Category: Anxiety

Introduction

Anxiety is generally described as a psychological condition which brings about distinct detrimental physiological responses which is caused as result of various external stimuli in the form of stressors which destabilize a person’s normal mental state.

In other words it is a condition with physical, mental, emotional, behavioral and cognitive effects brought by a variety of external events or factors which have a detrimental effect on a person’s well being (Alnæs, 409 – 412). What must be understood is that most individuals feel varying types of anxiety over the course of their life.

It is a natural response to tense, stressful or otherwise difficult situations which helps an individual concentrate more, develop a clearer picture of a situation and overall enables them to perform better than they otherwise would have. It is characterized by elevated blood pressure, shortness of breath, feelings of nervousness, restlessness and repetitive thoughts regarding particular actions.

When examining relevant literature on the topic it can be seen that most experts agree that anxiety responses evolved as a method of coping with unavoidable or inevitable situations wherein a greater degree of concentration, motivation as well as focus was needed in order to overcome the inevitable event or situation (Alnæs, 409 – 412).

What must be understood is that developing a certain case of anxiety after a particular event or problem is completely normal and within the bounds of average human behavior, what is abnormal though is if a person develops prolonged symptoms of anxiety which prevent them from functioning normally as a direct result of psychological stressors which manifests in distinct aberrant forms of emotional outbursts, behavioral responses or physical actions which are far from what can be considered normal behavior.

Anxiety Disorders

It must be noted that while anxiety is a common human attribute, anxiety disorders are not and are characterized by their debilitating physiological and psychological effects which hinder an individual’s ability to function normally. The five main types of anxiety disorders are classified as follows:

1.) Generalized Anxiety Disorder

2.) Obsessive-Compulsive Disorder (OCD)

3.) Panic Disorder

4.) Post-Traumatic Stress Disorder (PTSD)

5.) Social Phobia (or Social Anxiety Disorder)

What must be understood is that anxiety disorders are physiological and psychological manifestations of the effect stressors have on the body.

In average cases where anxiety is present people feel varying degrees of nervousness, apprehension, and the desire to accomplish a task and get it over with; in the case of anxiety disorders the manifestation of symptoms take on far more debilitating effects such as trouble concentrating, restlessness, sleeping disorders, depression, flashbacks of traumas, chest pains and even cases where panic attacks ensure which debilitate a person’s ability to act in a rational manner (Côté et al., 784 – 787).

Another factor that should be taken into consideration is the fact that unlike normal cases of anxiety the symptoms associated with anxiety disorders do not go away after a short period of time but rather remain for differing extended periods of time (Vroling & Jong, 110 – 112). This results in continued physical and mental stress being placed on the body which can, and often do, result in deteriorating health conditions for individuals who possesses varying types of anxiety disorders.

Vulnerability to Developing Anxiety Disorders

What must be understood is that not all individuals develop anxiety disorders or for that matter develop the same type of anxiety disorders. As mentioned earlier, external stressors play a distinct role in creating and maintaining anxiety within individuals however this particular factor is inherently dependent on a person’s lifestyle, job, living environment, economic situation as well as social condition.

Economic Conditions

Various studies examining the development of anxiety disorders within particular individuals have shown that a person’s inherent economic condition has an adverse effect on the amount of stressors they receive thus facilitating the development of various forms of anxiety disorders.

During the height of the recent U.S. financial recession it was shown that individuals experiencing job loss, home foreclosure and a variety of negative economic situations experienced elevated levels of stress and as a direct result developed distinct anxiety disorders. It is assumed that problems in relation to personal finances as well as the low job market acted as sufficient stressors which resulted in the development of elevated anxiety levels resulting in distinct anxiety disorders.

In fact numerous studies conducted over the years have shown that individuals experiencing negative economic conditions were more at risk in developing anxiety disorders as compared to individuals who were financially well off (Vroling & Jong, 110 – 115). In cases such as this it can be assumed that economic conditions act as greater stressors which result in an increased possibility in developing anxiety disorders as compared to ordinary stressors in a person’s life.

Working Conditions

Another factor that should be taken into consideration when examining vulnerabilities towards the development of anxiety disorders is the daily conditions a person experiences while working. Studies examining the prevalence of anxiety disorders as a direct result of work place environments show that the more stressful a job is the greater the prevalence of anxiety disorders within the worker population.

An examination of the call center industry in particular show that the prevalence of anxiety disorders among the worker populace is greater as compared to other industries due to the sheer amount of verbal abuse agents receive on a daily basis.

The difference in the development of anxiety disorders in this case as compared to economic stressors is the sheer repetition of anxiety causing situations on a daily basis as compared to relatively few events that occur as a direct result of economic problems. It is due to this that worked based anxiety disorders are among the most prevalent in the general population and account for more than half of current cases in the global population today.

Living Environments

Living environments should also be taken into consideration when examining the development of certain types of anxiety disorders, various studies examining the correlation between anxiety and its prevalence among local communities showed that individuals living with inner city neighborhoods namely some of the oldest sections of the city where crime and poverty are the most prevalent show greater degrees of daily anxiety pressures as compared to individuals who come from suburbs or gated communities.

It is thought that the greater amounts of security and safety people feel from living in suburbs and gated communities directly contributes to reducing the number of environmental stressors they feel as compared to individuals who deal with poverty and crime on a daily basis. It must also be noted that the level of danger in various inner city neighborhoods is greater due extent of crime and as such facilitates greater anxiety levels when travelling on a daily basis.

Biological Predisposition

Aside from the effects of external stressors it has been determined that certain individuals actually have an inherent predisposition towards anxiety and the development of anxiety disorders.

Various studies examining the behavioral characteristics of infants and their comparative behaviors when they reach a state of adolescence reveal that people with a more sensitive nucleus accumbens reach a state of anxiety or development anxiety disorders far faster and with a greater degree of prevalence as compared to individuals with a far less sensitive nucleus accumbens (Smoller et al., 965 – 968).

While there have yet to be studies to determine how such genetic differences occurred over the course of several generations within the current population group it is assumed that individuals with a more sensitive nucleus accumbens developed this trait as a direct result of environmental characteristics that have yet to be precisely determined (Smoller et al., 965 – 968).

Conclusion

Based on the various facts it can be seen that while anxiety is a common human behavioral condition, the development of anxiety disorders are not and are a direct result of various external stressors. It is based on this that it can be advised that in order to avoid developing acute forms of anxiety disorders it is recommended to avoid lifestyles choices, jobs and environments that have been noted in this paper as being primary causes towards the development of such a detrimental physiological and psychological condition.

Works Cited

Alnæs, Randolf, and Svenn Torgersen. “A 6-year follow-up study of anxiety disorders in psychiatric outpatients: Development and continuity with personality disorders and personality traits as predictors.” Nordic Journal of Psychiatry 53.6 (1999): 409-416. Academic Search Premier. EBSCO. Web.

Gilles Côté, et al. “Anxiety Disorders Among Offenders With Antisocial Personality Disorders: A Distinct Subtype?.” Canadian Journal of Psychiatry 55.12 (2010): 784-791. Academic Search Premier. EBSCO. Web.

