Lagunas 1

Edward Lagunas Jr

ENGL 1302-223

Dr. Sharity Nelson

28 February 2022

Anxiety Applied to The Different Levels of Society

Introduction

Worldwide, 1 in 10 people, a total of 615 million, suffer from depression and/or anxiety

(Disease and Injury Incidence and Prevalence Collaborators, 2018). While psychologist have

barely begun tapping deeper into anxiety and understanding the complexities between the causes,

effects, symptoms, coping mechanisms, and the best methods for anxiety reduction there is still a

lack of comprehension in the complexities of anxiety. “The present study set out to address the

absence of pandemic-specific screening tools for detecting those in Chinese societies who are-at-

risk for experiencing mental distress… (Chen et al., 1131). Anxiety’s effects are still to be

recognized at a more national level in societies worldwide, especially under the duress of

COVID-19. “There is need… for high-quality research regarding exercise interventions for

persons with anxiety disorders. … Patients were recruited from primary care in Sweden.”

(Henriksson et al., 26). Methods to treat anxiety are still being reviewed at a national level, and

one of the more prevalent methods at the time of research seems to include exercising. “262

adults… with symptoms of anxiety and depression, untreated with pharmacotherapy or

behavioral therapy, completed the DASS-42, WHOQOL, and custom surveys at baseline and

follow-up to assess symptoms… and lifestyle activity engagement.” (Holt-Gosselin et al., 366).

Other methods to fight anxiety besides exercise are necessary to promote a more overall

balanced lifestyle to help improve anxiety in groups.

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In all, this paper observes six peer-reviewed articles on anxiety at different levels of

society, and how these articles examine the different coping mechanisms used to improve overall

mental health and how it affects individuals at the national, group, and individual level while

also determining what causes anxiety and how many suffer from mental health issues on a day-

to-day basis. Therefore, the scales used to determine how much individuals are affected by

anxiety, surveys used to determine the levels of anxiety within individuals, and scales used to

determine anxiety at a national level are examined in their effectiveness, as well as the

effectiveness of the methods used within the articles used to cope with anxiety.

Anxiety Scales

Anxiety scales have been used to determine the level of anxiety within individuals,

groups, or society as whole while their effectiveness is yet to be determined as many are still

new. “The TSA Me/not me task is a validated task of temporal self-appraisal and was modified

(Sokol and Eisenheim, 2016) and used to measure the subjects’ view of their change over time.”

(Sokol et al., 309). This scale measures how anxiety is tied to self visiaulization within

indivduals, and how overtime anxiety dictates how these individuals perceive themselves. In this

test individuals are given a list of words with 2 different emotional ties positive & negative. The

individuals are then asked to rate the words on a scale from 1 to 6 with 3 different connotations

pasts, present, and future to determine their self-view with anxiety overtime. This is similar in

terms of the DASS-42 scale in determining anxiety symptoms overtime, however, their use

complete differs in intentions. For example, “262 adults…with symptoms of anxiety and

depression, untreated with pharmacotherapy or behavioral therapy, completed the DASS-42…

[to] assess symptoms, psychosocial function, and lifestyle activity engagement.” (Holt-Gosselin

et al., 366). The DASS-42 is used to assess anxiety changes overtime in groups of patients that
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are using different forms of therapy whereas the TSA ME/not me task is used to assess how

indivduals perceive themselves with anxiety overtime. In this case the DASS-42 is more

effective in group cases due to its ability in determining the changes in anxiety with individual

groups experiencing therapy. However, the TSA ME/not me task is more effective in

determining individual anxiety perception overtime as it better serves the individual.

On the other hand, the emergence of COVID-19 has effectively changed the results of

these scales as anxiety related COVID-19 is different from anxiety related to mental health

issues. “Whereas extant findings (e.g., Choi et al. 2020a, 2020b, Gonz a´lez-Sanguino et al.

