Two Peas in a Pod? Understanding Cross-Cultural Similarities and Differences in Anxiety Disorders

Abstract

Anxiety, like other psychological disorders, is shaped by culture with respect to meaning, experience, and expression. Although prevalence rates of anxiety vary across cultural groups, the rates of service utilization for anxiety disorders among cultural minority populations remain low. These findings suggest the need for culturally sensitive approaches to recognizing anxiety across cultures. Specifically, cross-cultural approaches to understanding anxiety require careful assessment of idioms of distress and syndromes that constitute locally meaningful cultural concepts of distress that can be assessed alongside transcultural and transdiagnostic constructs that underlie multiple anxiety disorders. For example, repetitive negative thinking (i.e., catastrophic cognitions regarding psychological and physical impact of such thinking), anxiety sensitivity (i.e., fear of anxiety sensations), and somatization (i.e., tendency to experience and express anxiety through somatic presentations) are transcultural and transdiagnostic targets relevant to anxiety disorders. This chapter explains local and transcultural approaches to holistic conceptualization of anxiety disorders. These approaches are then illustrated through case examples that explore culturally unique aspects of panic disorder, social anxiety disorder, and generalized anxiety disorder across cultural groups.