms together with his survival. This scene was chosen as a result of it clearly shows that there was an information in this war that Lt. Dan couldn’t overcome. It additionally shows the symptoms of anxiety disorder and accurately presents key info required to diagnose the disorder. Because it stands a great deal of individuals who have served in war have come home having posttraumatic stress disorder or some style of depression. During this scene, we have a tendency to see the trauma that Lt. Dan experiences within the war, however it’s affected him, and the way he’s reacting. He exemplifies PTSD in his actions his uneasiness, problem cope, and inability to just accept reality as it is.

The second scene that best represents PTSD and its complications is once Lt. Dan continues to be within the hospital with Forrest. Throughout this whole image, we have a tendency to observe Forrest partaking in various activities within the facility whereas Lt. Dan is caught during a trance-like state and is simply seen staring off into the gap. During this scene, Lt. Dan passed up food, isolated himself, and have become to a fault anti-social. These same symptoms are shared with depression that several anxiety disorder patients additionally suffer from. Lt. Dan could exhibit several of those behaviors as a result of he’s caught in his head experience the expertise and attempting to deal with the aftermath.

The scene that the majority deeply exemplifies handling posttraumatic stress disorder is when, straight off after Forrest leaves the tv broadcast congratulating him on his medal of Honor, we have a tendency to face a really torn up Lt. Dan. we have a tendency to later observe that he has been living his life during a run-down motor inn, indulgence in obscene amounts of alcohol and obtaining terribly accustomed to the native streetwalkers. This shows the tough reality of what horrors Lt. Dan has been subjected to. His inability to regulate himself to his new life or his overwhelming mental disorder drove him to use alcohol as a self-medicating device, as several others do once unsure a way to handle their issues. Those that suffer from anxiety disorder typically have bother adjusting to the traditional hustle and bustle of society and notice themselves during a similar difficulty to Lt. Dan.

the ultimate scene was one amongst personal triumph and triumph for Lt. Dan. he’s finally able to defeat his posttraumatic stress disorder and settle for the circumstances that he should endure whereas fishing for shrimp with Forrest. During this scene on the shrimp boat, Lt. Dan involves an enlightenment and involves peace. He now not an edgy, anxious individual however one who has come back to terms together with his life and tragedy and betters himself from it. From that time, following time we have a tendency to see Lt. Dan is at Forrest’s wedding wherever he shows up terribly well-dressed, clean-cut, and shaven, together with his wife, and a prosthetic leg. His clean look makes one believe that he was able to not solely adapt to society however additionally thrive in it. If this wasn’t proof enough of his recovery from anxiety disorder, we tend to see that Lt. Dan is married to a presumptively Vietnamese girl. If he wasn’t totally recovered she would be a continuing reminder of the war he fought in and therefore the trauma that he sustained; however instead, he sees her as simply a girl that he loves.

Lieutenant Dan exhibits clear symptoms of anxiety disorder. As expressed on top of, the initial trigger may be a traumatic expertise that he couldn’t overcome. In Lieutenant Dan’s case, this trigger are often argued to be one amongst 2 things. The primary is that he was shot, injured, and then, incapacitated as a results of his fight within the war. As a result of he came therefore about to death and was therefore severely slashed, he might not are able to overcome each the emotional and physical trauma. The second trigger is once he survives his war injuries, he’s forced to measure during a world he doesn’t would like to be in. Ironically, Lt. Dan place such a profound positive reward for dying in battle that he was traumatized by being ripped far from his destiny. Lt. Dan was excited to die within the war as a result of each man in his kinship group has fought and died in every American war. He not dying in the field tore his hope for the sole thing he wished.

