Treating adolescents with social anxiety disorder in school: an attention control trial
The following paper reviews the journal article “Treating adolescents with social anxiety disorder in school: an attention control trial” by Carrie Masia Warner et al, published in the Journal of Child Psychology and Psychiatry in 2007. The paper is divided into two main parts. The first part summarizes the research being conducted while the second part focuses on my views and reactions after critically reading this article.
Social anxiety in adolescents is an underdiagnosed and understudied disorder, with a prevalence ranging from 4 to 9% and long-lasting detrimental consequences. Several clinic-based treatments for this disorder have been devised including Social Skills Training (SST), Cognitive-Behavioral Group Therapy for Adolescents CBGT-A, and Social Effectiveness Therapy for Children (SET-C) (qt. in Warner). However, there has been a paucity of school-based interventions for the treatment of this disorder. This study was a randomized control trial, controlling for attention as a confounding factor, comparing the efficacy of cognitive-behavioral treatment i.e. Skills for Academic and Social Success (SASS), and attention control treatment i.e. Educational-Supportive Group Function (ESGF). The study population comprised of 9th to 11th graders, from two New York City high schools, with similar baseline demographic features. These individuals were first screened for anxiety disorder using three validated scales including the Multidimensional Anxiety Scale for Children (MASC), the Social Phobia and Anxiety Inventory for Children (SPAI-C), and Social Anxiety Scale for Adolescents (SAS-A). Those identified as high-risk individuals were subsequently diagnosed with social anxiety using the Anxiety Disorders Interview Schedule for DSM-IV: Parent and Child Versions (ADIS-PC). Participants were randomly assorted into active and control groups. The selected 36 students then received 12-week treatment sessions of either SASS or ESGF. SASS included sessions on psychoeducation, realistic thinking, social exposure, social skills, relapse prevention, and attending social events. On the other hand, ESGF was more nonspecific and included sessions addressing general relaxation techniques. The outcome of treatment was assessed, at the end of treatment and then at 6 months follow-up, using the Social phobia diagnosis and severity (ADIS-PC) and Clinical Global Impression Scale–Improvement (CGI-I). Outcome variables were then analyzed using completer analyses, intent-to-treat analyses, and sensitivity analyses. Chi-Squared test was used for the analysis of categorical variables while analysis of covariance (ANCOVA) or multivariate analysis of covariance (MANCOVA) was used for continuous variables. The results showed that cognitive-behavioral treatment (SASS) was more effective than attention control treatment (ESGF). Patients undergoing SASS had lower post-treatment severity of anxiety disorder as compared to ESGF. The response rate was also higher for SASS (82.4%) as compared to ESGF (6.7%). At the end of treatment 59% of the SASS group no longer qualified for a diagnosis of social phobia versus 0% of the ESGF group. SASS also had the added advantage of the treatment effect being continued for 6 months after treatment cessation (qt. in Warner).
The issue of social anxiety in adolescents in a school setting has been identified but not addressed adequately. Therefore, in my opinion, this unexplored arena needs attention and further research. I, therefore, chose this paper which addresses this very important issue of adolescent social anxiety and has laid the foundation for further research in this area. This study is unique for being the first one of its kind since no similar attention control trials have been performed prior to this. All the assessment and outcome measure scales used in this study have been previously validated and have a high sensitivity and specificity. Moreover, the researchers also made sure that all confounding factors were controlled for, the treatment was double-blinded and there was no selection bias. This, in my opinion, contributes to the strength of this study making its findings more reliable.
This study is also an important milestone from a public health perspective since it advocates school-based treatment for anxiety disorder and similar illnesses rather than a clinic-based approach which has a stigma attached to it. I also found certain limitations in this study. The sample size was too small and the sample consisted mostly of females. This limits the generalizability of the results. Also, only two high schools from a particular area were chosen. Future studies can improve this by recruiting a larger number of patients who are from different schools having varying socioeconomic and cultural backgrounds, as these factors also contribute towards both the etiology and management of social anxiety and related disorders.
References
Warner, Carrie Masia. “Treating adolescents with social anxiety disorder in school: an attention control trial.” Journal of Child Psychology and Psychiatry (2007): 676–686.
Since the invention of psychology, numerous theories have been advanced that attempt to explain, be it human behavior, personality types, processes of brain perception, cognition, and psychoanalysis, among others. Most notable of these theories are structuralism, functionalism, Gestalt psychology, multiple personality disorder theory, psychoanalysis, behaviorism, reinforcement, cognitive neuroscience, evolutionary psychology, and cultural psychology (Devarajan, 2006). Among all these forms of theories, the most influential theory, in my own opinion, is the theory of behaviorism developed during the 20th century, which was refined by the American psychologist John Watson.
Behaviorism is the branch of psychology that focuses on observation of human behavior from an objective perspective, thereby providing a form of common ground that other psychological theories could base their scientific concept (Devarajan, 2006).
Motivated by the James Angell earlier work on the field of behavior and the renown Pavlov experiments, Watson advocated the first theory at the time in the field of psychology that shifted the focus from studying what people experienced to what they did; what he terms as behavior (Devarajan, 2006). In his own way, Watson was attempting to discover another approach of gaining insight into the human mind and as well as understanding it without applying the current theories that had proved ineffective. The principle behind the behaviorism theory is accurately captured in the Pavlov experiments and revolves around the two concepts of stimulus and response (Devarajan, 2006).
In other words, what Watson advanced through this theory, in a nutshell, is that human behavior is a factor of stimulus that emanated from the mental processes which can therefore be studied by just observing the response alone, which is the behavior in this case (Devarajan, 2006).
The behaviorism theory was later advanced to another level from where Watson left by another renowned psychologist, B.F Skinner. Skinner was responsible for the discovery of another element in the equation of human behavior science, which is referred to as Reinforcement (Devarajan, 2006). This element in the context of behaviorism theory states that “the consequences of a behavior determine whether it will be more or less likely to occur again” (Devarajan, 2006).
It was a conclusion that was arrived after years of many experiments on animal behaviors that were also found to be true to humans, which formed his foundation for his work titled “The Behavior of Organism” (Devarajan, 2006). Today the behaviorism theory is one of the most developed and reliable theories of psychology because of its methodology and approach that is evident in human behavior. Indeed the behaviorism theory is one of the true branches that can be described to represent the science of psychology since it focuses on observation of human behavior to understand the mind, which is actually the definition of psychology.