Smoller, Jordan W., Stefanie R. Block, and Mirella M. Young. “Genetics of anxiety disorders: the complex road from DSM to DNA.” Depression & Anxiety (1091- 4269) 26.11 (2009): 965-975. Academic Search Premier. EBSCO. Web.

Vroling, Maartje S., and Peter J. de Jong. “Threat-confirming belief bias and symptoms of anxiety disorders.” Journal of Behavior Therapy & Experimental Psychiatry 41.2 (2010): 110-116. Academic Search Premier. EBSCO. Web.

Personality, mood and anxiety disorders show relevant overlaps because they have similar symptoms. For instance, anxiety is accompanied my certain mood disorders. The disorders therefore do not have major differences.

However, there are slight differences between personality disorders such as OCD and anxiety disorders. Social phobia and avoidant personality disorder have some common characteristics. The process of combining symptoms leads to wrong diagnosis of diseases. This mostly occurs to individuals with mood and generalized anxiety disorders.

Researchers often try to give a detailed explanation of anxiety and mood disorders in terms of their nature. Their research is driven by problems of taxonomy such as heterogeneity and comorbidity. Comorbidity is a situation where individuals show signs of different disorders at the same time.

The condition is caused by overlap of hypothesized elements that are considered distinct. Comorbidity therefore increases prevalence of discriminant validity when many people are affected. Although personality disorders sometimes overlap or show differences that are not clear, they are usually differentiated through three distinct methods.

The first method is used to distinguish personality disorders from anxiety and mood disorders and involves analysis of ego-syntonic features present, chronic causes and early onset of the disorders. Ego-syntonic features are elements that do not change their consistency with regard to identity of an individual.

The second method is used to distinguish anxiety disorders from depressive conditions by observing real symptoms, events and childhood characteristics. In addition, personality characteristics, indicators of differential outcome and genetic models are observed.

The third method distinguishes mood disorders from other disorders through specific methods. The diagnosis is done by observing physical impacts of medical conditions like stroke. In addition, the method focuses on the history of patients and related laboratory results or physical examination.

Introduction

In 1987 Oatley and Johnson-Laird (cited in Mogg & Bradley, 1998) supposed the evolutionary source to be the major consideration in the analysis of emotions.

For instance the primary role of the mechanism responsible for the fear emotion are to allow the identification of threat in the surrounding and to assist the organism react promptly an efficiently to the situation. The attention system in the brain facilitates the pathway for sensing and tracking environmental and interceptive signal which are related with the excitement of the organism.

Cognitive theory

Based on the current theories, biases in information encoding contribute considerably in the etiology and sustenance of emotional disturbances, including generalized anxiety disorders (GAD) and significant depressive disturbances (Beck, 1976; Eysenck, 1992; Matthews & MacLeod, 1994).

Particularly, dysfunctional schemata are responsible for information failure or loss characteristics of depression, while the schemata are receptive to danger or threat associated with anxiety, (Beck, 1976; Beck et al., 1979, 1986). The stimulation of the schemata produces bias encoding of congruent information.

Furthermore, he stipulated that susceptibility to emotional disturbances is an attribute of individual variation in the function of the schemata. For instance, an anxiety-prone person would present a hyperactive threat-schema which translates to elevated attention to external threat cues, an inclination to translate ambiguous stimuli to threat, and an amplified propensity to recall threatening incidents (Mogg & Bradley, 1998).

In 1981, Bower postulated a “semantic network theory of emotion,” wherein every emotion is denoted with a node in the corresponding network system in memory, limbic system. All the nodes are interconnected with other representation within the memory network, including the memory of happy or sad experiences.

Stimulation of a certain node elevates the stimulation of the connected nodes, resulting in encoding bias in favor of information that is harmonious with the emotion. This for instance translates to an increase in stimulation of a corresponding threat-relevant material in the network due to an increase in anxious emotions.

William et al. (1988) postulated a reviewed cognitive formulation of depression and anxiety, with the following prominent attributes;

1. Anxiety is majorly characterized by bias for threat signal in preattentive pathway and in selective attention. Based on Graf and Mandler (1984) model of memory, anxiety is related with a bias in automatic stimulation.
2. Persons who are prone to preattentive, habitual vigilance for threat excitation are more vulnerable to developing anxiety disturbances when subjected to stress.
3. Trait anxiety determines the course of attentional and preattentive biases to threat motivation. High trait anxious individuals have a chronic inclination to focus attention towards threat, while low trait individuals have an inclination towards avoidant of threat stimuli. Such focus biases are augmented by escalated anxiety. In other words, HTA persons tend to be more vigilant, while LTA tend to be more avoidant of threat. Thus, attentional and preattentive biases are an interrelated function of trait and state anxiety (MacLeod & Mathews, 1988).
4. Cognitive behavior therapy accomplishes its objective by focusing on amending the biases for threat. Thus the elimination of such biases must lessen anxious emotions and minimize susceptibility to later emotional imbalances.

In 1985 Gray argued that susceptibility to anxiety is related with personal differences in the function of the behavioral inhibitory system (BIS) of the septo-hippocampal region of the brain. The role of this area is to balance between the actual and the expected stimuli. The BIS functions in two modes.

First mode is the “checking” mode which is adapted when the real stimuli are harmonious with the expected stimuli, thereby subjecting behavior regulation function to other systems of the brain especially those concerned with enduring goals accomplishment. The other mode is engaged when the real and expected stimuli are discordant, or when the expected stimuli are not compulsive; ‘control’ mode.

Clearly, anxiety is major attribute of BIS activation which is associated with threats of disappointment or penalty, uncertainty and novelty. BIS excitation produces an inhibition of continuing behavior process, escalated arousal and intensive attention to vicinity stimuli. Therefore, the BIS in anxiety-prone people are highly sensitive which attributes them to hypervigilance to prospective threat stimuli in the background (Mogg & Bradley, 1998).

According to LeDoux (1995), anxiety is majorly associated with the brain system responsible for processing threat impulses. His model of anxiety speculates that the thalamic and amygdale neural pathways facilitate prompt major evaluation of threat stimuli, via quick assessment of stimulus path characteristics. Other structures, associated with the cortical and hippocampus networks influence such evaluation process by preparing feedback on the situational context and stimulus characteristics relevant to information bias.

The amygdala not only receive ‘quick-and-dirty’ thalamic signals that facilitate rapid reactions to restricted stimulus information, but also a comprehensive stimulus information through inputs from relatively longer and slower networks. Thus amygdala contributes majorly in assessment of threat by virtue of integrating information from various sources. Furthermore, when the amaygdala receives input from threat stimulus, it may influence an array of cognitive mechanisms, such as perception, explicit memory, and selective attention.

There are various perspectives psychologist may adopt in his or her approach of psychological issue. These different perspectives may be cultural, evolutionary, biological, cognitive, humanistic, behaviorist or psychoanalytic. Although majority of psychologist appreciate the value of each perspective, they concede that no perspective can solely offer a complete solution to a psychological problem.

Therefore, contemporary psychologists often adopt an eclectic, applying principles and methods from various perspectives that are relevant to the issue at hand (“Chapter 1: introducing psychology,” n.d).

Psychology students start by appreciating a single perspective and then more perspective as they progressively gain knowledge concerning each perspective. Often they come to appreciate the importance of each perspective in relevance to a specific situation as they continuously relate to psychological principles in their daily live challenges (Beck, Emery, & Greenberg,1985).