The primary scene that best represents his symptoms of anxiety disorder is when Lt. Dan rips Forrest out of Forrest’s bed within the hospital and yells at him for saving his life and blaming him for becoming crippled. He continues to scold Forrest and tells him that “it was his destiny to die in this war.’ this implies that Lt. Dan is re-experiencing this trauma in his head and cannot come back to terms together with his survival. This scene was chosen as a result of it clearly shows that there was an information in this war that Lt. Dan couldn’t overcome. It additionally shows the symptoms of anxiety disorder and accurately presents key info required to diagnose the disorder. Because it stands a great deal of individuals who have served in war have come home having posttraumatic stress disorder or some style of depression. During this scene, we have a tendency to see the trauma that Lt. Dan experiences within the war, however it’s affected him, and the way he’s reacting. He exemplifies PTSD in his actions his uneasiness, problem cope, and inability to just accept reality as it is.

The second scene that best represents PTSD and its complications is once Lt. Dan continues to be within the hospital with Forrest. Throughout this whole image, we have a tendency to observe Forrest partaking in various activities within the facility whereas Lt. Dan is caught during a trance-like state and is simply seen staring off into the gap. During this scene, Lt. Dan passed up food, isolated himself, and have become to a fault anti-social. These same symptoms are shared with depression that several anxiety disorder patients additionally suffer from. Lt. Dan could exhibit several of those behaviors as a result of he’s caught in his head experience the expertise and attempting to deal with the aftermath.

The scene that the majority deeply exemplifies handling posttraumatic stress disorder is when, straight off after Forrest leaves the tv broadcast congratulating him on his medal of Honor, we have a tendency to face a really torn up Lt. Dan. we have a tendency to later observe that he has been living his life during a run-down motor inn, indulgence in obscene amounts of alcohol and obtaining terribly accustomed to the native streetwalkers. This shows the tough reality of what horrors Lt. Dan has been subjected to. His inability to regulate himself to his new life or his overwhelming mental disorder drove him to use alcohol as a self-medicating device, as several others do once unsure a way to handle their issues. Those that suffer from anxiety disorder typically have bother adjusting to the traditional hustle and bustle of society and notice themselves during a similar difficulty to Lt. Dan.

the ultimate scene was one amongst personal triumph and triumph for Lt. Dan. he’s finally able to defeat his posttraumatic stress disorder and settle for the circumstances that he should endure whereas fishing for shrimp with Forrest. During this scene on the shrimp boat, Lt. Dan involves an enlightenment and involves peace. He now not an edgy, anxious individual however one who has come back to terms together with his life and tragedy and betters himself from it. From that time, following time we have a tendency to see Lt. Dan is at Forrest’s wedding wherever he shows up terribly well-dressed, clean-cut, and shaven, together with his wife, and a prosthetic leg. His clean look makes one believe that he was able to not solely adapt to society however additionally thrive in it. If this wasn’t proof enough of his recovery from anxiety disorder, we tend to see that Lt. Dan is married to a presumptively Vietnamese girl. If he wasn’t totally recovered she would be a continuing reminder of the war he fought in and therefore the trauma that he sustained; however instead, he sees her as simply a girl that he loves.

People form impressions of others they see, have described to them or encounter in the media (Schneider et al, 1979). It is common to save and store information about people, places or events as schemas. A schema is a defined and rational set of related thoughts and beliefs. When a schema is activated the mind fills in the missing details to have a better understand of the happenings (Hogg and Vaughan 2010). Schemas are sometimes related to stereotypes. Stereotypes are simplified images of members of a group. They are usually based on clearly visible differences between the group and the outsiders (Zebrowitz, Voinescu, Collins 1996). According to Buss (1977), outgroups are social groupings that are different from the individual’s own social group. Stereotypes commonly but not necessarily are accompanied by prejudice towards the members of the category in question (Tajfel, H. (1982). Information for developing schemas is coming from a variety of sources. People can simply share their schemas with others, or they can read about them. The most typical way to acquire or modify a schema is through various media (Schneider et al 1979).

Newspaper outlets are a major source of information for those motivated to seek information as they are highly informative in the realm of public affairs (Chaffee and Kanihan, 1977) This statement extends to the online newspaper outlets which provide modern and easy access to information for the public. It is easy to think that the political stance of a newspaper does not matter if the article is not about a political discussion. Previous research indicates that there is an association on how liberal and conservative newspapers portray different topics. Higher conservatism is linked to greater negative or anti-equality attitudes (Pratto et al., 1994), (Paxton and Mughan, 2006). By portraying particular groups in society in a certain way, newspapers with a political stance can normalise certain views and attitudes towards that group.

