Anxiety Disorder Presentations in Asian Populations: A Review

Abstract

This article reviews typical anxiety presentations in Asia, and among Asian refugees. In Asia, there are multiple functional somatic syndromes that are common anxiety presentations. These distress syndromes often produce catastrophic cognitions about anxiety-type somatic and psychological symptoms. These functional somatic syndromes should be understood, and specifically assessed and addressed, in order to optimize the evaluation and treatment of anxiety disorders among Asian individuals.

Generalized Anxiety Disorder: A Review of Recent Findings

“…18,19 GAD, panic disorder, and posttraumatic stress disorder may have other names in Asian cultures stemming from traditional medicine in China, Cambodia, Vietnam, and Thailandd for example, shenjing shuairuo, wind overload, weak heart and weak kidney, and neck soreness. Hwa byung is marked by catastrophic cognition about negative emotions in Korea.…”

Early Learning Experience and Adolescent Anxiety: A Cross-Cultural Comparison Between Japan and England

“…Many previous reports show that Asians affirm the presence of somatic symptoms (e.g. stomachache) rather than affective ones such as anxiety (Hinton et al 2009;Imada 1989;Takeuchi et al 1989;Yamasaki 1998). This may be related to the fact that the Japanese parents are more willing to accept sick role behavior related to physical conditions.…”

Cultural syndromes: Socially learned but real

“…All the same, the emphasis on the interaction with the cultural beliefs anti-realist social constructivists tends to leave an important element of the story, namely that the overwhelming negative emotions like distress, anger and anxiety makes a real and, I contend, typically more important causal contribution to the development of the syndrome than the beliefs. In the case of khyâl ko this is evident in the fear that overwhelms the cognition and make some Cambodians hyper-vigilant to any sensation they may feel on standing (Hinton et al, 2009). Not only do the emotions underwrite the counterfactual just as beliefs do (if the person had not been overwhelmed by these emotions, they would not have developed the syndromes), they also provide the conditions for self-ascription and potential feedback-loops, which make her beliefs causally relevant.…”

“…As the above examples brings to a fore, cultural syndromes typically occur in relation to the experience of overwhelming negative emotions, including fear, anger, anxiety, shock and panic (Sumathipala et al, 2004;Hinton et al, 2009). At the same time, these syndromes are intimately connected to specific beliefs systems and practices of a particular culture.…”

“…Cultural evolution may be much more rapid than biological evolution but past successful variants are rarely washed out within a generation or two. Instead, the recommendations for treatment of CS are typically in line with how to treat many other psychiatric disorders, like post-traumatic stress disorder and panic disorders such as taking both the initial anxieties and the illness attributions and representations as seriously as possible (Hinton et al, 2009). In other words, by at least initially giving precisely social recognition to the syndrome and the sources of distress and despair.…”