For instance they can recognize the significance of behaviorism in teaching their dog not to attack people or in rehabilitating themselves from smoking, as well as the significance of humanism in promoting a sense of accountability for their own lives (“Chapter 1: introducing psychology,” n.d).

Psychological research

A psychological research is driven majorly by two factors that include; the inability to integrate a new concept, and a drawback in the existing theories. A psychological research is step by step formal undertaking based on the following perspectives. First, conceptual skills are applied to develop a theory for the phenomenon of interest. Second, deductive logic is implemented in order to establish the hypothesis based on the theory. Third, researchers gather data methodically based on the research design.

Fourth, the inductive principle that underpins the experimental design allows exclusion of some prospective analysis of the data. Fifth, relevant statistical techniques are deployed in the tabulation and interpretation of data. Finally, deductive reasoning is applied to arrive to a theoretical conclusion. Eventually, the accomplishment of the research undertaking relies on a confluence of conceptual, methodological, meta-theoretical and statistical proficiency (Chow, 2002).

Psychologist may focus on specific aforementioned perspective(s) and neglect other concerns. Hence, psychologist employs a wide range of research methods. Perhaps, this may create the impression of essential methodological disparity within the psychology fraternity. Although this conflict is not necessarily objectionable, it is believed that concession of the philosophical and meta-theoretical issues will help shift the methodological contradictions within the fraternity into a better perspective (Koster et al. 2006).

For instance, prior to deciding if empirical research should be based theoretically on data or conceptually by theory, it is important to primarily establish if there is a plain observation in the research.

For instance, prior to deciding if empirical study should be based conceptually on theory or theoretically on data, it is important to establish primarily that it will involve plain observation. Simultaneously, acknowledging that observation made in the research process depends on theory, a question whether it is proper to dismiss the possibility of objectivity, especially when the professionals appeal to the mind, the incorporeal unit (Chow, 2002).

Psychological phenomena are explained based on the hypothetical mechanism which portrays the theoretical properties of interest. Thus, the following questions emerge from this conviction. First, do psychologists depict inconsistency when they employ psychometric or statistics tests? Second, how can a researcher employ quantitative data to substantiate qualitative theories? Through which means do psychologists replicate the data collected from a designed research to a real-life event?

What is the justification of empirical research in psychology? By what techniques can psychologists evaluate their research study? (Chow, 2002).

Bias to threat in High trait anxiety

High trait anxious individuals (HTA) have been revealed by numerous researches to express increased attention to threat compared to low trait anxious individuals (LTA). A research conducted by Koster and colleagues (2005), an investigation to elucidate “whether the intentional bias is related to facilitate intentional engagement to threat or difficulties disengaging attention from threat” (Koster et al., 2005),

The research involved HTA and LTA undergraduates on whom an altered exogenous prompt task was performed. The situation of the target was accurately or inaccurately signified by highly, mildly and neutral threatening images. The findings depicted that the at 100ms image presentation, HTA subjects engaged their attention more intensively and portrayed more impaired disengagement from highly intimidating images relative to the LTA counterparts.

Moreover, HTA subjects depicted a stronger trend towards attention evasion of threat at 2000 and 500ms presentation. Theses information supports differential characteristics of anxiety-based biases in attentive manifestation of threat during the initial phase relative to later phase of information development (Wilson, & MacLeod, 2003).

Attention bias in emotional disorder

Based on MacLeod, Mathews, and Tata (1986), recent research purports the relationship of anxiety with the processing prejudice that promotes the storage of volatile information. Nevertheless, the accessible data can be encoded via alternative explanations, such as bias accounts (Mogg, Mathews, & Weinman, 1987).

This study approaches the interpretive challenge from a novel paradigm that helps overcome the challenge. This is achieved by requiring participants to express a neutral, response by a button dial to a neutral signal signified by a dot probe. The situation of the probe was altered on a visual display unit (VDU) screen consistent with the words exhibited visually, which denoted either threat or neutral connection (MacLeod, Mathews, and Tata 1986).

This study relied on probe sensing latency information to establish the effects of the threat-centered stimuli on the spread of visual concentration. It was found that the clinically anxious subjects regularly focused attention on threat words, translating to decreased detection latency for probes associated with the corresponding location of the stimuli.

On the other hand, normal control participants, inclined to swing attention distal from such stimuli. The findings approved the existence of anxiety-based data encoding bias, suggesting that such cognitive mechanism may be partially responsible for the sustenance of such mood disorders (MacLeod, Mathews, and Tata 1986)..

Participants were required to undertake a full cycle of the Mill Hill Synonym Test, Beck Depression Inventory, and Spielberg State Anxiety Inventory (Section B of the Mill Hill Vocabulary Scale). They were position to view the VDU screen and instructed to read aloud the word which will present at the top or bottom of the screen. In certain cases a dot probe will persist in one of either site the two words showed, and the subjects were needed to promptly press a certain button (MacLeod, Mathews, and Tata 1986).

Analysis of anxiety

Proof of attention and pre-attentive biases associated with anxiety is analyzed from a cognitive-motivational approach. This analysis purports that susceptibility to anxiety emerges majorly from a lower a threshold for assessing threat, instead of a bias in the perspective of attention execution (Cohen, 1988).

Therefore, stimuli that are perceived innocuous are evaluated as those of higher subjective threat value by relative to the low trait anxious individuals. Further, it is speculated that every person inclines to stimuli that are deemed more threatening. However, this supposition is opposed with other latest cognitive replica of anxiety (Mogg & Bradley, 1998).

Selective attention to threat

“The dot probe task” (J of Abnorm Psychol 95, 1986) is commonly used approach for examining selective attention to threat. An induced reaction to probes that show at the corresponding site as the threat information in relation to the reactions to probes situated on the opposite site as the threat information is denoted as vigilance to threat assumption (Koster, Crombez, Verschuere, & Houwer, 2003).

Mackintosh, & Mathews (2003) argue that the outcomes in the dot probe approach are ambiguous proof of the vigilance to threat assumption. In addition the findings can also be translated as a problem to separate from threat.

The research involved a survey of 44 undergraduates who performed probe detection task employing pictures as stimuli. Considering the response times on neutral trials, there was no proof for induced detection of threatening stimuli. Conversely, it was discovered that the dot probe result were partially an attribute of separation consequence (Fox, Russo, & Dutton, 2002).

First subjects were taken through the entire State Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983). The subjects were seated about 60 cm from computer screen to do the probe detection task which comprised of 12 rehearsals, two buffers, and 80 trials.

All trials commenced with an attachment cross which was portrayed 1000 ms at the center. Subsequently, duo pictures presented 4.4 cm on top of each other (Mogg, et al., 2000). for 500 ms. A small dot probe promptly (14 ms) presented in place of one of the images following the offset of the pictures (Koster et al., 2003).

The participant were required to show the site of the probe with a press of either of the two button promptly and precisely on AZERTY keyboard. This involved left index finger corresponding to the q key for a probe presentation at the top and right index finger corresponding to the 5 key for the probe presentation at the bottom.

The presentation of the dot probe often accurately corresponded with that of the previous image presentation at the alternate site on the screen, and the sequence of trials was randomly selected for all the subjects (Koster et al. 2003)..

