Anxiety is a complex condition with psychological, biological and environmental factors causing predisposition to stress.
Psychological Factors
psychodynamic theories
Anxiety is a central concept in psychoanalytic conceptions of abnormal behaviour. According to Sigmund Freud, anxiety-based disorders, or neurotic disorders, are called neuroses. Psychodynamic Theory is a concept that explains a person's personality in terms of conscious and unconscious ways such as unconscious desires and beliefs.
Freud said our personality develops from the interactions of three fundamental structures of the human mind: the id, ego, and superego. Our efforts to find balance among the conflicts and desires of these structures determine our behaviour and approach of the world. The way we balance any situation determines our manner of resolving a conflict between two overreaching behavioural tendencies: our biological aggressive and pleasure-seeking drives vs. our socialised internal control over those drives.
Psychoanalysts believe obsessions and compulsions as ways of handling anxiety. According to Freud, obsessions are symbolically related to, but not as terrifying, as the underlying impulses. A compulsion is a way of taking back or undoing one's unacceptable urges, as with obsessive thoughts of dirt and compulsive handwashing are used to deal with one's dirty sexual impulses. Generalized anxiety and panic attacks are believed to occur when one's defences are too weak to control or contain neurotic anxiety, but strong enough to hide the underlying conflict.
The id is the most primitive form of the three structures; its only concern is of instant gratifications of its physical urges and needs. Its behaviour is entirely unconscious; outside of unconscious thought, for example; if it saw someone having something it likes, it would grab it for itself without knowing or caring that it's being rude. Its only concern would be of itself.
The superego cares about social rules and morals, similar to what some people call a moral compass or conscience. This develops as a child considers right and wrong according to its cultural background. For this reason, unlike the id, the superego wouldn't take what's not belonging to it even if it needs it as it would be rude.
On the other hand, if both the id and the superego were involved and the id was strong enough to override the super ego's moral compass, it would take what it wants with no knowledge or concern about being rude but would feel shame and regret in the aftermath.
The ego; in contrast to the id, who is all instinctual and superego, who is all about morals; is the rational pragmatic part of our personality. It's less primitive than the id and is partly conscious and unconscious. This is what Freud considered to be the 'Self'.
The ego's job is to balance the superego's and id's demands in a practical sense of reality. In the sense of the conflict between taking or not taking another person's thing, the ego would decide to buy what he needs instead. While this takes more time, the ego decides to make the sacrifice as an effort of compromise, which is satisfying your need for the thing you desire without taking part in an unpleasant social situation that could make you feel regret and shame in the aftermath.
Freud believed that the ego, superego, and id were constantly in conflict, resulting in adult personality and behaviour being rooted as a result of these internal struggles throughout childhood. Freud believed that a person with a strong ego has a healthy personality—and that imbalances in this system can cause neurosis (now thought as anxiety and depression, as well as certain unhealthy behaviours).
Cognitive Factors
Cognitive theorists stress that maladaptive thought patterns and beliefs associated with anxiety tend to magnify a situation worse than it is, causing people with anxiety to anticipate the worst outcome and making them powerless to cope effectively. Invasive thoughts about previous traumatic events are the main feature of posttraumatic stress disorder (PTSD). The presence of these thoughts after a traumatic event predicts later development of PTSD.
Cognitive processes play an important role in panic disorders. According to David Barlow, panic attacks are triggered by exaggerated normal misinterpretations of normal anxiety symptoms such as dizziness, heart palpitations, and breathlessness. A person misinterprets these as signs as a pending heart attack or psychological loss of control, creating more anxiety which spirals out of control, causing a full-blown panic attack. Helping panic-attack patients realize that it's just a bit of anxiety and not a heart attack can reduce the patient's anxiety and in turn, reduce panic-attacks.
The Role of Learning
From a behavioural perspective, classical conditioning observational learning or operant conditioning can contribute to the development of an anxiety disorder. Some fears are associated with traumatic experiences, which is a classical fear of response for a person who has had a traumatic experience like a fall from a height or almost drowning, which could cause fear of heights, or getting into a pool or other source of water.
However, classical conditioning cannot be the only case; there are people who have never been in a plane crash that are afraid of flying and people who have never had a bad fall, but fear heights (observational phobia). Seeing a random plane crash could trigger a fear in some people like some are afraid of spiders although they have never been bitten or there aren't any poisonous spiders in their counties.
Yet, most people don't develop phobias through observation. It could be a biological and cognitive fact that causes some to develop phobias from observing or hearing while others don't. Once anxiety is learnt classically or vicariously, it could be triggered by cues from the environment or internal cues such as thoughts and images. In phobic reactions, the cues tend to be external, relating to feared objects or situations; whereas in panic disorders, the cues to the arousal of anxiety are internal bodily sensations such as one's heart rate, mental images of collapsing, and having a seizure in a public place.
In addition to classical conditioning and learning, operant conditions also play a role in motivating people with anxiety to avoid or escape it due to the unpleasant emotional state behaviour successful in reducing anxiety such as compulsions, or phobic avoidance responses become stronger through negative reinforcement.
Sociocultural Factors
Social and cultural factors can play a role in anxiety disorder development. The role of culture is not shown in culture-bound disorders that only occur in certain locales. One such phobia is found in Japan called 'Tianjin Kyofushu'. People affected by this disorder are pathologically frightened of offending others by emitting offensive odours, staring inappropriately, blushing or having a blemish, or improper facial expressions. This condition has been attributed to the Japanese cultural value of extreme interpersonal sensitivity and cultural prohibitions against expressing negative emotions or causing discomfort in others.
Another culture-bound disorder is 'koro'; a South-east Asian anxiety disorder in which a man thinks that his penis will retract into his abdomen and kill him. Western culture has culture-specific anxiety reactions too. Formally classified as an eating disorder, anorexia nervosa has a strong phobic component (fear of weight gain) and so also obsessive-compulsive elements.
This eating disorder is mostly found in Western countries due to the cultural obsession of being thin. Causes of anxiety are complex and often interact with each other. These conditions can be viewed at biological, psychological, and environmental levels.
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