Anxiety Disorder Treatment
Many forms of psychological disorder are exhibited by the presence of delusions, paranoia, hallucinations, and sometimes bizarre speech in affected patients depending on the specific type of the disorder (Devarajan, 2006). Like many other mental disorders, there is no laboratory diagnosis for psychological disorders, which means that they can only be diagnosed through patient behavioral observation as well as a review of patient history and documentation of their experiences (Devarajan, 2006).
The different types of mental disorders classifications are categorized based on the DSM IV-TR framework; it is an abbreviation that stands for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, a manual that is developed by the American Psychiatrist Association (APA) (AmericanPsychiatricAssociation.com, 2009).
It consists of the most recent guidelines for classifying mental disorders; DSM IV-TR is, therefore, a guideline that is mostly referred by psychologists to categorize the various forms of mental disorders. Hence the diagnostic process of severe anxiety disorder among suspected cases should be done according to DSM IV-TR guidelines, which will involve specific key observations. The focus for diagnosing severe anxiety disorder according to the recent DSM IV-TR guidelines has shifted from somatic symptoms to psychic components that must fit in any of the following categories; poor coping strategies, distorted cognition, and physiologic arousal (MedicalNews.com, 2010).
One of the conditions that must be certified by the patient before the diagnosis of the disorder is the presence of characteristic symptoms of a generalized anxiety disorder (GAD) that persist for more than six weeks and which also negatively affects the patient ‘ss work or school responsibilities (MedicalNews.com, 2010).
The psychologist will then consult the patient history to determine the seriousness of the condition, which is categorized in any of the following groups; acute, intermittent, or brief (MedicalNews.com, 2010). Treatment of GAD is usually achieved through a combination or any of the following methods; psychotherapy, pharmacotherapy, and family therapy (MedicalNews.com, 2010).
Pharmacotherapy involves the use of medication such as antidepressants and buspirone, which are the most commonly used medications for the treatment of the GAD. Psychotherapy and family therapy involves sessions with a qualified specialist and is recommended where family or personality type is determined to be a causal factor of the condition.
Family environment and security of attachment to parents have a strong impact on a child’s personal qualities. Fear of the unknown among seven-year-olds going to school for the first time is normal unless it results in a child’s panic and refusal to go to school. Development of separation anxiety disorder (SAD) and aggressive behavior among first-graders is usually caused by experience of negative events, but there is a close link between this process and family variables. Secure attachment to mothers at the age of 15 and 36 months decrease the risk of child’s social and psychological problems (Dallaire & Weinraub 2007), while increase in maternal psychological distress is associated with increase in the child’s separation anxiety (Abdullah et al., 2009). Infant-parents relations play a significant role in development of separation anxiety among first-graders, increasing it in case of high level of mother’s anxiety or decreasing it in case of secure infant-mother attachment.
The effect-and-cause relations between child-parents affection and child’s psychological problems were established in both researches (Abdullah et al., 2009; Dallaire & Weinraub, 2007). The article Maternal Psychological Distress and Separation Anxiety Disorder in Children by Abdulah et al. (2009) is focused on the influence of maternal anxiety on development of Separation Anxiety Disorder (SAD) among their children. The research question of this study concerns the significant relationship between maternal anxiety and SAD symptoms in children. The authors admit that other factors of family environment may have an impact on child’s well-being. It is significant that the researchers accept the fact that mothers’ psychological distress is only one of factors influencing the process of child’s socialization and paying attention to the context of the problem. The study is aimed at covering the gap in theoretical knowledge concerning the influence of parental psychological well-being on separation anxiety disorder in their children. Reviewing the materials of the previous researches related to the subject, the authors proved the actuality of the issue. Working with the literature review of the research report, readers realize the obvious gap in theories and make a conclusion that the study is significant for further development of psychological knowledge. Establishing the cause-and-effect relations between the level of maternal disquiet and development of the child’s separation anxiety disorder is important for further planning of the work with children having disorder symptoms and their families. Notwithstanding the fact that the study does not suggest further practical implementation of the materials, the researchers point to the roots of the problem, and report may be used by psychologists and educators in their professional activity.
The article Infant-Mother Attachment Security and Children’s Anxiety and Aggression at First Grade by Dallaire and Weinraub (2007) is focused on infant-mother attachment as the factor protecting a child against the development of anxiety and aggression during the first school year. The research question of this study concerns positive effects of secure infant-mother affection on the process of child’s adaptation to the school environment and negative effects of insecure attachment resulting in aggressive behavioral characteristics of seven-year-olds. Literature review part of the research report provides the historical background of the current study. The topic chosen by the researchers for their study was narrow enough; they specified factors that were most important for the selection of the participants and assessment of the achieved results. Though the research report has a profound theoretical basis and its scientific significance is obvious, the report material may be helpful for education of would-be parents as well.
Abdullah et al. (2009) give direct definition of psychological phenomenon of SAD that is central for their study. Citing the work by Hock & Lutz (1998), the authors define the term of SAD as the child’s and parents’ disquiet concerning the loss of significant others in their lives. It is important that the researchers defined the issue in the introductory part of the research, as it clarified the criteria for selection of the survey participants and analysis of the study results. Dallaire & Weinraub (2007), the authors of the second article did not provide a definition, focusing on the criteria and omitting the definition that guided them in choosing the most important factors. This decision may be explained by the fact that the concepts of the attachment, anxiety and aggressive behavioral characteristics seemed to be obvious and not requiring additional definition to the researchers. The readers might draw conclusions concerning the researchers’ views concerning the concepts from the analysis criteria. The question whether direct definitions were required in the study is rather disputable.
Abdullah et al. (2009) proved the hypothesis that “maternal psychological distress may affect a child’s well-being, and more specifically that maternal anxiety has significant association with SAD symptom in children” (p. 387). Research of maternal psychiatric disorders and its impact on the children’s psychic health is an important point for analysis of causes of the SAD symptom. The researchers concluded that an increase in maternal anxiety is expected to result in an increase in the children’s separation anxiety. This conclusion is significant for solving the problem of the first-graders refusing to attend school. The research is aimed at establishing links between family environment and children’s SAD. 36% of mothers had a physical illness in the past, while 53% had a psychological illness in the past. This high rate of illnesses may be explained by Iran-Iraq and Iraq-Kuwait wars, increasing the citizens’ anxiety. In other countries mothers’ anxiety level is expected to be lower, the frequency of the separation anxiety disorders symptoms among the Iranian first graders provides opportunities for conducting the research, while the researches of schools in other countries would demonstrate other results. This factor does not decrease the effectiveness of the study.
