Anxiety disorders.

Abstract

Anxiety is a normal reaction of apprehension and worry to an event that an individual perceives as stressful. It typically initiates a series of coping behaviors that helps one prepare for the stressful situation. However, excessive anxiety that impairs one's ability to function is considered an anxiety disorder. For these individuals, anxiety disorders can be devastating, interfering with the ability to lead a productive, satisfying, and enjoyable life. Each specific anxiety disorder has a different constellation of symptoms, but symptoms common to all anxiety disorders include excessive and irrational fear, worry, and dread (National Institute of Mental Health [NIMH], 2009), and many anxiety disorders also include avoidant behavior resulting from the fear and worry.Anxiety disorders are the most prevalent mental disorders and affect approximately 40 million adults in a given year, about 18% of the U.S. population (Kessler, Chiu, Demler, & Walters, 2005). Of those, about 23% (about 4% of the U.S. population) have cases considered to be severe. In terms of lifetime prevalence of anxiety disorders, the percentage jumps to almost 29% of the population, with women having a significantly higher risk of having an anxiety disorder over their lifetime than men (Kessler, Berglund, et al., 2005). The average age of onset for anxiety disorders is 11 years. Anxiety disorders are often comorbid with other disorders such as medical illnesses, depression, and drug or alcohol abuse or addiction that may exacerbate or mask anxiety symptoms. In many cases, those problems should be treated initially, to facilitate successful treatment of the anxiety disorder (NIMH, 2009).Although generally believed to be successfully treatable by most mental health professionals, only about one third (36.9%) of those with anxiety disorders receive minimally adequate mental health treatment (Wang et al., 2005). Wang et al. ( 2005) defined minimally adequate treatment as either 2 or more months of pharmacotherapy plus four physician visits or eight or more sessions of psychotherapy. Medications considered effective for anxiety disorders include anxiolytics, antidepressants, beta blockers, and mood stabilizers. Effective therapies for anxiety disorders include behavioral and cognitivebehavioral therapy. Most mental health professionals consider the combination of cognitive-behavioral therapy and medication as the best treatment approach for many of those with anxiety disorders (NIMH, 2009).Given their prevalence, it is not surprising that the research literature on anxiety disorders is immense and continues to grow rapidly. In this chapter, we broadly summarize the current research literature on anxiety disorders among multicultural populations. As stated elsewhere in this handbook, the U.S. population is becoming increasingly diverse in many ways, such as age, ethnicity, religion and spirituality, country of origin, and disability status. Reviewing every aspect of anxiety disorders among every permutation of diversity in cultural groups in the Unite...