Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic anxiety disorder (PAD), are some of the commonly treated mental health problems (Khdour et al., 2016). Individuals with these mental conditions portray characteristics, including excessive worry, uneasiness, and fear of the future, which negatively impact on social and occupational functionality. The most dominant feature of anxiety disorders is their cognition component; this component is showcased through the biased information processing of new social situations and various threats (Khdour et al., 2016). Cognition and behavioral therapies (CBT) are the most effective techniques for treating anxiety disorders. Although treatments, such as psychodynamic and interpersonal psychotherapies, can also be used in the treatment of anxiety disorder, multiple randomized trials have shown the effectiveness of CBT in the treatment of anxiety disorder. Patients with anxiety disorders also suffer from depression, particularly comorbid depression or subclinical depressive symptoms. Therefore, it is essential to investigate the impact of cognitive behavioral treatments on depression when treating anxiety disorder.
History and Statistics
Previous studies suggest that anxiety disorder can be transmitted from parents to children. The transmission of the mental disorder is partly attributed genetics, and partly as a result of environmental transmissions from parents to children; parental anxiety can contribute to the adoption of a parenting style that encourages the development of anxiety disorder in children (Telman et al., 2018). Parenting traits such as overcontrolling behavior, which restricts a child’s independence, could lead to inhibition and anxiety among children. Also, children can also develop anxiety disorder through modeling. Thus, genetic, environmental, and parental factors have a significant impact on the development of anxiety disorder among children. According to a study conducted by Telman et al. (2018), children with an anxiety disorder were two to three times more likely to have one or both parents with current and lifetime anxiety disorder as compared to children without anxiety disorders. Children with anxiety disorders were more likely to have mothers with current anxiety disorders and fathers with a lifetime anxiety disorder (Telman et al., 2018). Moreover, based on the study outcome, mothers with anxiety disorder would often translate to children with a social anxiety disorder and generalized anxiety disorder (Telman et al., 2018). The prevalence of anxiety disorder is higher among children that were brought up by parents with anxiety disorders.
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Previous meta-analyses have been conducted to investigate the effect of cognitive behavioral therapy on anxiety disorder on depression. As mentioned earlier, most anxiety disorder patients have depression. The baseline severity of depression varies depending on the type of anxiety disorder being treated (Cuijpers et al., 2016). The highest baseline severity of depression is evident with GAD and lowest with SAD. Nonetheless, the level of depression is significantly lower as compared to patients being treated for depression. However, there is an argument that the effect of treatment of anxiety disorder is not only unique to depression but also affects other disorders.
The conceptualization of positive and negative feedbacks varies between anxiety disorder patients and individuals without mental health problems. Moreover, the cognitive characteristics also vary among anxiety disorder patients depending on the type of anxiety disorder they suffer from (Khdour et al., 2016). While SAD and GAD patients are more sensitive to negative feedbacks, patients with PAD as well as healthy individuals are relatively less sensitive. Response to positive comments is indifferent among anxiety disorder patients and healthy individuals. While cognitive correlates might vary significantly from healthy individuals, not all anxiety spectrum disorders share similar cognitive correlates.
Significance to Health
Exploring the relationships between anxiety disorder in parents and in children can help in the prevention and treatment of child attention disorder. Based on previous meta-analyses, there is a link between parent-child anxiety disorder. Therefore, a family history of anxiety disorder can be used as a basis for identifying children who are most prevalent in acquiring anxiety disorder and thus facilitating early interventions (Telman et al., 2016). In addition, CBT for children with anxiety disorders is less effective when their parents have anxiety disorders (Telman et al., 2016). Therefore, understanding the link between parent-child anxiety disorder transmission guide the choice of treatment technique. Since the treatment of anxiety disorder affects depression, understanding the variable impact of CBT on depression depending on the type of anxiety disorder helps in the determination of the most suitable treatment option.
Role of the Nurse
Nurses have the responsibility of checking patient records to determine the most effective treatment methods. Given the significant connection between parents’ and children’s anxiety disorder, there is a need to explore patients’ family history for better diagnosis. Family medical history can also help in the adjustment of the treatment method for optimum results. Furthermore, since cognitive behavioral therapy for anxiety can lead to depression, nurses ought to observe for symptoms associated with depression. When patients do not respond to treatment, referral to psychiatrist nurse practitioners for further evaluation, and treatment modification (Antai-Otong, 2016). Nurse practitioners have the responsibility of prescription. Nurses can also conduct second-line treatment to aid in the achievement of rapid remission.
Relevance to Nursing Practice
The interaction between patients and nurses is key to the effectiveness of the treatment process. The cognitive correlate between healthy individuals and anxiety disorder patients differs, with anxiety disorder patients being more sensitive to negative feedback (Khdour et al., 2016). Therefore, the relationship between nurses and patients should be built in a manner that the patient will be provided with a conducive environment for recovery. Nurses should avoid or delicately deliver negative feedbacks during patient treatment. The analysis of patient history is also relevant, particularly for psychiatric nurse practitioners.
Conclusion
There are many types of anxiety disorder, including GAD, SAD, PAD, which are commonly treated using CBT. Studies have shown a link between parents’ and children’s anxiety disorders. Therefore, children with parents with anxiety disorders are more exposed to anxiety disorder. Furthermore, the treatment process is affected when a child’s parent is suffering from an anxiety disorder. In addition, CBT for anxiety disorder has an impact on depression. Nurses have the responsibility of revising patient medical records to determine any history of anxiety disorder in the family. In addition, due to the different cognitive correlates in patients depending on the type of anxiety disorder, nurses’ behavior around these patients should vary depending on the patient’s diagnosis.
References
Antai-Otong, D. (2016). Caring for the Patient with an Anxiety Disorder. Nursing Clinics , 51 (2), 173-183.
Cuijpers, P., Cristea, I. A., Weitz, E., Gentili, C., & Berking, M. (2016). The effects of cognitive and behavioural therapies for anxiety disorders on depression: a meta-analysis. Psychological Medicine , 46 (16), 3451-3462.
Khdour, H. Y., Abushalbaq, O. M., Mughrabi, I. T., Imam, A. F., Gluck, M. A., Herzallah, M. M., & Moustafa, A. A. (2016). Generalized anxiety disorder and social anxiety disorder, but not panic anxiety disorder, are associated with higher sensitivity to learning from negative feedback: behavioral and computational investigation. Frontiers in integrative neuroscience , 10 , 20.
Telman, L. G., van Steensel, F. J., Maric, M., & Bögels, S. M. (2018). What are the odds of anxiety disorders running in families? A family study of anxiety disorders in mothers, fathers, and siblings of children with anxiety disorders. European child & adolescent psychiatry , 27 (5), 615-624.