Following the completion of the experiment, the subjects were requested to rate provocation and valence of the high-threatening (HT) and minimal-threatening (MT) images based on the self-evaluation manikin (Lang, 1980). This enabled the researchers to determine if the ratings of the subjects were consistent with the normative ratings. As a result of time limitation, just half the subjects were able to rate the five HT and five MT images. The remaining half of the subjects rated the 10 HT images (Koster et al., 2003).

Anxiety versus picture stimuli

Former researches employing search tasks has depicted an anxiety-based bias supporting attention to threatening phrases when they are displayed in synchrony with emotionally neutral phrases (Yiend & Matthews, 2001).

In the first experiment utilizing the same task, a corresponding consequence was accomplished with instead emotionally threatening pictures as stimuli. In this experiment two cohorts scoring high or low based on personal-report evaluation of anxiety, observed threatening or non-threatening couples of pictures (Lang, Bradley, & Cuthbert, 1999) displayed simultaneously on a monitor for 500ms.

Then either stimuli of interest presented in the site formerly occupied by one of the images, and the subjects were required to reply by dialing a corresponding key. Latencies to sensor such targets were applied to index the extent to which cohorts especially presented to mildly or highly threatening images (Yiend & Matthews, 2001).

The trials with error comprised 3.5% of the critical data which were then disqualified. Also 0.7% responses which had latencies above 1,100ms were omitted as outliers, using a box plot of the spread. A mixed-design analysis of variance (ANOVA) was performed on the averages of the residual data (Yiend & Matthews, 2001).

In a second experiment using pictures as site cues, high-trait anxious participants were slower compared to the low-trait anxious controls with regard to the response to stimuli requiring attention disorientation from threat (Derryberry, & Reed, 2002). They were found to be slower in overall highly threatening images (Yiend & Matthews, 2001).

In this experiment the trials were categorized into valid, invalid and no-cue. An arrow pointing up or down was used to signify a valid trial showed in the same site as the as the preceding image cue, on the right or left of middle fixation cross. The target arrow for the invalid trials showed on spatial location converse to the preceding image cue.

Whereas on no-cue trials no image was shown, as the computer screen remained blank for a similar duration before the presentation of target. Out of a total of 240 trials, 180 comprised the critical, of which were divided equally among the three categories. An additional 60 valid filler trials were excluded in the interpretation, so that the predictive credibility of the valid trials is sustained (Yiend & Matthews, 2001)..

A third experiment applying the same task but employing a prolonged cue exposure, revealed a connected disorientation problem across the two groups (Fox, et al., 2001)., while the more basic slowing associated with serious threat was similarly limited to the anxious population. Conclusively, attentional bias concern a particular problem in disorientation attention from the situation of any threat stimuli as well as a more basic interference effect associated with the degree of threat (Yiend & Matthews, 2001).

Reference List

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Matrix template

Causes of anxiety, mood and dissociative disorders

Biological components

Anxiety, Mood and Dissociative disorder involves malfunction in various physiological elements including:

The Autonomic Nervous System

The sympathetic division stimulates survival responses to perceived threats by signaling the adrenal glands to produce adrenaline and noradrenaline, which induces the heart to beat faster, increase breathing rate and intensity, dilate the pupils, and tense the muscle. An animal flees or attacks upon sensing danger because of extreme arousal of the sympathetic nervous division. The parasympathetic system reverses the activity of the sympathetic system when the danger passes, and restores the body to its resting, pre-anxiety state.

Panic attacks arise due to stimulation of the fight-or-flight response that happens inappropriately even without any actual threat. Individuals with history of panic attacks often tend to develop an intense panic attacks whereas individual without history of the attacks will not. This trend implies previous experience of threat have been encoded in the brain.

Neurotransmission

• Gamma-aminobutyric acid (GABA) functions as an inhibitor in the central nervous system to suppress neurological activity. GABA induces calm in the limbic system after it gets overexcited (Hansell & Damour, 2008, p.35). Seemingly, GABA does not work effectively in the brains of individual afflicted with extreme chronic anxiety, as is the case in GAD.
• Norepinephrine is the major neurotransmitter in locus coeruleus, which is associated with sympathetic nervous system. Under-activation of locus coeruleus results in inattentiveness and drowsiness, while over-activation results in distractedness and disorganization. The locus coeruleus becomes hypersensitive when conditioned to fear response, so that it fires even with slight stimulation. Scientists attribute Panic attacks to hypersensitivity of the locus coeruleus to Norepinephrine. Chronic experience of extreme stress may raise the sensitivity of norepinephrine brain receptors (Hansell & Damour, 2008, p. 36). The hypersensitivity translates to overstimulation of the sympathetic nervous system and subsequently the fight-or-flight response.
• Serotonin can elicit anxiogenic and anxiolytic effects based on the region of the brain of its release or the type of receptor it stimulates. Serotonin hypoactivity exposes the fight-or-flight system to slight stimulation leading to recurrent panic attack.

Autoimmune Disorders

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections [PANDAS] is a disease in which children who suffer from strep throat infection develop symptoms of OCD. Researchers speculated that antibodies that emanate from immune response to streptococcal infection interact with basal ganglia and caudate nucleus, leading to OCD.

Genetic factors

Genetic material underlies the physiology of the system of an organism. Genetic factors account for 30 to 50% people vulnerability to suffer an anxiety disorder. Nevertheless, the magnitude of genetic impact varies remarkably among the DSM-IV-TR disorders.

Panic disorders seem to be especially heritable; lifetime frequencies of panic disorders in first-degree relatives of individual indicated with the disorder ranges from 7.7 to 17.3% against a range of 0.8 to 4.2% in first-degree relatives of people without panic disorders (Hansell & Damour, 2008, p.36). A specific genetic anomaly that contributes to disturbances in neurotransmission of glutamic acid may be responsible for an early onset of OCD.

Cognitive component

Cognitive component of mood disorders include rumination and hopelessness. Rumination means a continual obsessive thinking about something, while hopelessness means a sense of lack of control about the future and that there is nothing optimistic in the future.

Anxiety patients tend to misjudge events in couple of ways viz. they preoccupy on perceived threats and dangers, they overestimate the seriousness of the perceived threat or danger, and they overly underestimate their capacity to adjust to the dangers and threats they anticipate.

Maladaptive assumptions and ideas influence the sufferer’s thinking and lead them to misconceive events. This can lead to self-stereotyping such as “Unless I do things perfectly, people will think I’m an idiot” (Hansell & Damour, 2008, p.47). Maladaptive ideas are pessimistic expectations concerning the relationship between behaviors and repercussions.

Emotional component (The Limbic System)

The Limbic System forms the basis for emotional responses (including anxiety), learning, inspiration, and some aspects of memory. It comprises of three division including amygdala, hippocampus, and hypothalamus.

The amygdala measures the emotional significance of impulses it receives from the brain cortex, and the encoding of memories seem to involve alterations in the neural course of the amygdala and the Hippocampus (Hansell & Damour, 2008, p.34).

The amygdala relays information to the hypothalamus, which is supposed to be responsible for encoding conditioned emotional responses.