Dallaire and Weinraub (2007) research proves that the relations with mother play an important role in child’s life, considering the positive effect of attachment. Mother’s anxiety results in her overprotecting and over-controlling the child. The researchers concluded that mother-infant attachment insecurity may result in development of anxiety disorders on the condition that it is coupled by negative life events and unhealthy family environment. Secure mother-infant attachment on the contrary prevents the development of the SAD symptoms and aggression towards the classmates among the first-graders. These results were significant for researching the close link between the mother-child relations and the child’s process of socialization. The authors noted that an overprotected child is deprived of opportunity to develop the skills of self-control, while his/her perception of the surrounding world is distorted. Mothers with high level of anxiety feel comfortable controlling life and activity of their children; their maternal instinct is influenced by their psychological problems and affects the child’s psychological well-being.
Abdulah et al. (2009) chose a survey, a non-experimental descriptive research method, collecting data via questionnaires. There was no control group, variables were not manipulated. 120 Iranian first-graders and their mothers participated in the survey, 66 girls and 54 boys answered the questions of Separation Anxiety Assessment Scale questionnaire in a quiet room at school during their school hours. Information about their mothers’ state of health was collected via General Health Questionnaire. Among the parents there were 47% with higher education, 27% with bachelor degree, 20% with elementary education and 6% with master degree and above. 49% of women were employed, the rest 51% were unemployed. The researches mention the cross-sectional nature of the study as its main limitation. That is why the study does not claim comprehensiveness. Abdulah et al. (2009) suggest further research of the role of the parents’ psychopathology in child’s anxiety in clinical and non-clinical settings. I agree that the research is limited due to its cross-sectional character. The life experience of Iranian citizens participating in the survey might result in psychic disorders of not only adults but children as well. Then instability in the socio-economic and political situation in the country could be additional factor resulting in increase of the children’s anxiety.
Dallaire & Weinraub (2007) chose an experimental method for their research, manipulating the independent variable of duration of the Strange Situation laboratory procedure and observing changes in the children’s behaviors. There were 1364 participants, but not all of them completed all assessments, there were only 866 mother-child and 662 father-child full set of assessments available. The socio-economic status of the participants was diverse: 24% of children were from the ethnic minorities families, 11% of mothers had no higher education, 14% of children were born by single mothers. The limitation of the study mentioned by the researches is the gap between the moment when the measurements were made and the moment when the outcome of aggression and separation anxiety was measured. They suggest conducting further research with closer moments of the measurements. More emphasis could be given to the children’s socialization patterns, it would provide opportunities for establishing of the cause-and-effect relations between the attachment to parents and development of the anxiety disorders.
Both articles illuminate the question of the importance of mother-child relations importance for the further process of the child’s socialization. From one side, increase in mother’s anxiety and overprotection of the child may result in increase in the child’s anxiety and development of the separation anxiety symptom. On the other hand, the secure mother-infant attachment is expected to prevent developing of the anxiety disorders among first-graders. Both researches may be useful for parents and teachers, but the research conducted by Abdullah et al. (2009) seems to be more persuasive. First of all, the logical parts of the survey are better organized. Clear definition of the researched phenomenon and goals of the survey are beneficial for logical structuring of the report. Data provided in the research conducted by Dallaire & Weinraub (2007) seems to be less reliable. The psychologists chose an effective method for their survey, but the study contains too many limitations, making the results achieved and conclusions made rather doubtful. The goals chosen by the researchers were difficult to achieve due to the broad time gap between different stages of the experiment and lack of participants’ motivation.
Research by Abdullah et al. (2009) and Dallaire & Weinraub (2007) were useful for deepening my psychological knowledge concerning relationship between infant-parents attachment and first-graders’ anxiety and aggressive behavior. Choosing different aspects and methods for their works, psychologists achieved results that confirm similar hypotheses concerning the significant role of the children-parents relationships in development of separation anxiety disorder among seven-year-old children. Analysis of the effects of parents’ behavior on children’s school achievements are important to understanding how parents can help children refusing to go to school due to their separation anxiety.
References
Abdullah, R., Bahaman, A.S., Mariani, B.M. et al. (2009). Maternal Psychological Distress and Separation Anxiety Disorder in Children. European Journal of Social Sciences, 8 (3).
Dallaire, D. D., Weinraub, M. (2007) Infant-Mother Attachment Security and Children’s Anxiety and Aggression at First Grade. Journal of Applied Developmental Psychology, 28.
Cognitive-behavioral Therapy (CBT) is a practice that has been in existence since 1980s. This approach involves a specific effort to preserve the positive impacts of behavior therapy that have been proved with involvement of the cognitive activities that are exhibited by the individual receiving the treatment.
The main aim of merging the two approaches is to produce therapeutic change in the client (Albano & Kendall, 2002). In its early years, it was highly utilized in Europe and North America for the treatment of various disorders. For instance, it was used for the treatment of panic disorder in United Kingdom and United States. This approach has been effective in the transformation of individual’s thinking and behavior.
An anxiety disorder is a condition that is very common among children and teenagers. The disorder is identified in an individual where a person develops a high level of fear that a bad event will happen. The individual becomes vulnerable since all the coping mechanisms are overlooked making him or her pessimistic.
The individual adopts a negative cognitive appraisal and becomes very hypercritical and self-focused. This makes him or her view any situation as posing a threat to their lives. There have also been cases of physiological arousal leading to somatic sensations and behavioral avoidance. This is where the child may avoid certain situations like going to school making it hard to ascertain predictions of a negative event (Bailey, 2001).
There have been increased rates in the number of children suffering from anxiety disorders in the past few years. This has forced therapists to develop treatment methods that are evidence-based in order to provide a solution to this crisis. Various approaches have been tried where the focus has been to adopt the method that has proven efficacy.
Cognitive-behavioral Therapy has been used in the treatment of anxiety disorder. The approach is based on the objective of changing the behavior of an individual that has developed from irrational thoughts (Bailey, 2001). This is through educating the individual and empowering him or her through positive experiences that result to development of coping mechanisms.
It involves methods which have been picked from behavioral therapy that have been included by dealing with cognitive components of adjustment. This approach has been used to direct the treatment of children and youths facing anxiety disorders. This is through building effective skills that enables the children to function properly in various situations by avoiding unnecessary anxiety.
The CBT treatment of children and young patients has been adopted from the practice that has been carried out on adults. This is where the therapists working with the young patients adjust the content and speed of the therapy so that it can match with the level of a particular child.
Due to existence of limitations in young patients in terms of metacognition and ineffectiveness in labeling of their feelings, the therapists working with these individuals adopt a more active approach so that they can utilize higher level of behavioral and cognitive techniques (Vonk & Early, 2002).
