Insomnia

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Insomnia PSY 492 Instructor James Liggett Jonathan Moretti December 14, 2009

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CHAPTER SIX The Age of Anxiety The multiple perspectives we have been using in this book are particularly useful in understanding the impact anxiety has on U.S. society. The word “anxiety” comes from a Latin root meaning to “choke or throttle” connoting a troubled state of mind (Tone, 2009). Anxiety disorders are believed to be the most common mental health problem in the United States. Two common measures are lifetime morbid risk (the theoretical risk of getting a disorder at any point in life) and 12-month prevalence (the proportion of the population thought to suffer from the disorder in any 12-month period). Baxter et al. (2013) conducted a meta-analysis of 87 studies from 44 countries between 1980 and 2009. They found that anxiety disorders are common across the globe with an estimated current prevalence of approximately as much as 28% of the global population. The prevalence of anxiety disorders in the United States is estimated for lifetime morbid risk/12-month prevalence as follows: Specific Phobia 18.4%/12.1%, Social Anxiety Disorder 13%/7.4%, Post Traumatic Stress Disorder (PTSD) 10.1%/3.7%, Generalized Anxiety Disorder 9%/2%, Separation Anxiety Disorder 8.7% /1.2%, and Panic Disorder, 6.8%/2.4%, (Kessler, Petukhova, Sampson, Zaslovsky, & Wittchen, 2012). Although anxiety disorders are prominent, it is important to realize that their incidence has remained steady over several decades despite pharmaceutically funded efforts to make the public think there is an epidemic that needs medicated (Baxter et al., 2014). Although psychotropic medications are available for anxiety disorders, many psychological treatments also have excellent track records. Remember, from an integrative perspective it is not enough to describe anxiety symptoms, posit a biological explanation, then describe how certain drugs act biologically to (at least temporarily) decrease or eliminate these symptoms. With sentient beings, we have to look to the psychological, cultural and social variables that contribute to anxiety. We recall a client (Elijah) who lived in what could be described as a “toxic environment.” Elijah's urban residence was the regular scene of violence, and he himself had witnessed two shootings in his 23 years. He was court-ordered to receive treatment for an alcohol-related charge (drunk and disorderly conduct). Even after abstaining from all drugs for 60 days, Elijah was what could only be described as “a nervous wreck.” He showed symptoms of both Panic Disorder and PTSD (the latter related to stimuli associated with the shootings he had witnessed). In consultation with a psychiatrist, who prescribed SSRI medication, Elijah asked why he had his symptoms, and the doctor replied, “Some people have a genetic predisposition to such things.” As Charlie Brown would say, “Good grief!” In this client's case, genetic predisposition not withstanding, there were clearly psychological, cultural, and social contributors to his anxiety. His alcohol use was a .

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abnormal psychology: an overview learning objectives 1 · 1.1 How do we define abnormality and classify mental disorders? · 1.2 What are the advantages and disadvantages of classification? · 1.3 How common are mental disorders? Which disorders are most prevalent? · 1.4 Why do we need a research-based approach in abnormal psychology? · 1.5 How do we gather information about mental disorders? · 1.6 What kinds of research designs are used to conduct research in abnormal psychology? Abnormal psychology is concerned with understanding the nature, causes, and treatment of mental disorders. The topics and problems within the field of abnormal psychology surround us every day. You have only to pick up a newspaper, flip through a magazine, surf the web, or sit through a movie to be exposed to some of the issues that clinicians and researchers deal with on a day-to-day basis. Almost weekly some celebrity is in the news because of a drug or alcohol problem, an eating disorder, or some other psychological difficulty. Countless books provide personal accounts of struggles with schizophrenia, depression, phobias, and panic attacks. Films and TV shows portray aspects of abnormal behavior with varying degrees of accuracy. And then there are the tragic news stories of mothers who kill their children, in which problems with depression, schizophrenia, or postpartum difficulties seem to be implicated. Abnormal psychology can also be found much closer to home. Walk around any college campus, and you will see flyers about peer support groups for people with eating disorders, depression, and a variety of other disturbances. You may even know someone who has experienced a clinical problem. It may be a cousin with a cocaine habit, a roommate with bulimia, or a grandparent who is developing Alzheimer’s disease. It may be a coworker of your mother’s who is hospitalized for depression, a neighbor who is afraid to leave the house, or someone at your gym who works out intensely despite being worrisomely thin. It may even be the disheveled street person in the aluminum foil hat who shouts, “Leave me alone!” to voices only he can hear. The issues of abnormal psychology capture our interest, demand our attention, and trigger our concern. They also compel us to ask questions. To illustrate further, let’s consider two clinical cases. Monique Monique is a 24-year-old law student. She is attractive, neatly dressed, and clearly very bright. If you were to meet her, you would think that she had few problems in her life; but Monique has been drinking alcohol since she was 14, and she smokes marijuana every day. Although she describes herself as “just a social drinker,” she drinks four or five glasses of wine when she goes out with friends and also drinks a couple of glasses of wine a night when she is alone in her apartment in the evening. She frequently misses early-morning classes because she feels too hung over to get out of bed. On several occasions her drinking has .

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1. Insomnia PSY 492 Instructor James Liggett Jonathan Moretti December 14, 2009

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