Dr Kate Edwards Psychology

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Seven pairs of sox, two magazines, a novel, makeup, umbrella, scarf, drink bottle (empty), gloves and a large pile of mixed clean tissues/napkins/receipts. Everything I really need (wallet, glasses, etc.) is still in my handbag. (Taken with Instagram)

Seven pairs of sox, two magazines, a novel, makeup, umbrella, scarf, drink bottle (empty), gloves and a large pile of mixed clean tissues/napkins/receipts. Everything I really need (wallet, glasses, etc.) is still in my handbag. (Taken with Instagram)

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Anxiety Disorders: Prevention Before Cure

Recent years have witnessed a move away from the traditional models of psychological treatment delivery toward a growing interest in prevention and early intervention. Large, empirically tested programs for the prevention of a range of problems are currently being conducted in many countries around the world. Typically, these programs have been aimed at problems that are of considerable overt interest to policymakers, such as substance abuse, criminality, or marital distress (Mrazek & Haggerty, 1994). To date, there has been little interest in prevention of anxiety disorders (Andrews & Erskine, 2001) despite their high community cost (P. E. Greenberg et al., 1999).

Anxiety disorders as a group are the most common mental health problem in the general community (Andrews, Hall, Teesson, & Henderson, 1999; Kessler et al., 1994) and represent a significant problem for most societies. Because of their high prevalence, anxiety disorders account for a large proportion of the burden of disease in western countries (P. E. Greenberg et al., 1999). Murray and Lopez (1996) have calculated that just two anxiety disorders, panic disorder and obsessive– compulsive disorder, account for 1.9% of the total burden of disease in developed countries. This is more than that accounted for by breast cancer, HIV, schizophrenia, or diabetes. Similar calculations in Australia have indicated that generalized anxiety disorder and social phobia together account for a greater burden than HIV/AIDS, cirrhosis of the liver, or melanoma (Mathers, Vos, & Stevenson, 1999).

Perhaps one reason for the lack of interest in prevention of anxiety disorders in earlier years has been the strong focus on development of good treatment programs. Indeed, treatments for anxiety disorders are highly efficacious (with effect size changes close to one), and the majority of treatment completers have shown marked change (Fedoroff & Taylor, 2001; Gould, Otto, & Pollack, 1995; Gould, Otto, Pollack, & Yap, 1997). However, effectiveness of these programs has rarely been examined, and it is possible that these effects may not be as large when generalized to the real world (Persons, 1997).

Furthermore, overall effect sizes of one standard deviation still allow considerable scope for further improvement, and there is little doubt that many sufferers of anxiety disorders still show considerable distress and impairment following treatment (Craske, 1999; Fisher & Durham, 1999). Finally, and perhaps most important, most sufferers do not access treatment until well into adulthood. Given that the age of onset for anxiety disorders is usually very early, even those who access appropriate help typically suffer for many years before receiving that help (Thompson, Hunt, & Issakidis, 2004; Thompson, Issakidis, & Hunt, 2004). Therefore, much of the life interference associated with anxiety—such as reduced career choices, increased absenteeism, unmarried status, secondary substance use, depression, and increased medical use—affects these individuals for many years despite the existence of efficacious treatments.



REFERENCE Rapee, Kennedy, Ingram, Edwards, Sweeney, (2005). Prevention and early intervention of anxiety disorders in inhibited preschool children. Journal of Consulting and Clinical Psychology 73(3) pp.488–497.

Filed under Anxiety Disorder prevention cure psychology scholar

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