Cultural Factors and Anxiety in Children and Adolescents: Implications for Treatment

In this chapter, we examine the prevalence and expression of anxiety in children and adolescents in various cultures. On the basis of several studies, we suggest that cultural values and beliefs may occasion events which in turn may place the children at risk for or protect them against anxiety. Thus, it is important to examine how culture impacts anxiety for numerous reasons. First, cross-cultural studies could enable us to examine the universality of anxiety and the factors which elicit it. Second, they could help to examine cultural differences in help-seeking behavior among children and adolescents with anxiety. Third, they may help to explore the meaning and significance of anxiety symptoms, which according to Hinton, Park, Hsia et al. (2009) could produce certain culture-determined explanatory models; and, this in turn could influence the presentation, chronicity, and treatment of anxiety disorders. Fourth, cross-cultural research could help to determine the generalizability of theories on the development and maintenance of anxiety that have been developed in Western (individualistic) culture to other cultures. Fifth, cross-cultural studies will help to deter possible mismatches between the DSM criteria and the local phenomenology of anxiety disorders in specific cultures. Among adults, these mismatches are related to the definition of social anxiety and social reference groups in separation anxiety disorder, and the priority given to "difficult-to-control worry" in generalized anxiety disorder. In panic disorder, it is related to "unexpectedness" and the 10-minute crescendo criteria for associated panic attacks. Finally, knowledge of anxiety from different cultural backgrounds may enhance our broad understanding of anxiety in children and adolescents, which could provide useful information for the development of culturally sensitive treatment protocols for anxiety disorders in these different cultures. (PsycINFO Database Record (c) 2017 APA, all rights reserved)