When applying this approach on the treatment of children with anxiety disorders, therefore, the therapist needs to understand that the individual is facing harmful thoughts of danger where fear for his or her well being dominate making the perception of the future appear disastrous.
The approach of treatment using CBT utilizes three main areas. Using various ways, the identification and understanding of physiologic arousal enable the children facing this problem to have the ability to control the arousal. This is through the instructions that these young patients are given making them empowered to control their bodies and also utilize practices that reduce the arousal.
The patients are led through the process of understanding the nature of their thoughts and how events that they encounter can be interpreted without arousing anxiety (Lewis, 2010). Through the provision of ways of challenging the truth of their thoughts, the young patients are able to come up with coping mechanisms through presenting the real nature of the situation at hand.
This is an important step in solving the anxiety disorder since the patients are able to deal with dangerous thoughts that lead to avoidance. The patients achieve this through adopting a framework that is rational and realistic. The other step in this approach is supporting the youths to deal with situations that arouse their anxiety (Compton et al., 2009).
This is a higher level where the patients are exposed to these situations and are encouraged to use the learnt methods to deal with the arousal. The therapist guiding these patients assist the patients to face the situation of fear without running away from the fearful situations until their can do so, on their own.
This approach is very effective for children facing anxiety disorders. Using the cognitive-behavioral approach, the child’s problem is analyzed where feelings of inability to cope with a situation at hand make the child pick an avoidance behavior thus increasing the fears that the child has already built within him or herself.
Therapists dealing with such patients have been successful through the adoption of transformational thought diary. This method enables the young patient to rate his or her level of discomfort using a subjective unit of discomfort scale that ranges from 0 to 10.
This helps to identify the patient’s progress and enable the child to move from a situation of helplessness. The child achieves this through developing the ability to identify the initial signs of anxious arousal and the training the child receives making him or her gain the skills of anxiety management like relaxation and positive imagery.
The patient overcomes the thoughts of danger by challenging them with evidences that are contrary to their perception. With time the patient uses these evidences to develop positive self-talk.
Kendall et al. (1993) summarizes the child’s development of coping mechanisms to deal with anxiety through a four step process. Firstly, the young patient learns to identify the anxiety and develops a way of relaxing.
Secondly, instead of expecting bad things to happen from a situation of anxiety, the individual overcomes this through positive self-talk. The third step is adoption of actions and attitudes that are helpful which the problem-solving strategies become. The final step is the self-evaluation where the patient is assisted to appreciate the steps he or she has made in coping with failure and negative self-image.
Various studies have discovered treatments that incorporate various methods that assist in the elimination of symptoms of anxiety in young patients.
These approaches have used these procedures where relaxation training has been used together with training to enable the patient deal with the negative thoughts concerning situations that he or she fears. The continued development is observed where the patient is exposed to these situations and instructed on how to utilize coping mechanisms to enable the situation not cause anxiety and distress.
The effectiveness of this approach as a therapeutic intervention on young children was illustrated in a program that was conducted by Kendall (1994). In this study, a total of forty seven young patients aged between 9-13 years were treated using CBT approach.
The subjects were analyzed using the criteria that involved grouping the subjects into those who had overanxious disorders, those with avoidant disorder and those who had separation-anxiety disorder. The numbers of these subjects were n=30, n= 9 and n= 8 respectively.
The program used the treatment condition that involved sixteen weeks of CBT. At the end of the program, the 65 percent of active treatments had noted decrease in illness. This was particularly after the therapists included family management in their approach.
The efficacy of CBT approach for the treatment of anxiety disorders in young patients was determined by a study that was conducted by Silverman and his colleagues (Silverman et al., 1999). This was through a follow up program that was done after initial intervention within a range of three, six and twelve months.
The study which involved fifty-six young patients aged between 6 and 16 years found that the approach was more effective than use of the control group. This is because individuals who were treated using the CBT approach more than five times the number of all the sample population emerged free from illness. This is in comparison with those who adopted the control group as their model of treatment.
Adoption of CBT in the treatment of children with anxiety disorders requires the therapist to look into other related issues that may influence the results of the therapeutic formulation. Firstly, the family of the child is very significant in the success of the treatment. This therefore means that the therapist dealing with the child need to involve the parent of the child (Cobham, Dadds & Spence, 1998).
The therapist does this after familiarizing him or herself with the family structure and system of belief that the family of the patient holds. This information may also be beneficial to the therapist since he or she is able to have a clear understanding on hidden issues like abuse or other disabilities.
The program by Kendall indicated that the involvement of the patient’s family is essential in facilitating the success of the treatment (Kendall & Warman, 1996). This is where the parents are directed on how to help their children gain the courage to face situations that they previously feared.
Using the acquired cognitive-behavioral skills, the children are encouraged by their parents through positive reinforcements to deal with these situations until the situations become a common occurrence to them such that it no leads to distress. The role that the patients’ families play in their treatment, therefore, cannot be overlooked.
Previous practices have also indicated that the age of the child is of essence when deciding to include the parents of the patient (Dadds et al, 1999). This is where for very young children; the parents are more involved in the therapy process.
This is because they need to be directed on how the cognitive-behavioral model functions and how it can be applied to solve the child’s problem. The parents are given specific directions on the management of this model in order to make the treatment process effective.
The training of a parent makes it possible to come up with an effective plan to solve problems in children facing anxiety disorders. In addition, therapists are able to advice the parents suffering from anxiety to seek treatment in order to avoid negative influence on the treatment of their children (Gowers, 2009).
Basically, the sex and age of the patient do not bring out significant differences in terms of the patient’s self-ratings of anxiety both before the treatment and after the process.
In a study that was conducted to demonstrate the efficacy of cognitive-behavioral therapy for young children facing anxiety disorders, reduction of anxiety in children was achieved using this approach (Wenar & Kerig, 2006).
This research indicated that the role of parent involvement in this treatment and the need to start the intervention early leads to positive results. This study illustrated that individual CBT combined with parental involvement led to better results.
There have been other methods that have been utilized in the treatment of anxiety disorders. For instance, pharmacologists have focused their treatment on the use of antidepressants (Silva, 2003). This method has led to positive results especially due to its efficacy (Scott, Mughelli & Deas, 2005).
However, this method when applied to children has led to negative effects. This has led to therapists turning to the use of cognitive-behavioral therapy since it has been used on adults without any side effects.
