Running head: Anxiety Disorder 1

Lack of Awareness of Anxiety Disorder & Disabilities

Kelly Kalonji & Tobias Cotto

Capstone 1 Proposal

6/12/19

Ms.Veillette
TITLE OF YOUR PAPER 2

Anxiety Disorder is a major cause of burden of disease. In the U.S, its affecting about 40 million

adults, ages 18 and older. Anxiety can affect 25.1% of children between 13 and 18 year old.

Research shows that untreated children with anxiety disorders are higher risk to perform poorly

in school, miss out on important social experiences, and engage in substance abuse. Treatment

gaps have been described, but a worldwide evaluation is lacking. Anxiety disorders are treatable,

and vast amount of people with anxiety disorder can be helped with professional care. There are

several standard approaches have proved effective; therapy, Medication, Transcranial Magnetic

Stimulation, and Complementary and alternative treatments (Anxiety and Depression

Association of U.S, 2018). However, these disorders can be strongly influenced by ethnic, and

cultural factors and the context and norms a person is exposed to. Reports from the Anxiety and

Depression Association of U.S shows that people with an anxiety disorder are three to five times

more likely to go to the doctor and six times more likely to be hospitalized for psychiatric

disorders than those who do not suffer from Anxiety disorders.

Source 1:

https://www.researchgate.net/publication/7496284_Evidence-

based_guidelines_for_the_pharmacological_treatment_of_anxiety_disorders_recommendat

ions_from_the_British_Association_for_Psychopharmacology

The British Association for Psychopharmacology guidelines covers the range and aims of

treatment for anxiety disorders. They are based explicitly on the available evidence and are

presented as recommendations to aid clinical decision making in primary and secondary medical

care. They may also serve as a source of information for patients and their carers. The

recommendations are presented together with a more detailed review of the available evidence.

A consensus meeting involving experts in anxiety disorders reviewed the main subject areas and

considered the strength of evidence and its clinical implications. The guidelines were constructed

after extensive feedback from participants and interested parties. The strength of supporting

evidence for recommendations was rated. The guidelines cover the diagnosis of anxiety disorders

and key steps in clinical management, including acute treatment, relapse prevention and

approaches for patients who do not respond to first-line treatments. As they look into the topic

about lack of awareness of anxiety disorder by sufferers and practitioners, poor confidence by

many practitioners in their treatment, and also lack of research because some patients receive

unnecessary or inappropriate treatment.

Anxiety symptoms are common in the general population and in primary and secondary medical

care. Symptoms may be mild, transient and without associated impairment in social and

occupational function, but many patients are troubled by severe and persistent symptoms that

cause significant personal distress, impair function and reduce the quality of life. Most research
TITLE OF YOUR PAPER 4

has used the diagnostic categories for anxiety disorders in the Fourth Edition of the Diagnostic

and Statistical Manual (DSM-IV)(American Psychiatric Association, 1994), which are similar to

those in the Tenth Edition of the International Classification of Disease (ICD-10) (World Health

Organization, 1992).

Source 2

Anxiety Disorders are the world's most prevalent and common psychiatric and

neurodevelopmental disorder. Globally an estimated 275 million people experience an Anxiety

disorder. Jack M. Gorman reviews the benefits and risk associated with pharmacologic and

psychological therapies to assess their ability to achieve the elimination of Generalized Anxiety

Disorder (GAD) symptomatology and restoration of normal function. The study shows that

patients with GAD tend to have cognitive abnormalities that hinder they're to effectively deal

with symptoms associated with GAD and other aspects, a patient with GAD apprehension

prevents the normal processing of information, memory, and problem-solving capacities. They

are more likely to incorrectly interpret obvious motives as dangerous or threatening or manifest

these symptoms through inordinate muscle tension. Likely with Psychotherapy, it's designed for

nourishment patient advance cognitive or to develop behavioral strategies so the patients can

manage both cognitive and define- somatic symptoms there has been evidence shown that