2020, Huang and Zhao 2020) have substantiated the need to screen for anxiety and related

symptoms during the COVID-19 pandemic, they have also exposed one shared drawback—the

inability to differentiate anxiety and associated symptoms that are directly related to the

pandemic from those that are not.” (Chen et al., 1132). With the pandemic exceedingly

continuing its worldwide effects most of the scales that measure anxiety have become blurred in

their results due to COVID-19 related anxieties bringing the need for pandemic specific

measures in anxiety measures. This is where the Coronavirus anxiety and obsession with

COVID-19 come into play as it is fitted to consider COVID-19 related symptoms at a national

level. “The CAS captured information regarding how frequently respondents experienced

COVID-19 anxiety in the past two weeks regarding behavioral and physiological symptoms.”

(Chen et al., 1133). To make the CAS effective in reducing results from other anxiety symptoms

they included a set of questions related to COVID-19 anxiety. “(e. g., “I felt dizzy, lightheaded,

or faint, when I read or listened to news about the coronavirus”).” (Chen et al., 1133).
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Annotated Bibliography

Baker, Holly J., et al. “The Effectiveness of Psychological Therapies for Anxiety Disorders in

Adolescents: A Meta-Analysis.” Clinical Child and Family Psychology Review, vol. 24,

no. 4, 2021, pp. 765–782., https://doi.org/10.1007/s10567-021-00364-2.

The authors, Holly J. Baker, Peter J. Lawrence, Jessica Karalus, Cathy Creswell, and

Polly Waite examine how effective psychological therapy is in reducing anxiety disorder

symptoms and remission from primary anxiety disorders. They also examine and

compare data from multiple sets of databases over 2 decades to evaluate what

psychological therapies are more effective in treating anxiety disorders to reach their

main points. In all, they examined over 26 studies of symptom severity outcomes,

analyses of diagnostic remission outcomes, post treatment, and remission from primary

anxiety disorder. Through examination of the results from the completed study they are

used to assess the best psychological therapy to use when trying to reduce anxiety within

individuals.

Chen, Juliet Honglei, et al. “Measuring Covid-19 Related Anxiety and Obsession: Validation of

the Coronavirus Anxiety Scale and the Obsession with Covid-19 Scale in a Probability

Chinese Sample.” Journal of Affective Disorders, vol. 295, 2021, pp. 1131–1137.,

https://doi.org/10.1016/j.jad.2021.08.104.

The authors, Juliet Honglei Chen, kwok Kit Tong, Xiaoyu Su, Eilo Wing-yat Yu, and

Anisde M.S. Wu set to validate the Coronavirus Anxiety Scale (CAS) and the obsession

with the COVID-19 Scale (OCS) in Chinese adults. They examine the psychological

evaluation of 1011 Chinese adults from June to July 2020 and how their results validate

the CAS and OCS scales. They also compare their results with those of other languages
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to see if the scales also align with the results of other studies done in different languages.

In all, their examination of over 1011 Chinese adults and the validation of CAS and OCS

are used to confirm the recommendation of use of these scales to identify and intervene in

COVID-19 related anxiety and obsessive thoughts. Through the examination of over

1000 adults the completed results are important in how anxiety can be assessed early on

in individuals to best mitigate developing anxiety.

Henriksson, Malin, et al. “Effects of Exercise on Symptoms of Anxiety in Primary Care Patients:

A Randomized Controlled Trial.” Journal of Affective Disorders, vol. 297, 2022, pp. 26–

34., https://doi.org/10.1016/j.jad.2021.10.006.

The authors Malin Henriksson, Alexander Wall, Jenny Nyberg, Martin Adiels, Karin

Lundin, Ylva Bergh, Robert Eggertsen, Louise Danielsson, H. Geroge Kuhn, Maria

Westerlund, N. David Aberg, Margda Waern, and Maria Aberg examine how effective

exercise is in reducing anxiety in individuals with anxiety disorders, and how different

intensity levels affect said individuals. They also examine patients using the Beck

Anxiety Inventory (BAI) and the Montgomery Asberg Depression Rating Scale

(MADRS-S). In all, 286 patients were selected using the (BAI) and (MADRS-S) scales

and were randomly assigned to two groups one with exercise programs consisting of

cardiorespiratory and resistance training and another group with control/standard

treatment non-exercise groups. Through the examination of 286 patients using the (BAI)

& (MADRS-S) scale the following results can be used to confirm the importance of

exercise in anxiety reduction and can be used to help reduce it in individuals with both

anxiety and depression.