The adoption of the approach on young children facing anxiety disorders has produced positive results since it does not cause any side effects like the pharmacologic agents do. According to Arnold et al (2003), CBT is the most effective treatment approach when dealing with children and other young patients suffering from anxiety disorders.
The most effective setting for the application of cognitive-behavioral therapy for young patients is in an education setup. This is because within the school setting, the program can be designed to fit both the patients and their families.
This is through adopting the appropriate timing for the therapy sessions and the time that the treatment will be delivered. The schedule can be arranged to avoid interfering with the school and family programs.
In addition, this setting is appropriate since the adjustment made ensures that the patients maintain regular attendance in the sessions of treatment and increase the chances of completing the program (Gail et al, 2005). When the needs of the young patients are considered, adoption of the treatment in the school setting can be the most effective for the therapy intervention process.
The strengths of CBT approach are seen in its ability to be applicable in various setting without reducing its effectiveness. This is unlike other methods that adopt the clinical-based intervention alone (Steele, Elkin, & Roberts, 2008).
CBT on the other hand can be applied in the community setting. The program can be initiated in schools and the follow up done in the patient’s homes. This makes it possible to involve the families of the patients a factor that has made the approach bear more positive results.
The strength of the CBT approach can be pointed in its commitment to empowering the patient thus making him or her take control of the situations that may emerge even in the future (Stallard, 2009). By exposing the individual to situations that have always aroused fear and distress and helping him or her utilize the learnt coping mechanisms, the individual feels as part of the solution making him or her develop a positive self image.
Despite its success in treatment of young patients facing anxiety disorders, cognitive-behavioral therapy has several limitations. Firstly, the accessibility of these services has proved hard to many families, thus limiting the benefits that this approach brings to these individuals.
This has been caused by the number of individuals who have been trained to undertake the processes are fewer than the number of patients who require their services. This is particularly because the skill is mostly learnt by psychologists and psychiatrists who are not enough when compared with the high rate of the occurrence of this condition among children and young adults (Raul et al., 2006).
Secondly, the application of CBT in the treatment of individuals with anxiety disorders has sometimes been a challenge to most families.
This is because most parents find it hard to refer their children for therapy treatment especially when the children are very young with the fear that the society will point a blaming finger on them as the cause of their children situation (Barrett, 1998).
In addition, some families lack the understanding of the importance of therapy for their children. This is because these parents may not understand what problem their children may be facing thus; they do not see the need for the therapy intervention. Some families may not afford the cost of the therapy especially when the model is individual as it may overstretch their resources.
Another concern that has been proposed especially when involving the parents of the patients is occurrence of overprotective behaviors among the parents towards their children. When the parents are not instructed properly on their role they might prevent their children from dealing with their former fears by shielding them from these situations (Barrett, Dadds & Rappe, 1996).
In conclusion, cognitive-behavioral therapy has led to good results in the treatment of children and adolescents with anxiety disorders. This is both when applied on an individual or a group. Cognitive-behavioral therapy aims at helping the individual to identify thoughts that are irrational after which the individual deals with these unproductive thought through methods like reinforcement and role play among others.
This approach is patient-centered since the therapist only act more as a director and instructor while the patient determines how the progress will be achieved. Parental involvement in the treatment process has also been beneficial since it has led to improvement of these results.
This is where the individual programme for children with anxiety disorders is improved through “Family Anxiety Management (FAM)” programme (Barrett, Dadds & Rappe, 1996). It is also important to consider the setting of the therapy sessions as the appropriate setting will make the therapy successful.
For instance, the education setting is the most effective for young patients as indicated above. Cognitive-behavioral therapy is one of the most validated methods of treatment of anxiety disorder where its greatest success has been proved in various researches that have been launched to come up with solutions to various disorders.
References
Albano, A. and Kendall, P. (2002). Cognitive behavioral therapy for children and adolescents with anxiety disorders: clinical research advances. International Review of Psychiatry, 14(2), 129-134.
Arnold, P, Banerjee, S. P. and Bhandari, R. et al. (2003). Childhood anxiety disorders and developmental issues in anxiety. Curr Psychiatry Rep., 5(4):252-265.
Bailey, V. (2001). Cognitive–behavioural therapies for children and adolescents. Advances in Psychiatric Treatment, 7: 224-232 doi: 10.1192/apt.7.3.224
Barrett, P. M. (1998). Evaluation of cognitive-behavioral group treatments for childhood anxiety disorders. J Clin Child Psychol., 27(4):459-468.
Barrett, P. M., Dadds M. R. and Rappe, R. M. (1996). Family treatment of childhood anxiety: a controlled trial. J Consult Clin Psychol., 64(2):333-342.
Cobham, V. E., Dadds, M. R. and Spence, S. H. (1998). The role of parental anxiety in the treatment of childhood anxiety. J Consult Clin Psychol., 66:893–905.
Compton, S. and March, J. et al. (2009). Cognitive behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: An evidence based medicine review. Journal of the American Academy of Child & Adolescent Psychiatry, 43(8), 930-959.
Dadds, M. R, Holland, D. E., Spence, S. H., Laurens, K. R. and Mullins, M. et al (1999). Early Intervention and prevention of anxiety disorders in children: results at 2-year follow up. J Consult Clin Psychol., 67:145–150.
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Anxiety disorder has affected human beings for a long time. This prevalent mental health problem that affects millions of people was common at the beginning of the 19th and 20th centuries. A study carried out by Dowbiggin (2009) showed that anxiety is traced throughout history by mainly making an observation on the social events that were outstanding at that time and how the people reacted to issues.Therefore it is proper to identify gender, culture, medical fields, and education and how these affected anxiety among the people at various times in history. Most importantly, looking at how categories of social disorders had been diagnosed through the efforts of various groups and how the problem was progressively addressed by various experts to find a solution to reduce problems of mental health among the people was a point to note. The hypothesis of this study was that anxiety disorder is contributed by the social factors.
The independent variable is anxiety disorder. The social anxiety disorder (SAD) which affects millions of people in the world.The examples of SAD include posttraumatic stress disorder (PSTD), and generalized anxiety disorder (GAD).The social anxiety disorder shares some symptoms with other psychiatric conditions called phobias such as agoraphobia (fear of places or social situations), and body dysmorphilia (fear of the deformity of the body member, or dislike of one’s body figure by an individual).
