Anxiety disorder or poverty?

Anxiety disorder or poverty?

By Liz Lockhart

Interesting findings have emerged this week from a study entitled ‘Is it Generalised Anxiety Disorder or Poverty?  An Examination of Poor Mothers and Their Children’.

In the study, Judith C Baer, an associate professor in the School of Social Work and her team, found that poor mothers are more likely to be diagnosed with generalised anxiety disorder (GAD) because they live in poverty and not because they actually have a psychiatric disorder.

The study is published online in Child and Adolescent Social Work.  It argues that although the high levels of stress associated with poverty can lead to psychological problems, there is no evidence that GAD in poor mothers is due to any form of ‘internal malfunction’.

Earlier studies have already suggested that the poorest mothers have the highest rates of being classified as suffering from GAD.  This study noted that ‘there is no evidence for a malfunction of some internal mechanism.  Rather, there is a physical need in the real world that is unmet and produces anxiety.’

Baer said "The distinction is important because there are different ways to treat the problem.  While supportive therapy and parent skills training are often helpful, sometimes the most appropriate intervention is financial aid and concrete services."

The researchers feel that changing and broadening definitions for GAD has resulted in some instances, mental health professionals categorising the 'normal' reactions of these mothers to the real and extreme conditions, as symptoms of the anxiety disorder.

Psychiatric diagnoses are currently assessed using the Diagnostic and Statistical Manual of Mental Disorders (DSM).  DSM uses symptom-based criteria to determine disorders.  Baer says ‘Our findings suggest that anxiety in poor mothers is usually not a psychiatric problem but a reaction to severe environmental deficits.  Thus, assessment should include careful attention to contextual factors and environmental deficits as playing a role in the presentation of symptoms.’

In a time of austerity when benefits are being cut or reduced it is important to remember that not only mothers but many other disadvantaged groups are feeling the natural stresses caused by financial pressures.  Professionals should be mindful that misdiagnoses of any condition can bring with it many problems, both in gaining the correct treatment and the social and emotional repercussions for the individual diagnosed.

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