Benzodiazepines were used since the 1960s because of their anxiolytic, anticonvulsant and

muscle relaxant. There has also have been researched off the effects of benzodiazepines are

mediated through activation the Y- aminobutyric acid (GABA) system at receptor complex, that

will lead to reduced neural transmission throughout the central nervous system. Benzodiazepines

have shown to the rapid onset of explain: anxiolytic action inpatient. Overall, many medications

currently available offer anxiolytics benefits, however, antidepressants are way more effective

than benzodiazepines. Cite this line: Benzodiazepines are still relevant tools to use, especially in
TITLE OF YOUR PAPER 5

acute or critical situations. However, Antidepressants that are approved for GAD treatment,

namely venlafaxine XR and paroxetine, are considered the first line up for pharmacotherapeutic

options.

Source 3

David Clark discusses the natural history of Anxiety and how there are so many people in the community

who have developed an Anxiety Disorder and then recover without any treatment or medications and

proposes that anxiety results from distorted beliefs about the dangerousness of certain situations,

sensation and or mental events. While looking into the proposal, numerous studies have shown that

patients with anxiety disorders overestimate the dangerousness of various stimuli. Several other studies

have similarly shown that overestimates are disorder-specific associated with a particularly different type

of negative beliefs. If patients beliefs are mistaken, why do the opinions persist? If the world is not as

dangerous as the patients assume, why do they not notice this and correct their thoughts? With this

research, David Miller hopes to address this problem and help understand the maintenance of Anxiety

Disorders to develop an effective treatment.

Davids starts to look at the natural history of Anxiety Disorder and how there are many people who

develop anxiety disorder but never recover without treatment. With that, David finds that negative

thinking seems to be self-correcting which prevent such self-correction from occurring in patients who

present for treatment, even with some patients with Chronic Anxiety Disorders the persistence of their

Fears seems irrationals, but some patients with Chronic Anxiety who think that during their attack that

they may be having heart attacks before they come for treatment they have already had several other

panic attacks, in which way they think they're dying, but are not dead. despite what they appear to an

outsider might be stunning disconfirmation their fears the patient's thinking still has not changed. There

are similar problems within Social phobia. a patient who is diagnosed with social phobia are afraid of
TITLE OF YOUR PAPER 6

negative evaluation from other people and as Children, they often been either bullied or teased at school.

However, as adults, they rarely receive an explicit negative evaluation from other people despite going

into difficult social situations. However, they do not notice that they come across better than they think.

The research starts to identify factors that prevent patients from changing their negative thinking

normally. With that, it's very much a collaborative effort, which involves many colleagues. using six

different maintaining processes: safety seeking behavior, attentional development, spontaneous imagery,

emotional reasoning, certain types of memory processes and the nature of threat representations are

discussed. Afterward, an illustration of the way each maintains anxiety disorders, and how the treatment

implications of the maintenance process are them described and illustrated with their empirical status.

In conclusion Negative beliefs in some people but not others is still not entirely clear, However, six

factors that seem likely to contribute to the maintenance of negative beliefs and anxiety disorders have

been identified. Cognitive Therapy Programs that specifically target these factors have proved highly

effective in panic disorder and hypochondriasis. preliminary data have suggested that they may be

similarly valuable in social phobia and PTSD.

Source 4

Generalized Anxiety Disorder or for short GAD is a characterized condition that occurs along with other

anxiety or mood disorders. it causes worry that is difficult to control and interfere with day-to-day

activities, especially if your life is stressful. However, There no concerns about Generalized Anxiety and

the treatment, many patients with GAD do not receive adequate treatment classes of drug, including

Benzodiazepines, Azapirones, Selective Reuptake Inhibitors.

There are many patients with GAD do not receive fair treatment. there are several classes of

drugs, which includes Benzodiazepines, Azapirones, Selective Serotonin Reuptake Inhibitors,

Serotonin-Norepinephrine reuptake, Antihistamines, Channel modulators, and atypical

Antipsychotics which can consistently beneficial in patients with GAD. treatment such as

Cognitive therapy was seen to be effective to patients. However, when individualizing treatment,

drug dose ranges and side effect profiles need to be considered, as well as the patient's comorbid

conditions. some doses may need to be re-produce for elderly or medically ill patients or even

those taking other medications, some doses may need to be also increased for refractory cases.

