A psychological disorder can be defined as “a mental health
condition that disrupts the normal feelings, mood, or ability of one person to
interact with others” ("Psychological Disorders," 2007). There are several factors that contribute to
psychological disorders such as “biological, cognitive, psychodynamic and
humanistic and existential components” (Hansell & Damour, 2008 p.115). The
DSM-IV-TR classifies psychological disorders in different categories and of all
those categories I would like to focus on the anxiety disorder category, more
particularly panic disorder. In this
paper I will discuss the Epidemiology of panic disorder, socio-cultural and
environment factors associated with panic disorder, the relationship between
human development and socialization as it relates to panic disorder, treatment
of panic disorder and how understanding an individual’s culture is important to
the diagnosis and treatment as well as treatment options.
Feelings of sadness and fear can very well be a normal part of
life because of certain experiences that individual’s may have that create
these feelings. Anxiety is also a
feeling that an individual can have when they sense that it’s a possibility
that something bad is going to occur and that feeling can be justified
depending on the circumstances, however anxiety is said to be “a feeling of
dread, fear, or apprehension, often with no clear justification” (anxiety,
2014). While it is normal for
individual’s to experience anxiety in certain circumstances, if the anxiety
continues and they are not able to control those feelings it could be very well
possible that an anxiety disorder is present.
Panic Disorder is a psychological disorder identified in the
DSM-IV-TR as one of the main anxiety disorders.
Panic disorder is defined as “an acute anxiety attack often accompanied
by agoraphobia or fear of being separated from a safe place”
("Psychological Disorder," 2001 p. 518). When someone is suffering from panic disorder
they often experience panic attacks “in which they feel overwhelmed by anxiety
and have a strong urge to escape or get help” (Hansell & Damour, 2008 p.
120). A study conducted on the lifetime occurrences
of panic disorder and recurring panic attacks revealed that “females are almost
twice as likely as males to suffer panic disorder, and about seven times as
likely to suffer repeated panic attacks.
Overall, panic disorders or panic attacks occur in up to one in ten of
the general population” ("Panic disorder: History and epidemiology,"
1998). The occurrence of panic disorder
is specific and different for every individual and there are “demographic
factors such as an individual’s age, gender, and social class are among the variables
that can significantly influence” (Hansell & Damour, 2008 p. 129) how panic
disorder is displayed.
Gender differences in the rates of anxiety disorders, such as
panic disorder are explained through socio-cultural factors because “women have
noted that traditional female gender roles have not typically emphasized
assertion and self-sufficiency” which are “skills that are important for
overcoming anxiety” (Hansell & Damour, 2008 p. 135). Environmental factors that may contribute to
panic disorder could come from parents who suffer from panic disorder and their
children witness the panic attacks, overbearing parenting styles, abusive
childhood, and traumatic experiences during childhood, stressful home
environment and stressful events in life.
Human development ‘is viewed as the changes in physical,
psychological, and social behavior that are experienced by individuals across
the life span-from conception to death.
Socialization is the process by which an individual becomes a member of
a particular culture and takes on its values and behaviors” (Shiraev, 2010 p.
196). Human development is how an
individual continuously change and evolve as they age, in which their
attitudes, beliefs and values may change as they develop new ones. The process of human development and
socialization can be very difficult for someone suffering from panic disorder
because of their fear of change panic attacks are more likely to occur followed
by shortness of breath, the feeling of being suffocated, light-headedness, weakness,
trembling, and pain in the abdomen along with more symptoms making it
impossible for an individual to be in a social situation.
There are cultural and historical relativism on how anxiety
disorders are defined and classified because the symptoms are similar across
cultures, however “different cultures, experience, define, and classify anxiety
problems differently” (Hansell & Damour, 2008 p.133). Some examples of how
different cultures classify anxiety are nervios, which is “ a term used by
Latino populations in Latin America and in the United States to describe a
range of symptoms of nervous distress; Ataque de nervios is a term used in some
Latino cultures to describe an episode of intense anxiety; Shenjing shuairuo is
an anxiety syndrome recognized in China including symptoms of physical or
mental exhaustion, difficulty sleeping, and concentrating, physical pains,
dizziness, headaches and memory loss” (Hansell & Damour, 2008 p. 133).
Latino and Asian cultures often reveal only the physical aspects when
describing their anxiety because signs of emotional stress are denounced in
some cultures and individuals are deterred from expressing those types of
feelings to anyone outside of their immediate family making diagnosis of panic
disorder difficult. That is why it is
very important to understand cultural differences when diagnosing and treating
individuals suffering from psychological disorders such as panic disorder.
Cognitive behavior is known as the most effective form of
treatment for individuals suffering from panic disorder. Cognitive-behavioral therapy “is an
action-oriented form of psychosocial therapy that assumes that maladaptive, or
faulty, thinking patterns cause maladaptive behavior and negative emotions.
(Maladaptive behavior is behavior that is counter-productive or interferes with
everyday living.) The treatment focuses
on changing an individual’s thoughts (cognitive patterns) in order to change
his or her behavior and emotional state” (Ford-Martin & Lerner, 2011).
Systematic desensitization is another form of treatment for individuals
suffering from panic disorder that is “intervention involving gradually
increasing exposure to a conditioned stimulus (such as a feared object) while
practicing relaxation techniques” (Hansell & Damour, 2008 p. 144). Medications such as antidepressants,
tricyclic antidepressants and benzodiazepines are used to provide temporary
relief of symptoms that individual’s experience with panic disorder; however
these medications do not treat the disorder. The use of medications is more
likely to be effective when combined with therapy, changes in lifestyle that
focuses on the primary cause of panic disorder.
Understanding cultural differences is a very important component
in diagnosing and treating panic disorder because many cultures classify their
disorders differently based on the morals and beliefs that they are accustomed
to. Cross-cultural psychology “examines
psychological diversity and the underlying reasons for such diversity”
(Shiraev, 2010 p. 2) which allows for individuals with different cultural
backgrounds suffering from panic disorder to receive the proper diagnosis and
treatment.
In conclusion, panic disorder is a psychological disorder that has
been said to be more common in women because they lack certain skills that are
used to overcome anxiety, however in relation to culture panic disorder is
classified in different ways in different cultures making treatment a bit more
complex because in some cultures they avoid exposing certain symptoms because
of the beliefs and values of their culture in regards to expressing certain
feelings outside of the immediate family.
The differences in cultural beliefs, values and morals is a key
component that must be understood to properly diagnose and treat and individual
suffering from panic disorder.
Ron-Byrne, P., Craske, M. G., &
Stein, M. B. (2006). Panic disorder. The
Lancet, 368(9540), 1023-32.
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