New Insights about the Experience of Anxiety among African-Americans?

By Alford, Darlys J. | Journal of Cognitive Psychotherapy, January 1, 1995 | Go to article overview

New Insights about the Experience of Anxiety among African-Americans?


Alford, Darlys J., Journal of Cognitive Psychotherapy


New Insights About the Experience of Anxiety Among African-Americans? Anxiety Disorders in African-Americans Steven Friedman, (Ed.). New York: Springer Publishing Company, 1994, 248 pp., $41.95 (hardcover)

This volume presents the proceedings of a 2-day symposium on anxiety disorders in African-Americans sponsored by the Department of Psychiatry, State University of New York, Health Science Center in Brooklyn, which was held in December of 1992. The book is divided into four parts: Part I contains an address by Congressman Major Owens and outlines his views on the necessity of cooperation between providers, researchers, and politicians in formulating decisions in a time of federal budget austerity. In Part II, authors discuss diagnostic, epidemiological and cultural factors related to anxiety disorders among African-Americans. Discussions of the role of culture and language in the diagnostic process and help-seeking behavior of this population are also included. Part III includes chapters targeting unique or typical manifestations of anxiety disorders in African-Americans such as isolated sleep paralysis, anxiety and fears in children, and the interplay between exposure to violence, drug abuse, and posttraumatic stress disorder. The book concludes with a focus on panic disorder and obsessive-compulsive disorder (Part IV) which are named as the most common of the anxiety disorders among African-Americans. In addition, the final chapters include some description and evaluation of behavioral and psychopharmacological treatments used with this special population.

Congressman Owens emphasizes the importance of increasing the influence of knowledgeable mental health professionals and researchers in the policy making process to insure that governmental officials stay well informed about the link between the social conditions that drive the "misery index" and the psychological health consequences associated with them. In spite of this important call to redefine anxiety disorder in a larger cultural and social context, the majority of the contributions to this volume fall short of this mission. For example, Jenkins and Bell (Chapter 7) surveyed inner-city high school students in Chicago to assess violence exposure, psychological distress symptoms, and stressful events. Early in their chapter, they suggest that excessive exposure to violence might lead to overload, PTSD, psychic denial and rage, and they contend that we might be incarcerating African-American youth who should be receiving treatment for psychological distress. Their findings are alarming-of 203 African-American high school students surveyed, almost two thirds had seen a shooting and nearly half had seen someone killed. There was also a high degree of overlap between witnessing violence and being victimized. In addition, 70% of the young people indicated that a friend or family member had been raped, robbed, shot, stabbed, severely beaten, and/or killed. The researchers found a strong relationship between violence exposure and psychological distress symptoms for females while violence exposure for boys was related to high-risk behaviors (drinking, drug use, gun carrying, knife carrying and trouble at school). After providing compelling evidence about the social conditions that contribute to the "misery index" and psychological distress among African-American youth, Jenkins and Bell have the opportunity to either make a strong argument against the automatic incarceration of youth with histories of high-violence exposure or at least call for PTSD screening of youths in juvenile lockup facilities. …

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