Therapy for anxiety Therapy for anxiety
Related Articles
Anxiety
Anxiety is ubiquitous to the human condition.
From the beginning of recorded history, philosophers, religious leaders, scholars, and more recently physicians as well as social and medical scientists have attempted to unravel the mysteries of anxiety and
to develop interventions that would effectively deal with this pervasive and troubling condition of humanity.
Today, as never before, calamitous events brought about by natural disasters or callous acts of crime, violence, or terrorism have created a social climate of fear and anxiety in many countries around the world.
Natural disasters like earthquakes, hurricanes, tsunamis, and the like have a significant negative impact on
the mental health of affected populations in both developing and developed countries with symptoms of anxiety and posttraumatic stress showing substantial increases in the weeks immediately following the disaster (Norris, 2005).
Elevated levels of anxiety and other posttraumatic symptoms spike in the first few weeks after acts of terrorism, war, or other large-scale acts of community violence.
In 5–8 weeks after the September 11, 2001, terrorist attacks on the World Trade Center towers in New York City, symptoms of posttraumatic stress disorder (PTSD) doubled (Galea et al., 2002). An Internet-based survey (N = 2,729) found that 17% of individuals outside New York City reported PTSD symptoms 2 months after 9/11 (Silver, Holman, McIntosh, Poulin, & Gil-Rivas, 2002).
The National Tragedy Study, a telephone survey of 2,126 Americans, found that 5 months after the 9/11 terrorist attacks month, 30% of Americans reported difficulty sleeping, 27% felt nervous or tense, and 17%
indicated they worried a great deal about future terrorist attacks (Rasinski, Berktold, Smith, & Albertson, 2002).
The Gallup Youth Survey of American teenagers conducted 2½ years after 9/11 found that 39% of teens were either “very” or “somewhat” worried that they or someone in their families will become a victim of terrorism (Lyons, 2004).
4 COGNITIVE THEORY AND RESEARCH ON ANXIETY
Although large-scale threats have their greatest impact on the psychological morbidity of individuals directly affected by the disaster in the weeks immediately following the traumatic event, their wider effects are evident months and years later in the heightened concerns and worries of a significant proportion of the general population.
Fear, anxiety, and worry, however, are not the exclusive domain of disaster and other life-threatening experiences. In the majority of cases anxiety develops within the context of the fluctuating pressures, demands, and stresses of daily living.
In fact anxiety disorders represent the single largest mental health problem in the United States (Barlow, 2002), with more than 19 million American adults having an anxiety disorder in any given year (National Institute of Mental Health, 2001).
Approximately 12–19% of primary care patients meet diagnostic criteria for an anxiety disorder (Ansseau et al., 2004; Olfson et al., 1997). Moreover, antidepressants and mood stabilizers are the third most prescribed pharmacotherapy class, having 2003 global sales of $19.5 billion (IMS, 2004).
Thus millions of people worldwide mount a daily struggle against clinical anxiety and its symptoms. These disorders cause a significant economic, social and health care burden for all countries, especially in developing countries that face frequent social and political upheavals and high rates of natural disaster.
This chapter provides an overview of the diagnosis, clinical features, and theoretical perspectives on the anxiety disorders. We begin by examining definitional issues and the distinction between fear and anxiety.
The diagnosis of anxiety disorders is then considered with particular attention to the problem of comorbidity, especially with depression and substance abuse disorders.
A brief review of the epidemiology, course, and consequence of anxiety is presented, and contemporary biological and behavioral explanations for anxiety are considered.
The chapter concludes with arguments for the validity of a cognitive perspective for understanding the anxiety disorders and their treatment.
