Generalized anxiety disorder in different cultures
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This article summarizes current knowledge about social and ethnocultural variations in the prevalence of anxiety disorders as well as in their symptomatology and course. Some of the substantial differences in rates found in clinical epidemiologic studies probably are related to differential patterns of help-seeking among different ethnic groups. Cultural factors play an important role in the interpretation of behaviors, that is, whether there are reasons in family or social dynamics to make biased judgments about others. Substantial differences also have been found in the symptomatology of culture-related forms of anxiety disorders with variations in content and focus, and in accompanying somatic manifestations as well. Through the case study of a woman with post-traumatic stress disorder, the social embedding and cultural meaning of anxiety in clinical practice are described, and culturally responsive strategies for diagnosis and treatment are outlined. Clinicians should be encouraged to think of innovative ways of approaching anxiety in its social and cultural context. Cited by (0)Copyright © 1995 Elsevier Inc. All rights reserved.
AbstractThe GAD-7 is a popular measure of generalized anxiety disorder (GAD) symptoms that has been used across many cultural groups. Existing evidence demonstrates that the prevalence of GAD varies across self-identified ethnic/cultural groups, a phenomenon that some researchers attribute to cross-cultural measurement error rather than to actual differences in rates of GAD. Nonetheless, the effect of culture on factor structure and response patterns to the GAD-7 have not been examined and could result over- or under-estimated GAD-7 scores across different cultural groups. The current investigation assessed the factor structure of the GAD-7 in White/Caucasian, Hispanic, and Black/African American undergraduates and tested for cultural-based biases. A modified one-factor model exhibited good fit across subsamples. Results revealed that Black/African American participants with high GAD symptoms scored lower on the GAD-7 than other participants with similar GAD symptoms. Results highlight the need for culturally sensitive GAD screening tools. Section snippetsParticipantsParticipants were recruited from the undergraduate research pools of the University of Regina and the University of Houston as part of a larger data collection project (currently unpublished). Data collection for the larger study was approved by the University of Regina and the University of Houston research ethics boards. All participants completed the self-report scales in an online Internet survey. The survey included 12 bogus items that assessed for careless responding (e.g., “sometimes my ResultsThe GAD-7 item and total means and standard deviations for each group are presented in Table 1. Results of a one-way ANOVA revealed significant mean differences between groups on GAD-7 total scores, F(3,946) = 5.68, p = .001. A Tukey post hoc test revealed that the Black/African American subsample differed significantly from all other subsamples on GAD-7 total scores (p < .05). The White/Caucasian and Hispanic subsamples did not differ significantly from each other (p > .05). CFAs of the unitary model ( DiscussionA primary aim of the current investigation was to test the unitary factor structure of the GAD-7 across White/Caucasian, Hispanic, and Black/African American participants, using self-reported ethnicity as a proxy for culture. With the exception of the White/Caucasian Houston subsample, the CFA results indicated that the original unitary model as proposed by Spitzer et al. (2006) provided a relatively poor fit to the data. A revised unitary model was tested (Kertz et al., 2013), allowing for AcknowledgementsH.A.P. is supported by a Canadian Institutes of Health Research (CIHR; FRN: 131152) Regional Partnership Program Doctoral Award. M.A.T. is supported by a CIHR Doctoral Award (FRN: 113434). C.J.B. is supported by the National Institutes of Mental Health (1 F31 MH099922-01A1). Preparation for this paper was supported in part by the University of Regina President's Chair for Academic Excellence in Adult Mental Health Research awarded to G.J.G.A. The authors declare no conflicts of interest.
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Ethnic differences in the reliability and validity of a panic disorder screenEthnicity & Health(2007) Validity of the generalized anxiety disorder-7 scale in an acute psychiatric sampleClinical Psychology & Psychotherapy(2013) Cited by (52)Recommended articles (6)Copyright © 2015 Elsevier Ltd. All rights reserved. Does anxiety exist in other cultures?Cultural differences in social anxiety are known to exist. Research tells us that how social anxiety disorder (SAD) presents itself can vary depending on where you live and the culture in which you are raised. This makes sense because different cultures have different social rules and expectations.
Is there any relationship between culture and the prevalence of anxiety disorders?One of the main differences seen across cultures is the way anxiety and depression is expressed. Someone from a culture where it is common to know psychological terms, could easily describe anxiety and depression using those specific words. In other cultures, other words might be more common.
Are certain ethnicities more prone to anxiety?Focusing specifically on race, we found that whether a respondent expressed anxiety symptomology or described feeling fearful, Native American, white, and Hispanic respondents were significantly more likely to receive an anxiety disorder diagnosis compared to black respondents.
What are the cultural causes of anxiety?Researchers have illustrated that certain factors vary by culture and hence lead to a different trajectory of social anxiety disorder: individualism/collectivism, social norms, self-construal, and gender role and gender role identification.
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