For instance, when a person with a snake phobia sees a snake, the amygdala process the visual input in conjunction with the hippocampus to decode the emotional impact of the snake, and then relay a warning signal to the hypothalamus to activate emergency response (fight-or-flight response).

Behavioral component

Scientists have based behavioral component of disorders into classical conditioning, operant conditioning, and modeling theories. Based on classical conditioning, a phobia can be developed when a neutral stimulus that does not normally elicit fear occur during an intense fear response to a terrifying stimulus.

Based on operant conditioning, once individuals develop a phobic response, they express avoidance of what they fear. The operant conditioning theory posits that people negatively reinforce such avoidance behavior because it removes them from feared unpleasant circumstances (Hansell & Damour, 2008, p.33).

Finaly, prepared conditioning hypothesis that people may express genetic predisposition to fear stimulus inherited from their ancestors.

References List

American Psychiatry Association. (2000). Diagnostic and statistical manual of Mental disorders: DSM-IV-TR (4^th Ed.). Arlington: American Psychiatry Association.

Hansell, J., & Damour, L. (2008). Abnormal Psychology (2^nd Ed.). New York: John Wiley & Sons Inc.

The article by Orsillo, Roemer and Salters-Pedneult (2008) involves a study on the effectiveness of an acceptance-based behavioral therapy (ABBT) designed to enhance the reception of internal experiences. The study was also aimed at encouraging action in significant areas of Generalized Anxiety disorder (GAD).

The study involved 31 participants selected from a list of patients who sought CARD treatment at different times between 2003 and 2005. The treatment was randomly administered to 15 of the 31 clients while the remaining 16 clients formed the waiting list control.

During the procedure, two participants left the therapy while another four left the waiting list. Participants in the waiting list received delayed treatment. The participants were required to be over 18 years old.

Assessments were based on both primary and secondary measures. Primary measures involved the analysis of anxiety and worry while secondary measures accessed the level of depression, quality of life and suggested techniques of change. Current and lifetime DSM–IV diagnostic status was checked using the Anxiety Disorders Interview Schedule for DSM–IV—

Lifetime Version. Each diagnosis was accessed according to the clinical severity rating (CSR), which ranged from 0 to 8. The indicators of anxiety used in the study included an anxiety subscale of 0.79, and a stress subscale of 0.87.

Secondary outcomes were measured using a Beck Depression Inventory (BDI) of 0.87, and a measure of life satisfaction of 0.836. The 9-item scale was used in the test due to its sensitivity to change, as well as enhanced internal consistency.

Treatment for the waiting list was administered 14 weeks after the consent meeting. Individual assessments of the clients were conducted by a CARD assessor immediately after the treatment was administered, and again after 3 and 9 months.

The first four sessions took 90 minutes while the following 12 sessions took 60 minutes. The treatment process was aimed at enhancing various characteristics of clients including alertness to typical anxious responses, the function of emotions and the objective of judgment and pragmatic evasion in cases of absurdly worsening grief.

Assessments were also made using psycho education, pragmatic demonstrations and between-session self monitoring. The clients were also encouraged to develop mindful awareness to actions and avoid valued activities.

The analysis of results was carried out using Hierarchical Linear and Nonlinear Modeling software program (HLM). The results were observed to be consistent. The next measure involved the analysis of uncontrolled effects, as well as the evaluation of treatment gains for all clients.

The pretreatment assessments of the waiting list participants were based on their post treatment assessments. Various clients missed different follow-up assessments, as well as self-report measures.

The results of the study showed that the treatment administered had a considerable effect on both Generalized Anxiety specific outcomes and depressive symptoms. Effects that reached level four were found to be significant.

These effects comprised symptoms of self-reported anxious arousal, quality of life and clinician-rated additional diagnoses. The changes identified due to ABBT after 9 months of the study were identified to clinically significant and durable.

Some limitations were noted during the study. For instance, the waiting list control was flawed since it did not eliminate the possibility of affecting nonspecific factors. It was also noted that longer follow-up periods were necessary in order to evaluate the durability of the effect of the treatment.

The CARD assessors were also considered to be biased due to their involvement with some of the clients. Future research should incorporate competency ratings to identify the degree of treatment based on the efficacy of delivery of the intervention. In addition to this, the study should include participants from a wide racial and ethnical background.

What is meant by this statement: “Death anxiety is a multidimensional concept”?

The idea that death anxiety can be discussed as the multidimensional concept means that it is impossible to explain the notion of death anxiety from only one perspective because researchers determine four types of concerns associated with the concept which form death anxiety, and these researchers also determine eight types of fears which are typical for people while discussing the concept of death.

As a result, the main concerns which cause people’s suffering are the death of self, the deaths of significant others or loved people, the aspects associated with the process of dying, and the specific state of being dead (Leming & Dickinson, 2011, p. 65).

While concentrating on these dimensions of the death anxiety, it is possible to determine such concrete fears as the fear of dependency, the fear of the pain experienced in the dying process, the fear associated with the indignity in the dying process, the fear connected with separation and rejection as the aspects of the dying process, the fear to leave close and loved people, the fears associated with the aspects of the afterlife, the finality of death, and the fears connected with the fate of the person’s body (Leming & Dickinson, 2011, p. 65).

This is the fact that the concept of death anxiety is multidimensional because different people concentrate on different fears which form four main concerns. In spite of the fact that people’s fears are grouped and classified, they can also be different in relation to the intensity of the expressed fear.

Furthermore, death anxiety is also influenced by the variety of factors such as the persons’ perceptions of their possible deaths, persons’ experiences associated with the others’ deaths, and people’s feelings of helplessness and depression (Leming & Dickinson, 2011, p. 66).

Depending on the factor which can influence the person’s vision of death, death anxiety can also be associated with the development of phobias (Princy & Kang, 2013, p. 637).

The discussion of death anxiety as the multidimensional concept can also be supported with references to the statistics received with the help of Michael Leming’s scale. Thus, the fears affecting the notion of death anxiety can differ in their popularity among people.

According to the survey on the problem, 65% of persons are inclined to focus on fears of dependency and pain in the process of dying as the causes for the anxiety; and 15% of persons demonstrate the significant anxiety related to afterlife concerns and fears about the body’s fate (Leming & Dickinson, 2011, p. 68).

Although there are many fears associated with death, the process of dying and sufferings make people experience the most significant levels of death anxiety.

The multidimensional character of the concept of death anxiety is also observed with references to the fact that the levels of anxiety are various in relation to genders and different age groups. Thus, the level of death anxiety decreases, if persons become older.

Moreover, the level of death anxiety is higher in relation to women while comparing their reactions with men’s ones (Leming & Dickinson, 2011, p. 68). Women are inclined to react to deaths more emotionally when men demonstrate rather optimistic attitudes to the notion of death, as a result, women suffer from the high levels of death anxiety more often (Princy & Kang, 2013, p. 641).

From this point, the concept of death anxiety cannot be examined only from one point or position because of its multidimensional character.

References

Leming, M., & Dickinson, G. (2011). Understanding dying, death, and bereavement. Belmont, CA: Wadsworth Cengage Learning.

Princy, P., & Kang, T. K. (2013). Death anxiety (Thantaphobia) among elderly: A gender study. Indian Journal of Gerontology, 27(4), 637-643.