Generally, individuals seek a political grouping that validates their experience and views. If the newspaper shares the reader’s beliefs, they might sympathise more with the political party (Feezell 2016). This study is conducted to expand our understanding of how people obtain political knowledge in online mainstream media and how much impact the media has on influencing attitudes regarding certain groups in society. The group chosen for this research is the anxiety disorder sufferers.

Attitudes and beliefs about mental illness are shaped by personal knowledge about it, knowing and interacting with someone living with mental illness, cultural stereotypes, media stories (Choudhry, Ming, Khan, 2016). The general public sees adults with anxiety disorders in a neutral, often more negative light. Many of them fail to recognise that this group suffers for a mental illness or they believe this illness is over-exaggerated and the sufferers simply do not want to take responsibility for their actions, and they blame it on their disorder. According to the survey conducted by Reavley and Jorm (2011), many people sometimes even the ones with the illness think It’s a sign of personal weakness.

The aim of this report is to test an association between the political stance of online UK based mainstream newspaper outlets and their portrayal of the adults suffering from anxiety disorders.

The hypothesis of this report is that there will be a significant association between the political leaning of a newspaper and the way they portray adults who suffer from anxiety disorders.

The null hypothesis of this report is that there will not be a significant association between the political leaning of a newspaper and the way they portray adults who suffer from anxiety disorders.

Design

This is a deductive frequency content analysis study, using both quantitative and qualitative style coding elements in which the data was collected from online newspaper outlets.

The data was categorised by two variables. The first variable was how the newspaper outlets portray anxiety disorders. The two categories were either a positive portrayal or a negative portrayal. The second variable was the political stance of the newspaper. The two options are conservative or liberal stances. The design was given to test for an association between these two variables.

Data Collection

Overall, sixteen online newspaper articles were collected, examined and coded. They were specially collected to be an equal amount of both right and left-leaning political stances. 36 units from these articles were chosen to be proof for either the positive or negative portrayals. A unit here is considered to be a piece of text which can be understood it its own without the need to be referenced to other units. The sizes of the units varied between sentences to paragraphs within an article.

Data Collected

The data was sourced from various mainstream UK based online newspaper articles which are available for the public without subscription or logins needed to access the data (or where logins were required these were paid through university subscriptions). The data was collected from an equal amount of politically left-leaning newspapers such as: The Independent and The Guardian, and from politically right-leaning newspapers such as The Daily Telegraph, The Daily Mail and the Sunday Telegraph. The ethical issues considered in collecting and preparing the data included the issue of anonymity. Giving consent was not an issue as the newspaper articles in the public domain are under the expectation that their work might be analysed.

Data Analysis Process

A content analysis was conducted on the data collected. The collected data has been placed in the data collection sheet. Each unit then has been arranged by the political stance of the newspaper outlets with the guidance of the coding manual. There were to categories regarding the political stance of the newspaper; conservative (right-leaning) and liberal (left-leaning). After the articles had been arranged, units were chosen and placed in the coding summary document. Overall, 36 units than were coded in two categories. The first category included the units that showed a positive portrayal of anxiety disorders while the second category included the negatively portrayed units. The positively portrayed units were describing positive qualities and actions of the out-group or suggested that there was no link found between them and negative activities. The negatively portrayed units suggested the outgroup’s higher rate of negative or undesirable activity and describing their negative qualities. The summarised, coded data was placed in an SPSS data file in order to run the Chi-square analysis.

Results

Deductive frequency content analysis was applied in this study. This approach involved coding the collected articles in terms of whether they expressed positive or negative portrayals of anxiety disorder sufferers. The aim was to test for an association between the attitude and the political leaning of the newspapers they were collected from.

