Introduction
While it is acknowledged that everyone can get worried under normal circumstances, the problem may arise when the worry and fear persist unusually, subsequently interfering with one’s ability to carry out routine duties. Like in the case of James, it can be concluded that James is suffering from Generalized Anxiety Disorder (GAD), attributed mainly to the kind of pressure he got from his place of work (hospital) as a resident medical intern. James has two other sisters who have become very successful both professionally and in general well-being. But how could this happen, yet they all grew up in the same environment? Half of the variance in personality traits in behavioral genetic research is derived from the environment, but this portion is almost entirely “unshared” (Judd et al. 1998). The findings have revealed that environmental influences on traits are not necessarily derived from being raised in the same family, which James’ case may well back.
Considering some past studies that revealed that genes and environment are inseparable when it comes to their impact on an individual’s public life (Kendel & Jablensky, 2003; Judd et al., 1998), the personality traits are inheritable, with genetic factors accounting for nearly a half of the variance (Judd et al. 1998). But James’ other family members have not experienced any of such problems; hence the necessity to acknowledge that environmental influence is the major contributor to his problems. According to Beck & Freeman (1990), in behavioral genetic research, half of the variance in the personality trait is derived from the environment. That single temperamental characteristic emerges from complex and interactive polygenic mechanisms associated with variations in multiple alleles- quantitative trait loci. It is almost impossible to link James’ disorder with genetic makeup and traits. These findings have fundamentally generated a lot of arguments among the classical ideologists in developmental and clinical psychology, who focused their views on the theory that parenting is a primary factor in shaping personality development (Kendel & Jablensky, 2003; Beck & Freeman, 1990).
There are several reasons why these unshared environmental factors are essential in analyzing James’ problems. The first is that his behavioral response or temperament will affect others under normal circumstances, as seen in the father and most probably other family members. In a large-scale study of adolescents that used a combination of twin and family methods, multivariate analysis indicated that a child’s temperament is the underlying factor driving differential parenting and differential behavioral outcomes (Kendel & Jablensky, 2003).
However, it could be said that even when the family provided a similar environment for James and his siblings, each child may have perceived experiences differently and given a different behavioral pattern response. Furthermore, temperamental differences can make the environmental influences unshared (Judd et al. 1998).
Some studies have also indicated that some of the environmental factors that affect individual personality are extra-familial (Kendel & Jablensky, 2003). For example, many researchers have concluded that pressure from peers, interactions with teachers, or community leaders may have a more powerful impact on the development of an individual personality than parenting does. The other possibility that may have impacted James is that of a biological environment that is not shared- an intrauterine factor (Beck & Freeman, 1990). However, there is little research to support this hypothesis; hence may not hold much in the case of James, at least for now.
Treatment of GAD
Many clinical and epidemiological studies suggest that generalized anxiety disorder and major depression occur more frequently than expected by chance (Kendel & Jablensky, 2003; Judd et al., 1998). Other evidence suggests that the onset of generalized anxiety disorder occurs before major depression in most cases. Under some circumstances, generalized anxiety occurrences may be a precursor to the beginning of significant depression (Kendel & Jablensky, 2003). This clearly shows the gravity of the disorder, hence the need for a proper multifaceted treatment mechanism.
Several treatment options for GAD have been proposed, with health professionals emphasizing the need to adopt therapeutically (Psychological) and self-help measures.
Therapy for GAD
Many clinical studies have supported the therapeutic approach to treating generalized anxiety disorder, with findings indicating that therapy is as effective as medication for many people, no matter the background. In addition, it is favored for its lack of side effects (Kendel & Jablensky, 2003).
One of the most commonly used psychological treatments is Cognitive-behavioral therapy (CBT) (Kendel & Jablensky, 2003. CBD will help examine the distortions in how James looks at the world and himself. That is to say that the therapist will be crucial in helping to identify some critical negative thoughts that usually engulf James and contribute to his persistent anxiety. As a result, the patient can confront his personal feelings with such questions as “Why do I believe that this worst-case scenario will occur?” and “What are the possible positive outcomes shortly?” In brief, the cognitive-behavioral therapy for GAD will entail the following five components: education that involves learning about (GAD), Monitoring where the patient is learning how to monitor their anxiety, physical control strategy where the patient can learn techniques such as deep breathing, cognitive control strategy where the patient realistically learn to evaluate and change the pattern of thinking, and Behavioral approach where the patient learns to tackle the situations head-on rather than being in denial and evasive (Kendel & Jablensky, 2003).
However, treatment can never be relied on solely. This is mainly because the treatment and general healthcare of GAD patients requires a continuous process that would be sustainable while not forgetting a short-term pain relief for the patient. Furthermore, it is always necessary to get professional advice, which means one should not just assume that they are suffering from GAD simply because of some symptoms. This is why many health professionals would advise a combination of therapeutic, self-help, and even medication, where the latter would best apply when one wants to get temporal relief from pain.
In designing a plan for the treatment of GAD, I would lay out the program for treating GAD by outlining the three treatment options, i.e., therapy, self-help plan, and lastly, medication. However, I would emphasize the self-help technique and the treatment approach to ensure the sustainability of the treatment method. The remedy would only come in when the patient is experiencing some pain that would need quick pain relief.
Reference List
American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd ed). Washington, DC, American Psychiatric Association.
Beck, A,T & Freeman, A. (1990). CognitiveaTherapy of Personality Disorders. New York, Guilford.
Judd, L.L., Kessler, R.C., Paulus, M.P., Zeller, P.V., Wittchen, H.U., & Kunovac, J.L. (1998). Comorbidity as a fundamental feature of generalized anxiety disorders: results from the National Comorbidity Study (NCS). Acta Psychiatr Scand Suppl; 393:6-11.
Kendel, R & Jablensky, A. 2003. Distinguishing between the validity and utility of psychiatric diagnosis. Am J Psychiatry, 160:4-12.