Living in a fast and overcrowded world, people usually act in the condition of constant stress and tense. The cases of abnormal behavior and some other disorders have increased recently in society. Considering the abnormal behavior of people, the following disorders may be identified, such as anxiety, mood or affective, and dissociative or somatoform, which have different diagnoses, symptoms, and criteria, which may be analyzed from the point of view of biological, emotional, cognitive, and behavioral perspectives.

People’s abnormal behavior is usually characterized as “behavior that significantly differs from some consensually agreed upon norm and that is in some way harmful to the differently behaving person or to others” (Meyer, 2006, p. 1). The main behavioral disorders, which are identified among others, are anxiety, mood or affective, and dissociative/somatoform disorders. All these disorders have biological, emotional, cognitive, and behavioral characteristics, which have some specific identities if to consider them from the point of view of different disorders.

Considering anxiety, the definition of this disorder may be given as follows: anxiety is the emotional suffering, which bothers people by means of fears and anxious behavior. Anxiety may be discussed from different perspectives, such as behavioral, emotional, cognitive, and biological, and the symptom, which these perspectives identify, may be helpful in the diagnosis implementation. The specific diagnosis, from the cognitive perspective, is the difficulty in concentration, problems with memorizing things, and concentration on different things and conversations. Turning to emotional diagnoses, the following issues may be pointed out, abnormal worry, which is characterized by feelings of unexpected worry and anxiety without any visible reasons, and restlessness, constant worry, and inability to relax. Sleep disturbance, which is found out by sleeplessness and unexpected wakes up at night, and irritability, the main features of which are nervousness, inability to calm down, and crying and hysterics without any reason, are the behavioral perspective of the problem. The biological component, which may be identified in the discussed case, is muscle tension, which is characterized by the constant pain and stress of the whole body in muscles (Hansell & Damour, 2005). The combination of all these symptoms may never function in one person, so the diagnosis should be provided separately to every person, as well as the treatment.

Discussing mood or affective disorder, the main characteristic of which is fast and often change of the emotional condition of the person, the two main types may be identified, bipolar disorder and depressions disorder. The main feature of this type of disorder is that it may be characterized only from emotional and behavioral perspectives. To be more specific, there are three diagnoses, which may be stressed, schizophrenia, mania, and depression (in general, there are a lot of diagnoses as the mental condition of every person is different as well as the number of symptoms and diseases are varied). To put additional light on the problem it may be stressed that the attempts of subsiding are usually noticed in people who suffer from mood or affective disorder. The criteria, according to which the diagnoses may be identified may be behavior and emotional in the discussed disorder, as it was mentioned. The behavioral disorder may be viewed in the cases when a person withdraws from society, acts in theatrical roles, provides some aggression or just his/her behavior is changeable fast and rapidly. Delusions, hallucinations, disinterest in life, rapid change of mood, the feeling of constantly being watched, dissatisfaction with life, unwillingness to speak to anybody, and sad mood are the general emotional criteria, according to which mood or affective disorder may be identified (Hansell & Damour, 2005).

Analyzing the dissociative or somatoform disorder, the core idea of the problem should be explained. Dissociative or somatoform disorder is characterized as a problem, which occurs on the conscious level with the body organs without any visual trouble with them. The definition is rather confusing and should be discussed. The person feels some problem with his/her health, some pain in organs or inability to operate some simple actions, but the problem is not in the body organs, but in mind, as all signals to a person’s body comes through his/her brain. From the biological perspective, the following disease may be diagnosed through the following symptoms, blindness, amnesia, tingling or crawling, extend or loss of pain, paralysis, troubles in the functions of the body parts, problems with the inner processes, such as swallowing. It should be stressed one more time that all mentioned symptoms should not have any physical signs, such as stroke or other mechanical damages, only in this case the problem will be considered as mental and may be treated from the discussed perspective. The dissociative or somatoform disorder may be also identified from the behavioral point of view when in the combination of the mentioned above problems the desire to escape from people is observed (Hansell & Damour, 2005).

In conclusion, anxiety, mood or affective, and dissociative or somatoform, were analyzed from the point of view of biological, emotional, cognitive, and behavioral perspectives. The conclusions were made that the symptoms of different diseases may coincide, but the aim of the specialist is to combine them in the proper way and to provide the patient with the correct treatment.

Reference

Hansell, J., & Damour, L. (2005). Abnormal psychology. Hoboken, NJ: Wiley.

Meyer, R. (2006). Case studies in abnormal behavior. (7thed.). Upper Saddle River, NJ: Pearson.

The book Status Anxiety by Alain de Botton describes social problems and psychological distress experienced by modern people. The author claims that mny people are unable to fulfill the American dream and achieve high social position in society valued and preached by the majority. Low social status leads many people to distress, anxiety and loneliness. The ability to bind anxiety, to perform effectively in the face of inner turmoil, is a characteristic associated with higher levels of ego functioning, such as would ensue from formation of an identity. One caution about interpreting studies of anxiety among the identity statuses is that most of these have used paper-and-pencil self-report measures, which yield the estimate of anxiety that a subject is willing to report. In general,

The first part of the book describes problems caused by social inequality and inability of people to reach a desired social status. Alain de Botton defines the main outcomes of low social status: lovelessness, expectations, meritocracy, snobbery and dependence. Although differences among social statuses in stability of self-esteem were established in early studies, findings have not been clear on absolute levels of self-esteem. One problem in this research area is the differing theoretical definitions of social status anxiety. Within the ego psychoanalytic theoretical context of the identity statuses, social status ought to refer to the similarity experienced between one’s personal attributes and one’s ego ideal standards, a match that should improve in adolescence as the unrealistically high goals of childhood introjects are modified. The identity formation process of questioning, exploration, and commitment is central to this modification. Low achievers, who have not undergone the differentiation process, should have unrealistically high ego ideals and correspondingly low self-esteem. Social achievement persons should have a more realistically reconstructed ego ideal and higher resultant self-esteem. Some evidence for this description was found in low achievers tendency to maintain and even raise their goals in the face of failures on a concept attainment task and their tendency toward underachievement density-self-esteem relationship awaits the construction of a more theoretically relevant measure. The main advantage of the book is that it proposes numerous historical examples and illustrates arguments and standpoints of the author.