The dependent variables include work related anxiety. It emanated from giving presentations, taking phone calls, leading workshops and doing launches. Other variables included the self promotional state of modern culture like Survivor and American Idol. The next dependent variable included the revolutionary in the psychopharmacology that led to the production of tranquilizers that were used by the people as a relief of the social anxiety in the 1950s and 1960s.In addition the use of new terminologies such as stress by the psychologist and the psychiatrists to as a diagnosis to the anxiety disorder to the patient that concept was commonly used.Another dependent variable was the self help and recovery moments (SHRM) which constitute a team of experts like counselors, human rights activists among others who gave the diagnosis to the posttraumatic stress disorder encouraging the veterans of war, sexually abused women to live a normal life. Conspirational thinking that emerged due to terrorism activities e.g. 9/11 U.S attack (Dowbiggin, 2009).
The participants included the working elites like Gail Andrew, the patients, the Psychiatrists (American Psychiatric Association), war veterans of both the 2nd world war and the Vietnam war, American Department Program of Affairs on War Veterans, women and men in business and education portfolios historians and SHRM. The population size that was sampled included 3 millions Canadians who were middle aged and 20 million adult Americans.
The research method used in the study was survey that was carried out by the medical institutes e.g. National Institute of Mental Health Problem (2001) and World Mental Health Survey (2002) declared and reported that anxiety was prevalent mental health among the Americans and the world at large. The random sampling technique was used e.g. 10% of the Canadians and Americans suffered from social anxiety and 1in5 men and women in France used tranquilizers as anti anxiety depressants. The use of theoretical approach e.g. Freudian Psychoanalytic theory to explain the issue of stress and its diagnosis to the patient. Use of the secondary sources such as history works of the historian was used.
The findings of the study show that anxiety disorder rises due to social factors, revolutions in the pharmaceuticals that makes more people to rely on tranquilizers and other depressants to overcome anxiety disorder and self help and recovery movements(SHRM)which encourages the victims of wars and sexually harassed women to live a stress free life, social interactions ,self promotional state of modern culture which affects the way of life people across the world, social trends ,use of new terminologies like stress to explain anxiety disorder, change in the gender roles of women has increased social anxiety among women in the their new roles as business women ,executives, administrators and as education scholars. conspirational paranoism that creates anxiety to the people e.g. terrorism.
There is also the role of gender in the development of this mental complication. Gender based analysis shows that in the 1970s many women were in the job charts holding very senior corporate and management portfolios. But their concern to the increase in the level of anxiety was partly based on social and biological factors. These factors featured mainly on how women reacted to some certain bodily sensations as compared to men. Their reactions from the demands of the area of profession and the education experiences also affected them differently.
Finally, he turning of major global issues such as terrorism especially when terrorists attacked World Trade Center on 11/9/2001 in the US ushered in the conspiracy thinking ideas among the people which brought in fear and worries which forced people to handle issues and situation from different perspectives in order to avoid becoming the victims of circumstances. The new conspiracy movies and web materials were written to uncover conspiracy thinking in order to reduce social anxiety disorder among the people in the so society or the world at large. The conspiracy fearism affected the whole society whether political class and the educated fellows are no exception since they are battled by the spirit of anxiety through paranoid tandem with the help of the work of conspiracy.
The limitation of this study is the disagreement on the arrival to a consensus on discussing the issue of anxiety between the psychiatrists and the theorists of psychology. Large population size of 3 million to 20 million participants could be tedious in the study of the research.The limitation of the study to Canada and U.S.A which hinders getting to know how the other continents like Africa faced with anxiety over the same period of time. Long scope time makes the study to be general.Thus extension of the research should be carried out to other parts of the world, few population sample to be given to reduce chances of biasness.
Reference
Dowbiggin, R. I. (2009). High Anxieties: The Social Construction of Anxiety Disorders. Canadian Journal of Psychiatry. Web.
This study tries to address a very important question or issue. The authors wanted to investigate whether anxiety can modify the ability to match or identify photographed faces. In the article, the researchers asked whether acute anxiety could affect a person’s ability to match different faces. The study was necessary because the face-matching practice was becoming necessary towards dealing with insecurity. The researchers wanted to present the best ideas and practices towards improving the performance of eyewitnesses. This research was necessary because the identification of strange faces was always poor in different matching tasks.
Methods
The authors used the best methods to conduct their study. The researchers selected 28 individuals to undertake the study. Every participant was encouraged to provide informed consent. The participants were encouraged to inhale medical-grade air. They also inhaled air enriched with 7.5 percent carbon dioxide (CO2). They completed the Glasgow Face Matching Test (GFMT) twice. The inhalation of 7.5 percent CO2 is one of the legalized approaches for inducing acute anxiety. The collected data included arousal, measures of anxiety, and performance on the GFMT. The collected data would be termed as psychophysical thresholds.
Results and Conclusions
The findings indicated that face-matching performance was always impaired under states of arousal or elevated anxiety. However, the effect was specifically restricted to hits. According to the study, anxiety is capable of corrupting performance whenever individuals are engaged in face-matching activities. Anxiety will result in detrimental effects on face-matching activities. This situation usually occurs when an individual is not required to remember the targeted incident.
The authors also explain why there should be a dissociation between the ability to identify an accurate face match and the capability to spot a lack of one. The study findings supported the targeted hypothesis because acute anxiety can make it impossible for an individual to perform well in any face matching performance. The study findings also support the identified hypothesis. The authors have also correctly interpreted their results. The findings explain why security officers should focus on encoding processes to improve face-matching performance. The approach will be relevant towards dealing with crime and international terrorism.
Article Critique
I agree with the authors’ interpretation. The authors have explained why security officers and governments should establish the extent to which acute anxiety is capable of affecting the accuracy of face matching. After conducting the study, the researchers identified why anxiety can affect performance. The challenges associated with the accuracy of facial analysis and identification should be resolved to deal with terrorism and insecurity. Identification inaccuracy will always increase when the targeted viewers are suffering from acute anxiety. The authors used the best experimental design for the study.
The outstanding strength is the use of a proper research method for the study. The authors use the GFMT to get the required data. However, the authors fail to combine both qualitative and quantitative techniques to come up with the best results. The article does not have any source of bias. The authors have encouraged healthy participants to be part of the study. The authors used the best research design to control bias in the experiment. The authors also used the best tools and hypotheses to reduce error in the experiment. The participants were also not aware of the contents of the inhaled air. This approach was effective because the researchers obtained the best study findings.
Anxiety can be caused by such factors as stress at school, a stressful relationship, family problems, emotional trauma, serious disease, and many others. Apart from outside stressors, there can be biological preconditions for anxiety. In its turn, anxiety negatively influences the educational process and the person’s concentration. Thus, this paper discovers the impacts that anxiety has on studies and students’ concentration as well as its biological causes.