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Holt-Gosselin, Bailey, et al. “Greater Baseline Connectivity of the Salience and Negative Affect

Circuits Are Associated with Natural Improvements in Anxiety over Time in Untreated

Participants.” Journal of Affective Disorders, vol. 295, 2021, pp. 366–376.,

https://doi.org/10.1016/j.jad.2021.08.039.

The authors Bailey Holt-Gosselin, Arielle S. Keller, Megan Chesnut, Ruth Ling,

Katherine A. Grisanzio, and Leanne M. Williams examine how natural trajectories of

depression and anxiety relate to neural functions and how engaging in activities such as

exercise, hobbies, and social interactions are impacted by symptom trajectory-circuit

relationships. They also examine patients with anxiety and depression, both untreated

with pharmacotherapy or with behavioral therapy. In addition, six circuits implicated in

the symptoms which consist of default mode, salience, negative and positive affect,

attention, and cognitive control under fMRI in task-free and task-evoked conditions. In

all, 262 adults were examined with 60% of the patients consisting of females and 40%

males and were surveyed using the DASS-42, WHOQQOL, and other custom surveys.

Through the examination of 262 patients 24% of patients demonstrated improvements in

anxiety and 26% in depression symptoms the following results can be used as ways to

improve natural anxiety symptoms and are critical in future studies for development of

personalized treatment targets.

Sokol, Yosef, et al. “Anxiety and Temporal Self-Appraisal: How People with Anxiety Evaluate

Themselves over Time.” Journal of Affective Disorders, vol. 296, 2022, pp. 309–314.,

https://doi.org/10.1016/j.jad.2021.09.081.

The authors Yosef Sokol, Chayim Rosensweig, Chynna Levin, and Mairav Linzer

examine the association between a singular presence of anxiety and self-appraisal. They
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also examine groups of depressed (n=142), anxious(n=95), comorbid depressed and

anxious(n=335), and euthymic individuals (n=535) using the Depression Anxiety and

Stress Scales. In all, anxiety was found to be associated with self-appraisal, especially

individuals with anxiety who had similar positive self-views to the euthymic group but

fell short in some points. Whereas those with depression had a more balanced past-to-

present view of themselves, and an improving present-to-future self-views. Through the

examination of the different groups of individuals with different mental health issues the

findings can be used by clinicians for possible interventions and treatments for anxiety

and depression.

Solis, Ericka C., et al. “The 9-Year Clinical Course of Depressive and Anxiety Disorders: New

NESDA Findings.” Journal of Affective Disorders, vol. 295, 2021, pp. 1269–1279.,

https://doi.org/10.1016/j.jad.2021.08.108.

The authors Ericka C. Solis, Albert M. van Hemert, Ingrid V.E. Carlier, Klaas J.

Wardenaar, Robert A. Schoevers, Aartjan T.F. Beekman, Brenda W.J.H. Phenninx, and

Erik J. Giltay examine the possibility of switching diagnoses when examining patients

with depression and anxiety. They also examine patients from the Netherlands Study of

Depression and Anxiety (NESDA) and use psychiatric diagnoses described as

‘consistently recovered,’ ’intermittently recovered,’ ‘intermittently recurrent’, and

‘consistently chronic’. In addition, the patients are given a follow-up every two, four, six,

and nine years. Also, the latent class growth analysis (LCGA) with depressive, anxiety,

fear, and worry symptom scores were used to identify the distinct classes. In all, the study

failed to fully capture the persistence of affective symptoms observed when using
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dimensional approaches. However, the study was able to confirm that further research is

needed to confirm the impact on long-term prognoses.