Alain de Botton admits that what makes these psychological responses negative is that they are proffered by the dominant cultural group with a patronizing, even condemnatory attitude. The transaction serves to prop up the chauvinism of the master group. Sadly, its victims occasionally yield to the force of convention and accept the roles proffered so as to survive in a hostile environment. For this reason, acquiescing to a stereotypical negative identity leads to self-hate. This feeling, which is often intensified in the identity crisis of youth, accounts for the more irrational manifestations of anarchic and radical attitudes. In contrast, the success of one’s positive identity generates feelings of self-mastery and ego gratification. The “black is beautiful” movement and the Native American “first peoples” movement capture the meaning of symbolic power over one’s own cultural role structure. The issue of identity may, however, be dealt with in other ways–and there are political risks involved. For many, and perhaps for most, identity is conferred rather than achieved. One’s caretakers, perhaps in league with social pressures, present a finished identity to the young person. In the most definite mode, the process of identity formation is foreclosed either by circumstances or by the individual’s own acceptance of what is offered. There is a sense of identity as a result, but it is not seated in the individual’s own psychological maturation. Finally, there may be a failure to achieve a sense of identity. The resulting identity diffusion becomes a troubling impediment as the individual confronts the subsequent challenge of intimacy vs. isolation and the remaining elements of the life cycle. Here the problem is that neither competence nor integrity nor mutuality seem to be within reach. The term aimless denotes the result for those suffering from identity diffusion. Serious social class diffusion needs to be distinguished from role confusion, which is an occasional problem for all individuals, and an identity moratorium, where vital processes are at work to make identity achievement possible. The differences in social statuses’ reported anxiety are likely to be obtained for differing reasons. Many underachiever are in a stressful, in-crisis state, and because they tend to be excruciatingly honest. Underachievers may score low both because it may be a particularly adaptive status in some groups in certain historical periods, and because they are reluctant to admit pathology. The latter is reflected in their high social desirability scores

Alain de Botton is right that the individualist position is indeed merely a justification for private aggregations of power and the untrammeled ability to enforce self-preferment through the use of that power to shape social forces that affect others to their disadvantage. At the core of politics is the existence of power in society. Coercion is only one aspect of governance, however. Governance encompasses the voluntary as well as the coercive. Legitimate authority is characterized by voluntary compliance. In modern society, social equality acquires its legitimacy through voluntary participation. A theory of politics must have a conceptual basis for understanding both the voluntary and the coercive aspects of governance. Moreover, this suggests that the nature of the coping response (active avoidance, passive tolerance, or depressive withdrawal) may determine the type of problem that develops as well as the course of the illness. The diathesis-stress model proposes further that subsequent maladaptive physiological responding such as increased and persistent sympathetic arousal and increased and persistent muscular reactivity may induce or exacerbate pain episodes

In order to overcome anxiety, negative feelings about status and personal worth, in the second part of the book, Alain de Botton proposes the following techniques: new life philosophy, involvement in artistic activity, political role in society, religiosity and bohemianism. Life philosophy can be interpreted as one’s assignment of responsibility for what befalls oneself either to an external (luck, fate) or an internal source. Because they have undergone a self-constructive identity formation process, individuals high in identity are expected to be more internal, and underachievers are expected to have a more external orientation. These results were found for men, for women, and for men and women. Achievement people are to be somewhat more internal than the other statuses. The Underachievers apparent internal orientation reported here may be due to socially desirable responding. In summary, social achievements tend to have an internal locus of control.

Having formed an initial social identity at late adolescence (social class achievement), an individual might be expected to undergo subsequent social class cycles. Some people proceed through adulthood with their initial identity resolution unreconstructed and seem like underachievers. Studying identity development in adulthood, “openness to experience” predicted identity flexibility in adult men and women. Thinking along similar lines, there are two variables thought to predict to life-span identity development: dialectical reasoning and an experiential (as opposed to instrumental) outlook. Whether these variables will predict for adult development remains to be seen. The second reason for changes in status ordering has to do with changes in social conditions: there has been a pattern of increasing support for women undergoing the choice and struggle involved in the identity development process.

Alain de Botton proposes a detailed account of coping strategies techniques for those people who experience personal problems connected with low class location. He states that perfection of the developmental process is rarely achieved but that the objective is to acquire needed sources of strength in dealing with the contested terrain between somatic development and social circumstances. Everyone is shadowed by negative identities that threaten and confuse daily life, but the key is to have the means of coping with, or even mastering, the urge to give in to the negative typing of oneself or others. The best countersuits lie in demonstrating competence, working out sensible ways of becoming integral in a community, and carrying through on a commitment to mutuality. n the absence of tolerance, democracy falls prey to demagogy and the coercion of the minority by the majority. political formations have a considerable impact on identity, but they do not constitute identity, except in extreme cases. The individual social state can limit or prevent the pathologies of discrimination, exploitation, and domination by means of coercion, example, or the indirect effect of policies that remove the conditions for the emergence of these pathologies. Similarly, the state can play a constructive role in providing developmentally critical choices to individuals who do not have essential options available. Policies in areas of child care, education, health, and economic opportunity play a crucial role in enriching the environments within which identity is formed. What is needed is a method for avoiding the extremes. The perversion of group relatedness into aggressive pseudo speciation, as the research on authoritarian and stereotypical thinking illustrates, is seemingly at least as easy as the selective reinforcement of those aspects of group identity that are productive. We now turn to the question of how democracy may be constituted so as to become just such a method. Identity analysis is consistent with the view that learning takes place not through the revelation of divine truth, or of an absolute morality, but through the working out of relationships between individual promptings and social interactions.

People cannot be false to our individual talents and find a true identity. Nor can we assert a wholly idiosyncratic identity and expect that it will be ratified as a form of competence by the community. Similarly, experience teaches us that the failure of mutuality is debilitating, just as the sustenance of it is rewarding. The assertion of a version of our place in the world that has us, or our group, in some status of exclusive privilege is bound to be undone in the test of human interaction. The interesting question is how we can translate this sort of learning to the level of a political process that will yield sensible policies that support human development. By this test, private centers of power would be required to give way to public forms of decision making in community decisions. The justification provided here is not so much that the majority may know the truth as that, given the inevitable power of social forces over individual life, the shaping of those forces should reflect the widest possible participation of the community under conditions most likely to produce a wise application of social knowledge.

Self-preferment is, by its nature, particularistic and dispersed just as knowledge is, and the former is known to corrupt the latter. The purpose of democracy is to mobilize knowledge while limiting the effects of self-preferment. The double test of an argument in a properly deliberative democracy is whether it makes sense or not, and whether it is socially useful or merely self-serving. Because democracies might well simply aggregate the self-preferring decisions of a majority at the expense of minorities, we have constitutions designed to place boundaries on such preferences, even while establishing processes that include the open pursuit and free expression of knowledge. Yet, to say that knowledge is dispersed and particularistic does not mean that it cannot be communicated, shared, and validated by communities. It is the control of knowledge at the community level that contains the seeds of tyranny, not the nurturing and aggregation of shared experience in a democratic society.

Social participative processes need to incorporate means of communication that facilitate exchanges whereby differing visions can be expressed of the integrative principles that tie communities together. These principles can make it possible for individuals to bring into balance the particular and universal aspects of their own strivings for identity. Some of the greatest abuses of democracy in this century have been systems that are inclusive in the plebiscitary sense only–where everyone has a voice, but the voice can only say yes or no to the leader. The analogue is public opinion polls that ask yes or no questions on taxation without regard to fiscal realities. The latter may provide some kind of useful information but no realistic participation in effective decision making. Particularist approaches in the name of identity politics can likewise threaten democracy. Where there is only the demand for “voice” without any consideration for shared values or common needs, there is the potential for rising levels of insecurity and the fragmentation of community. Identity in its social dimension is an interactive process.