Anxiety is a condition that frequently troubles students, and the number of young people affected by it is increasing (Rix, 2015). Scholars define anxiety as “a response which encompasses physiological, affective, and cognitive changes” (Robinson, Vytal, Cornwell, & Grillon, 2013, p. 1). It is a proven fact that anxiety has a negative influence on cognition, which is the ‘information processing’ of a person (Robinson, 2013).
First of all, anxiety distracts a person’s attention from important things, which can negatively affect the learning process. Moreover, anxiety has an impact on short-term memory, which is crucial for learning. Also, it causes problems with concentration. As a result, students who experience anxiety demonstrate worse academic performance than those who are not anxious.
As for the biological aspect of anxiety, such factors as genetics, brain chemistry, and the issue of fight-or-flight response should be mentioned. Researchers provide evidence that anxiety has genetic roots meaning that there is a certain predisposition to anxiety disorders (Thompson, 2017). As for brain chemistry, the studies prove that the same neurotransmitters that cause depression, such as serotonin and norepinephrine, can influence the development of anxiety. Finally, a fight-or-flight response, which is an automatic reaction of the brain to stress, both real or perceived, can also cause anxiety.
On the whole, anxiety is a person’s response to stress provided by the environment. It is guided by biological processes and cannot be immediately controlled. It negatively influences academic performance because anxious people have worse memory and cannot concentrate on the subject.
Robinson, O. J., Vytal, K., Cornwell, B. R., & Grillon, C. (2013). The impact of anxiety upon cognition: Perspectives from human threat of shock studies. Frontiers in Human Neuroscience, 7, 1-21.
Thompson, K. (2017). Biological perspectives on anxiety. Live Strong. Web.
Primarily, cognitive therapy is assumed to be concise, centralized, and reliant on a fixed scheme. These assumptions diversify cognitive therapy from the humanistic approach, which is not that structured. The clients’ irrational mindsets can be recuperated relying on three major concepts, which are the Rational Emotive Behavior Therapy, the ABCDE Model, and the Dysfunctional Thought Record. The ABCDE model is a sequence of cognitions that can be recorded and analyzed as to its influence on the clients’ feelings (Pomerantz, 2014).
The client under consideration, Angela, is having a thought distortion. She catastrophizes the events taking place in her life and has pessimistic views – which are exorbitant.
The best way the anxiety can be mitigated is the ACT (Acceptance and Commitment Therapy). The Acceptance refers to ceasing the battle with unfamiliar experiences and gaining self-trust. Commitment to one’s personal values probably needs determining what their values actually consist of and relying on them in order to make decisions. The T stands for taking actions based on the value-related decisions (Pomerantz, 2014).
The written version of the ABCDE model would probably look as follows:
Activating event: Angela’s prolonged delay in job-finding;
Belief: Angela’s assumption that the blame for her failures is hers and the sensation of her worthlessness;
Consequence: Angela’s anxious thoughts that exacerbate her self-consciousness and further delay her success;
Dispute: getting a job can be complicated for a post-graduate, but Angela will eventually find a job if she does not stop searching;
Effective new belief: any result is a result in itself; Angela needs to accept – as in the ACT – and do some “practice jumping” on her way to success (Pomerantz, 2014, 448-449).
As to the behavioral therapy, it has served as a starting point to the cognitive one. The therapists observe, hypothesize, and test the validity of their hypotheses deploying an empirical approach (Pomerantz, 2014). In relation to Angela, the therapy relies on a structure that does not presuppose altering the conditions, which is strictly the prerogative of behavioral therapy.
Addiction Withdrawal Treatment
The client Maxine is in her second stage of drug – probably alcohol – withdrawal. Miller, Forcehimes, and Zweben (2011) identify this stage as the “contemplation,” which subsumes the readiness to make a change in the next half a year (p. 111). Above all else, the withdrawal is characterized by obsessive-compulsive disorder which the client is experiencing at the moment. The reasons for such choice of the stage of change are the client’s eagerness to make the right decisions – as well as her being unsure she will be able to make it without support. As to the disorder she suffers, it is stated that drug and alcohol problems are often attended by obsessive-compulsive behaviors (Miller et al., 2011). The pattern in the client’s behaviors can be seen: the client has had three relationships that had ended in a distressing way, with each of the break-ups resulting in a drug relapse. It is obvious that the client has a persisting intrusive thought about getting into a relationship, having it as an overvalued idea. The substance the client can have difficulties with can be alcohol; acute and post-acute withdrawals are often characterized by obsessive-compulsive disorders and anxiety that the client seems to be experiencing when stating her ideas concerning her unlucky relationships and the “importance” of having a new one.
References
Miller, W. R., Forcehimes, A. A., & Zweben, A. (2011). Treating Addiction: A Guide for Professionals. New York, NY: Guilford Press.
Pomerantz, A. (2014). Clinical psychology: Science, practice, and culture (3rd ed.). Thousand Oaks, CA: Sage Publications.
While it is acknowledged that everyone can get worried under normal circumstances, the problem may arise when the worry and fear persist unusually, subsequently interfering with one’s ability to carry out routine duties. Like in the case of James, it can be concluded that James is suffering from Generalized Anxiety Disorder (GAD), attributed mainly to the kind of pressure he got from his place of work (hospital) as a resident medical intern. James has two other sisters who have become very successful both professionally and in general well-being. But how could this happen, yet they all grew up in the same environment? Half of the variance in personality traits in behavioral genetic research is derived from the environment, but this portion is almost entirely “unshared” (Judd et al. 1998). The findings have revealed that environmental influences on traits are not necessarily derived from being raised in the same family, which James’ case may well back.
Considering some past studies that revealed that genes and environment are inseparable when it comes to their impact on an individual’s public life (Kendel & Jablensky, 2003; Judd et al., 1998), the personality traits are inheritable, with genetic factors accounting for nearly a half of the variance (Judd et al. 1998). But James’ other family members have not experienced any of such problems; hence the necessity to acknowledge that environmental influence is the major contributor to his problems. According to Beck & Freeman (1990), in behavioral genetic research, half of the variance in the personality trait is derived from the environment. That single temperamental characteristic emerges from complex and interactive polygenic mechanisms associated with variations in multiple alleles- quantitative trait loci. It is almost impossible to link James’ disorder with genetic makeup and traits. These findings have fundamentally generated a lot of arguments among the classical ideologists in developmental and clinical psychology, who focused their views on the theory that parenting is a primary factor in shaping personality development (Kendel & Jablensky, 2003; Beck & Freeman, 1990).