The two most frequent combinations the 36 units were: the liberal-leaning outlet and positive portrayal combination and the conservative-leaning outlet and negative portrayal combination.

The Pearson chi-square analysis was applied to examine whether there was an association between the two categorical variables.

According to the test, there was no significant association between political leaning of the newspaper outlet and the portrayal of anxiety disorders as the frequencies were χ2(1) = 2,86, p>.05.

Conservative-leaning was associated with greater expression of negative portrayals as 72% of all those units coded in conservative-leaning sources provided negative portrayals (only 28% positive) while 44% of those coded in liberal-leaning sources provided negative portrayals of anxiety disorder sufferers (56% were positive).

Discussion

Begins with a statement of which of the alternate or null hypotheses is being accepted/rejected, and reference to any association found/not found. Finding then compared/linked back to previous research reviewed.

On the basis of the Chi-square test, the alternate hypothesis was rejected, and the null hypothesis was accepted, that is: that there is no significant association between the political leaning of a newspaper and the way they portray adults who suffer from anxiety disorders.

The findings of this is report do not relate to the previous conclusion that there could be an association on how liberal and conservative newspapers portray different topics. Finding no significant association between portrayal and newspapers with political stances means that conservative or liberal newspaper outlets do not portray adults with anxiety disorders either in a negative or positive way. Therefore, they do not influence on how society’s views are formed towards anxiety disorders.

In contrast to what Paxton et al (2006) and Pratto et al (1994) found this finding only mildly supports that higher conservatism is linked to greater negative or anti-equality attitudes. The analysis suggested that conservative-leaning outlets expressed more negative portrayals with 72% being a negative portrayal of anxiety disorders. Liberal outlets, however, displayed an equal amount of both positive and negative portrayals with a bit of the positive portrayals on the top with 56%. This finding might support the targeting of an audience by the newspaper outlet as generally, individuals seek a political grouping that validates their experience and views. If the newspaper shares the reader’s beliefs, they might sympathise more with the political party (Feezell 2016).

The reason more people might see adults with anxiety disorders in a negative light is that many times outsiders fail to realise that they have a real mental illness. Many consider anxiety disorder as a personal weakness rather than a mental health problem. Therefore, they think it should not be medicated and that the sufferers could snap out of it if they tried hard enough (Reavley and Jorm (2011). These are common stigmas around mental disorders which can cause the sufferer not to seek help and support because of the negative judgment. In effect many of the sufferers consider their illness to be just a negative characteristic than accepting that they have an illness.

To conclude, based on the study’s results that there is no significant association between political leaning of a newspaper and the way they portray adults who suffer from anxiety disorders but there is still, however, a notable number of negative portrayals among conservative newspaper outlets. Therefore, a deeper study could be conducted investigating the association between the amount of negative portrayals and the conservative political stance of a newspaper. another more specific research could be made by looking at the mental health disorders and their positive or negative portrayal in society or in the view of the ones suffering from mental illnesses.

During the conduction of this study, there were several method limitations. Looking at future studies there could be improvements made regarding sources, time frame and research methods. The time frame for conducting this study was no more than eight weeks, therefore for future research, it could be advised to have a longer timeframe to be able to do a deeper study in the subject.

The researcher’s background had no effect while conducting this study as being neutral was a priority while coding the data.

The data for this study was collected from UK based mainstream newspaper outlets which were either in print once or still can be found in physical form. To conduct this study, other types of qualitative data could have been used such as personal interviews or surveys. The findings of this study cannot be transferred to other types of media like television or online platforms as the results may differ. Future research could look at regional or worldwide newspapers as well as online platforms and online newspapers to gain a wider understanding of the subject. The data was collected from public domains that were subscription free. For a more qualitative and deeper study, it would be a good decision to look at data coming from a bigger range of sources that may need a subscription and are not available for the public.

To expand our understanding better in the subject there could be other specific studies made in the direction of if anyone has changed their belief thanks to a positive or negative portrayal of the outgroup. This could be conducted by qualitative research interviews.