In sum, the book proposes an interesting interpretations and discussions on social class, social status and coping strategies. Alain de Botton clearly explains that assertions of worth that are not grounded in shared values lead to counter assertions from threatened groups. The concept of personal identity advanced here suggests that the building of respect on the basis of various kinds of competence, contributions to the integrative purposes of the community, and the demonstration of mutual commitment and sustained effort at progressive reform are the building blocks for a lasting recognition of diversity. Participation has an explicitly qualitative dimension. The forms of participation that foster mutuality and the inculcation of a shared sense of responsibility are essential aspects of democracy. A state that is run as if it were a shopping mall where many gather solely for the purpose of individual self-interest will not survive very long. Personal emotional traditions that institutionalize accountability, responsibility for collective decisions, and the careful development of leadership make possible the governing of large, complex communities. Various kinds of partnerships, cooperatives, and profit-sharing plans serve the purposes of democracy in smaller associations. The book would be interesting to everyone studding psychology, sociology and history. It proposes a unique interpretation of events and emotional reactions to personal problems of millions of people.

Works Cited

Botton Alain de Status Anxiety. Pantheon, 2004.

Treatment Plan

Anxiety is a serious issue that can affect a person’s everyday life, as displayed by the case of Shana who currently avoids social interactions. However, prior to treatment, more information about the patient’s condition should be assembled, including details about previous anxiety disorder that she had two years ago. Additionally, general physical health data is required to evaluate the current condition of Shana and ensure that other diseases are not causing the symptoms.

In case the anxiety disorder diagnosis is confirmed, the one treatment plan that can be applied in this case is the attention bias modification program (ABM). A general approach to treating the condition is cognitive behavioral therapy (CBT). However, newer researches on the topic have identified several important aspects that contribute to anxiety, more specifically concentration on personal experiences is the essential aspect.

The mentioned program utilizes the aid of a computer program to retrain a person’s reactions. According to MacLeod and Clarke (2015), it has therapeutic potential for improving one’s condition. The authors note that in some studies the approach has failed to display the necessary anxiety reduction result; however, their research offers alterations that can be applied to reduce such risks. De Voogd et al. (2016) conducted a trial study with children and adolescents aged 11 to 18 to identify the effectiveness of the approach.

The examination found that visual search training as part of the ABM program had positive outcomes in regards to participant’s mental health. According to De Voogd et al. (2016), “symptoms of anxiety and depression reduced, whereas emotional resilience improved” (p. 12). Thus, such programs can be utilized to improve Shana’s mental health and minimize the anxiety symptoms that she is experiencing.

Other studies that compare CBT and ABM should be taken into consideration when choosing an adequate approach. Huppert et al. (2018) analyzed the two to identify which of the methods is more effective. It should be noted that ABM has several advantages as it can be performed through online sessions, which is helpful in cases where patients experience extreme symptoms that obstruct them from leaving their homes.

Thus, it can be argued that in Shana’s case ABM can be applied to reduce current symptoms with a follow up of the CBT to enhance the overall mental health state and minimize negative thinking. Additionally, the dramatic change in behavior can be triggered by a specific factor, which should be identified. It is possible that stress at school or tension in interpersonal communication with peers or family worsened the condition of Shana (Beiter et al., 2015). Thus, addressing the issue that caused anxiety can help improve her state.

Discussion of Peer Responses

Response one provides an excellent point about the assessment of the overall healthcare state of Shana before beginning treatment. It is crucial to ensure that the symptoms are not confused with other medical conditions, based on previous mental health history. Discussion two supports the initial inquiry for more information and adds an important aspect that can be prevalent to both children and adolescents – caffeine intake as a contributing factor to anxiety.

Additionally, as was mentioned the approach of CBT is a valid solution for treating anxiety, and the two responses offer different perspectives that can be taken for the treatment. Thus, the two discussion answers provide a valuable point of a need to adequately diagnose the patient by excluding other possible causes of the case and offer reasonable treatment plans supported by the evidence-based literature.

References

Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders, 173, 90-96. Web.

De Voogd, E. L., Wiers, R. W., Prins, P. J., de Jong, P. J., Boendermakerac, W. J., Zwitser, R. J., & Salemink, E. (2016). Online attentional bias modification training targeting anxiety and depression in unselected adolescents: Short- and long-term effects of a randomized controlled trial. Behaviour Research and Therapy, 87, 11-22. Web.

Huppert, J. D., Kivity, Y., Cohen, L., Strauss, A. Y., Elizur, Y., & Weiss, M. (2018). A pilot randomized clinical trial of cognitive behavioral therapy versus attentional bias modification for social anxiety disorder: An examination of outcomes and theory-based mechanisms. Journal of Anxiety Disorders, 59, 1-9. Web.

MacLeod, C., & Clarke, P. J. (2015). The attentional bias modification approach to anxiety intervention. Clinical Psychological Science, 3(5), 58-78. Web.

Introduction

Generalized Anxiety Disorder is among the most frequent mental disorders. It can develop as an independent disorder and be diagnosed according to DSM-5 criteria (DSM code 300.02 (F41.1). However, generalized anxiety disorder often develops as a comorbid condition of other mental disorders, for example, depression, panic disorder or post-traumatic stress disorder. There are some factors that influence the prevalence of this disorder and can increase or reduce the risk of its development. These factors include age, gender, race, culture, and environment.

Age

It is generally accepted that generalized anxiety disorder is more characteristic of adults. Thus, for adolescents, its lifetime prevalence is less than one percent while average lifetime prevalence for adults is about three percent. Although generalized anxiety disorder can be observed in people of different age, it is mostly common for the third decade of life. However, the risk to get is decreases in the later years.

Gender

Generalized anxiety disorder can affect both men and women. Nevertheless, females are diagnosed twice more often than males. Probably, it can be explained by the fact that women worry about the daily problems more often than men. Moreover, females typically report their symptoms and visit specialists more eagerly than males. Moreover, although male and female patients reveal similar symptoms of generalized anxiety disorder, the comorbidity patterns are significantly influenced by gender differences. For example, women are more likely to develop generalized anxiety disorder as comorbid condition to bipolar depression while men demonstrate the symptoms of generalized anxiety disorder as comorbid to disorders related to substance use.

Race and Nationality

Race is an accepted factor that has an impact on the prevalence of generalized anxiety disorder. Thus, Europeans or Whites are more exposed to this mental disorder than the representatives of the other races. For example, Africans, Asians, Native Americans, or Pacific Islanders experience generalized anxiety disorder less frequently than the others. Nevertheless, in the United States, African Americans are considered to be the group that is most affected by this disorder. Moreover, the citizens of the developed countries are more likely to observe generalized anxiety disorder than the citizens from nondeveloped countries. However, it can partially be caused by the lower level of diagnosing in less developed countries.

Culture

Culture can be also included as a determining factor for the development of generalized anxiety disorder. It can be explained by the fact that the cultural background of a person has a significant impact on his or her life experiences and the way of expressing emotions. The concepts of ethnopsychology and ethnophysiology can be reviewed to identify the ways every culture treats the functions of body and mind. Although the direct comparison of generalized anxiety disorder is complicated due to the differences in contexts, some peculiarities can be singled out. Thus, in the context of the United States, Asian Americans are less subject to this mental disorder while African Americans demonstrate the highest rates of generalized anxiety disorder prevalence among the national minorities. At the same time, White Americans are more subject to developing the symptoms of generalized anxiety disorder than any of the national minority groups. Such division can probably have sociopolitical and historical roots.

Environment

Unfavorable environmental factors also can increase the risk of generalized anxiety disorder. Thus, stressful events of different nature can contribute to the development of this mental problem. However, environmental factors are not considered significant enough to influence the diagnosis.