Common comorbid conditions with GAD include depression, alcohol use or drug abuse, Social

Anxiety Disorder, and panic disorder. patients with significant Depression who uses Anti-

Depression are more likely to succeed than with Benzodiazepine. GAD is a chronic illness that

requires long term treatment. Remission attainable but can also take several months or even years

on stopping medication increase risk of relapse within the first year of initiating treatment ( J Clin

Psychiatry, 2009).

Several drugs have classified as consistently beneficial for GAD, and Cognitive Therapy is also

effective as a first-time treatment. Medication and doses should also be selected to meet the same

needs of the individual patient, including comorbidities, the simultaneous presence of two chronic

diseases or conditions in a patient. and make a long term treatment for GAD so many patients

won't relapse or reach remission.

When Cognitive behavioral therapy was involved with helping GAD patient detect cues that

provoke anxiety and learn new coping skills that would usually target the psychic and somatic

symptoms of GAD, many outcomes was shown at 6 months the recovery rate was 51% for an

individual, 33% for groups, and 60% for applied relaxation( Side effect Profiles of Drug Classes

With Efficacy in GAD, J Clin Psychiatry , 2009). and the treatments that were least effective

were individual behavioral therapy 11% and traditional analytical psychotherapy 4%.
TITLE OF YOUR PAPER 8

Drug classes have approved agents for treating GAD include Selective serotonin reuptake

inhibitors (SSRIs) drugs that typically used as antidepressants, Serotonin and

norepinephrine reuptake inhibitors (SNRIs) medications that are effective in treating

depression, Benzodiazepines, Azepirines, and Antihistamines a drug that inhibit the

physiological effects of histamine, used especially in the treatment of allergies. However,

Anti Depression are generally preferred over Antidepressants because patients with GAD

frequently have Axis I comorbidity, which can be defined as an acute episode of signs

and symptoms that can come and go for years ( Handbook of Clinical Neurology, 2015).

Psychological treatment is underutilized despite evidence that cognitive distortions are

core feature needed for GAD, well-being therapy and other techniques turn out to be the

benefits for GAD. Remission has shown 50% of patients with GAD but it may take some

time, and long-term treatment for most patients with GAD.

Source 5

Anxiety is a normal part of childhood, but some children who suffer from an anxiety disorder experience

fear, nervousness, shyness and would start to avoid places and activities. Anxiety disorders in childhood

have a chronic course and are associated with anxiety problems in adulthood.

There have been testing shown that the estimates of the number of children who may require

mental health services are quite high, with recent figures ranging from 12% to 22% in community

samples (Costello, 1989). among those children referred for treatment, the acting-out, aggressive

child dominates in number and internalizing problems that may be underserviced and have been

unresearched. However, the prevalence of internalizing disorders, as well as the widespread

interference associated with anxiety in children, necessitate a concurrent focus on treatment for

internalizing disorder.

Anxiety in children interferes with adjustment, including social adjustment and academic

functioning ( Chansky and Kendall, 1997; Strauss, Frame. and Forehand, 1987; Strauss, Lease,

Kazdin, Dulcan, and last, 1989). Epidemiologies data show anxious distress as common in

childhood, and anxiety disorder has been one of the most common psychological ailments in

childhood and adulthood ( Anderson, 1994; Bell- Dolan, Last, & Strauss, 1990). Anxiety disorder

is often comorbid with other difficulties ( depression, attention deficit hyperactivity disorder,

conduct problems) and may increase the risk of significant dysfunction ( Brady Kendall, 1992;