There are several reasons why these unshared environmental factors are essential in analyzing James’ problems. The first is that his behavioral response or temperament will affect others under normal circumstances, as seen in the father and most probably other family members. In a large-scale study of adolescents that used a combination of twin and family methods, multivariate analysis indicated that a child’s temperament is the underlying factor driving differential parenting and differential behavioral outcomes (Kendel & Jablensky, 2003).
However, it could be said that even when the family provided a similar environment for James and his siblings, each child may have perceived experiences differently and given a different behavioral pattern response. Furthermore, temperamental differences can make the environmental influences unshared (Judd et al. 1998).
Some studies have also indicated that some of the environmental factors that affect individual personality are extra-familial (Kendel & Jablensky, 2003). For example, many researchers have concluded that pressure from peers, interactions with teachers, or community leaders may have a more powerful impact on the development of an individual personality than parenting does. The other possibility that may have impacted James is that of a biological environment that is not shared- an intrauterine factor (Beck & Freeman, 1990). However, there is little research to support this hypothesis; hence may not hold much in the case of James, at least for now.
Treatment of GAD
Many clinical and epidemiological studies suggest that generalized anxiety disorder and major depression occur more frequently than expected by chance (Kendel & Jablensky, 2003; Judd et al., 1998). Other evidence suggests that the onset of generalized anxiety disorder occurs before major depression in most cases. Under some circumstances, generalized anxiety occurrences may be a precursor to the beginning of significant depression (Kendel & Jablensky, 2003). This clearly shows the gravity of the disorder, hence the need for a proper multifaceted treatment mechanism.
Several treatment options for GAD have been proposed, with health professionals emphasizing the need to adopt therapeutically (Psychological) and self-help measures.
Therapy for GAD
Many clinical studies have supported the therapeutic approach to treating generalized anxiety disorder, with findings indicating that therapy is as effective as medication for many people, no matter the background. In addition, it is favored for its lack of side effects (Kendel & Jablensky, 2003).
One of the most commonly used psychological treatments is Cognitive-behavioral therapy (CBT) (Kendel & Jablensky, 2003. CBD will help examine the distortions in how James looks at the world and himself. That is to say that the therapist will be crucial in helping to identify some critical negative thoughts that usually engulf James and contribute to his persistent anxiety. As a result, the patient can confront his personal feelings with such questions as “Why do I believe that this worst-case scenario will occur?” and “What are the possible positive outcomes shortly?” In brief, the cognitive-behavioral therapy for GAD will entail the following five components: education that involves learning about (GAD), Monitoring where the patient is learning how to monitor their anxiety, physical control strategy where the patient can learn techniques such as deep breathing, cognitive control strategy where the patient realistically learn to evaluate and change the pattern of thinking, and Behavioral approach where the patient learns to tackle the situations head-on rather than being in denial and evasive (Kendel & Jablensky, 2003).
However, treatment can never be relied on solely. This is mainly because the treatment and general healthcare of GAD patients requires a continuous process that would be sustainable while not forgetting a short-term pain relief for the patient. Furthermore, it is always necessary to get professional advice, which means one should not just assume that they are suffering from GAD simply because of some symptoms. This is why many health professionals would advise a combination of therapeutic, self-help, and even medication, where the latter would best apply when one wants to get temporal relief from pain.
In designing a plan for the treatment of GAD, I would lay out the program for treating GAD by outlining the three treatment options, i.e., therapy, self-help plan, and lastly, medication. However, I would emphasize the self-help technique and the treatment approach to ensure the sustainability of the treatment method. The remedy would only come in when the patient is experiencing some pain that would need quick pain relief.
Reference List
American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd ed). Washington, DC, American Psychiatric Association.
Beck, A,T & Freeman, A. (1990). CognitiveaTherapy of Personality Disorders. New York, Guilford.
Judd, L.L., Kessler, R.C., Paulus, M.P., Zeller, P.V., Wittchen, H.U., & Kunovac, J.L. (1998). Comorbidity as a fundamental feature of generalized anxiety disorders: results from the National Comorbidity Study (NCS). Acta Psychiatr Scand Suppl; 393:6-11.
Kendel, R & Jablensky, A. 2003. Distinguishing between the validity and utility of psychiatric diagnosis. Am J Psychiatry, 160:4-12.
Emotional and anxiety disorders, such as obsessive-compulsive disorder, anxiety disorder, and depression, are generally characterized by emotional and social disturbances caused by impaired brain functioning. The recent developments show that disturbances in social cognitive processes contribute substantially to the development of psychotic disorders (Washburn et al., 2015). They are thought to be a result of cognitive problems rooted in childhood and developed in the course of adult life.
Nikolic studied the role of social emotions and social cognition in the development of social anxiety disorder. He proposed that dysregulated social emotions (such as fear and shyness) are crucial for social anxiety disorder and are closely connected with the disturbances of socio-cognitive abilities (Nikolic, 2020). The study proved that in early childhood, negative cognitive experiences, such as situations causing an elevated sense of fear or shyness, can result in the development of social anxiety disorder.
Depression is often associated with cognitive problems and the impairment of higher mental functioning, which have a significant impact on the patient’s life. In recent research, depression is started to be viewed as cognitive, rather than emotional disorder (Perini et al., 2019). Regarding such emotions as fear and shyness as learned rather than biologically inherent, researchers argue that their disturbances are a result of cognitive problems experienced in childhood.
Jansen’s research aimed at establishing the connection between social cognition and obsessive-compulsive disorder states that almost all patients have certain cognitive problems. They show deficits in recognition of social clues and certain facial expressions, while themselves having poor emotion regulation skills (Jansen et al., 2020). The research of cognitive and emotional impairments in obsessive-compulsive disorder shows abnormalities in brain functioning linked to cognitive and emotional tasks (Goncalves et al., 2016). They include inhibitory control, cognitive flexibility, working memory, as well as feelings of fear and guilt.
The studies contribute to the perception of emotional and anxiety disorders as being both cognitive and emotional in their nature. Such disorders as obsessive-compulsive disorder, social anxiety disorder, and depression are rooted in childhood, with negative cognitive experiences being the underlying cause for their development. Studying these disorders from a cognitive perspective provides new insights into the nature of the human brain and offers new opportunities for treatment.
Washburn, D., Wilson, G., Roes, M., Rnic, K., & Harkness K. (2015). Theory of mind in social anxiety disorder, depression, and comorbid conditions. Journal of Anxiety Disorders, 37, pp. 71–77. Web.