Mattison, 1988). However, an Anxiety Disorder in childhood although is not dramatic in

presentation as externalizing disorders represent serious mental health problem for children and

families. While focusing on aggressive and antisocial children, it was no surprise that the

outcome shows that with externalizing children has been far more common than similar work

with anxious children ( see Borduin et al.., 1995; Kanzdin, Siegel, & Bass,1992). most of the

early studies of anxiety in childhood were concentrated on the nighttime fears, fear of dental or

medical produces, and evaluation anxiety, and a few clinical case studies (Kendall, Kortlander,

Chansky, & Brady, 1992). few Psychopharmacological studies have been reported for childhood

anxiety but the results were left disappointed, Antidepressant and anxiolytic medications such as

clonazepam, imipramine, and buspirone have not been tested benefits for children diagnosed with

an Overanxious Disorder or Social Phobia.

Ninety-four children from ages nine to thirty with an Anxiety Disorder were randomly assigned

to Cognitive Behavioral treatment or a waiting list control. However, the outcome was evaluated

by using diagnostic status child self-reports, parents and teacher reports, cognitive assessments
TITLE OF YOUR PAPER 10

and behavioral observation maintenance, examined using a one year follow data. some Analyses

indicated a significant improvement over time. The researcher was maintaining at a 1 year follow,

clientage and comorbid status show that it did not moderate outcomes.

Problem Statement

The World Health Organization has reported that between 1990 and 2013,
nearly 615 million people are suffering from an anxiety disorder. Which is
close to 30% of the global population.

Disability is one of the major causes of dependency and deprivation

Method

Participants

Some of the methods that we will be experimenting is to test students knowledge on Anxiety
Disorder and Disability. We chose this study to see how they will perform or to even at least get
to learn from this experiment. Previous studies would use other methods or even research and
studies to determine their study.

Some questions on our project that will be not answered are if some students will be successful
TITLE OF YOUR PAPER 11

in finding information on the topic, things such as cross-cultural difference or even different
moods changes can limit our experiment in any way. Many students cultural background
influences can be strongly affected.

There are a lot of safety precautions that we will need to be cautious with, some students may
feel uncomfortable with the topic, or even because of cross-cultural differences. Before we begin
our experiment, we will ask students safety questions about themselves to get more information
and be more cautious about the questions on our survey.

To start we will give each student a survey to do with five to eight questions about Anxiety
Disorder and facilities, just to test their knowledge. Some questions that might be asked are ”
Does anyone within your family suffer from disabilities?” or “ Do you know anything about
Anxiety disorder?”. Afterward, we will be giving them computers to examine how fast they
could locate information about those questions. After they are done with our surveys, we will
show them our website that we will build on Wix, after they are done examining our Wix
website, we will ask them questions such as “ Was our website helpful?” or “ Was our website
more comfortable to use instead of looking it up online?” to get our results that we will need at
the end of our experiment.

Conclusion

If students were given a platform with information on disabilities and mental disorders, then they
will be able to learn more information on these topics and be more aware of issues regarding this
topic
TITLE OF YOUR PAPER 12

Our idea is to create a platform that can provide information and help better promote awareness
on disabilities and mental health .
TITLE OF YOUR PAPER 13

References

Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, et al. The global

burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys.

Epidemiologia e Psichiatria Sociale. 2009;18:23–33.

Kendall, P. C., Flannery-Schroeder, E., Panichelli-Mindel, S. M., Southam-Gerow, M.,

Henin, A., & Warman, M. (1997). Therapy for youths with anxiety disorders: A second

randomized clinical trial. Journal of consulting and clinical psychology, 65(3), 366.

https://www.researchgate.net/profile/Michael_Southam-

Gerow/publication/14047500_Therapy_for_youths_with_anxiety_disorders_A_second_randomi

zed_clinical_trial_Journal_of_Consulting_and_Clinical_Psychology_65_366-

380/links/0deec51756504a2d38000000/Therapy-for-youths-with-anxiety-disorders-A-second-

randomized-clinical-trial-Journal-of-Consulting-and-Clinical-Psychology-65-366-380.pdf

Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2016

(GBD 2016) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME),

2017. http://ghdx.healthdata.org/gbd-results-tool

Baldwin, D. S., & Polkingtorn, C. (2005). Evidence-based pharmacotherapy of

generalized anxiety disorder. Neuropsychopharmacology (2005), 293-302. Retrieved March 22,

2019, from https://watermark.silverchair.com/8-2-

293.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAkAwgg

I8BgkqhkiG9w0BBwagggItMIICKQIBADCCAiIGCSqGSIb3DQEHATAeBglghkgBZQMEAS

4wEQQM2MQPpKGUlb6TIwLAAgEQgIIB87Rv2Uo-YId2DK03DEQArIY3NGdwepxuVBc-

ykKRbNMXakV-m5j9CCJt6-BTyPmAhkBEBCkCJvYFQabXmJq-

ZonoKIA2ipKR2WQdtRg14ywP-ESUrE3RBW-
TITLE OF YOUR PAPER 14

3KxfgFfWLUJuF8FqegzRopl0nkxmVfCKvYqcWcj1O_WZV2TEhk-hpfmVK14_nwzP-

r0iYzclbSA0XA-

L8AC19_lvoQEdejoSvTmUrPbO6dMvUKS58X0eQQuhcffq8ENM3lUA0efnUGRsbHTeDpgId

zIEWBvKpUbp4QQ0NkXswK89i_lLTZSnWNLY0E-HTK8D4wSRCX3OwZJSlp-

wfxI7nUp3_8La4Kn02n005mO8ai5SiVigC4HS4loYYxD2O06n_yWU7YOrjNihUrXhTfpyc3ek

n8xnnuBuP5mZx9g41yWUBgPH_Ku13llF5q9-tlUpC5psuVbo0s2dDM1MsE-

H3ihem6gSFrFJiMRy5YjIt5L2w2O6GQEE3J2-jsgIsS8ycmXoNUTbZeeM2eRK7Nyzw-

PRzgVHTqxOHXvQqqQzGV3xU0RcNSId-kOyx4moYnVjBe-

uJ6p2zV7_zA1gLediuTcUrvOH0dw4OXJxty43V13URlO0j1qM_nvr6o5RFvfceJ46ZLNGOv_ii

PpbKnLGTNR5se6vlMm2eapw.

Fricchione, G., M.D. (2004). Gregory Fricchione, M.D. Generalized Anxiety Disorder, 351-675.

Retrieved March 24, 2019, from http://jasoncartermd.com/resources/pdf/Generalized Anxiety

Disorder.pdf

“During the past four weeks, have you been bothered by feeling worried, tense, or anxious most of the

time?”

Gorman, J. M. (2001). Pdfs.semanticscholar.org. Generalized Anxiety Disorder, 3(3), 37-43. Retrieved

March 22, 2019, from

https://pdfs.semanticscholar.org/bad0/9cb7f5a25c755bba851f8dc27e0308e8236f.pdf.

Laakmann, G., Schule, C., Baghai, T., Kuhn, K., & Ehrentraut, S. (1997). Researchgate. Buspirone and

Lorazepam in the Treatment of Generalized Anxiety Disorder in Outpatients, 357-366. Retrieved March

22, 2019, from

https://www.researchgate.net/profile/Thomas_Baghai/publication/287032900_Buspirone_vs_Lorazepam_

in_the_Treatment_of_Generalized_Anxiety_Disorder_-_A_Placebo-controlled_Double-

blind_Trial_on_Efficacy_in_Outpatients/links/5677d72e08ae125516ee4224/Buspirone-vs-Lorazepam-in-
TITLE OF YOUR PAPER 15

the-Treatment-of-Generalized-Anxiety-Disorder-A-Placebo-controlled-Double-blind-Trial-on-Efficacy-

in-Outpatients.pdf.

Ritchie, H., & Roser, M. (2018). Ourworldindata.org. Mental Health. Retrieved March 22, 2019, from

https://ourworldindata.org/mental-health. "Mental health disorders are complex and can take many forms"