A psychology topic from a cross-cultural lens on anxiety disorder and social disorder and connect the topic to a United Nations (UN) Sustainable Development Goal (SDG). You may wish to read Berry (202

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Introduction

Anxiety disorders are among the most common mental illnesses worldwide, with cross-national prevalences estimated at around 7-8%. As a group of serious conditions characterized by excessive fear, worry, and tension, anxiety disorders not only comprise a leading cause of disability but also increase the risk for other health issues if left unaddressed . United Nations Sustainable Development Goal 3.4 recognizes the need to promote mental health and well-being globally by 2030 by reducing premature mortality from non-communicable diseases partly resulting from untreated anxiety and related disorders (Kirubasankar et al., 2021).

Literature Review

USA

Socioeconomic disparities play a role in anxiety levels among Americans. A study by Smith and colleagues (2020 ) administered surveys to patients from various income brackets with chronic illnesses like diabetes or asthma. It found those making less than $30,000 annually reported the highest rates of feeling stressed, worried or uneasy on a daily basis. Patients from low-income households were 3 times more likely to lack medical insurance compared to higher earners. The lack of universal healthcare seems to compound stressors from medical issues and financial instability according to the researchers (Smith et al., 2020). This is consistent with other literature pointing out that economic vulnerability without a safety net of insurance can exacerbate mental health struggles.

Cultural values also shape perceptions of anxiety disorders. Research by Gonzalez et al. (2019) took an in-depth look at views within different ethnic communities in various US cities. It uncovered diverse attitudes, with some subgroups less likely to pathologize worries and more open in discussions of distress. Among European Americans interviewed, themes of grit, resilience and self-sufficiency dominated conversations per the study. Feelings of unease were seen as a sign of weakness rather than a treatable condition if impairing according to participants (Gonzalez et al., 2019). This indicates cultural norms still encourage suffering in silence rather than acknowledging distress openly as commonly seen in some Eastern societies.

China

Many cultural factors in China influence the experience of anxiety disorders. One study by Gong et al. (2021) examined the applicability of the GAD-7 screening tool for assessing anxiety among pregnant Chinese women. Traditionally, in Chinese culture, protecting progeny and facilitating healthy pregnancies takes precedence. The validation of GAD-7 allows for standardized anxiety screening during this critical life phase when additional support is needed. However, the study found lower cut-off scores optimal compared to Western norms, showing manifestations of the disorder can differ based on cultural context (Gong et al., 2021). With China emphasizing collective well-being, interpersonal struggles were highly correlated with anxiety scores, demonstrating societal pressures on new mothers. Standardized tools must consider unique cultural presentations to ensure accurate diagnosis and care .

Another relevant study by Zhang et al. (2021) explored anxiety rates in Chinese adolescents post-pandemic . Confucian ideals framing families as fundamental social units were disrupted by lockdowns. Consequently, family relationship problems emerged as a key risk factor for anxiety in youth. Diverging from Western individualism, issues with peers held little association. Instead, filial piety dictates young people derive self-worth from meeting family roles and expectations (Zhang et al., 2021). The inability to do so during the pandemic damaged mental health. This illustrates how socio-cultural frameworks shape anxiety triggers. The studies shed light on insufficient Western diagnostic models not capturing culturally shaped Chinese presentations emphasizing social hierarchical dynamics, family-centeredness, and consequentialism of behaviors.

India

Cultural factors strongly influence conceptions of anxiety disorders in India. A study by Kirubasankar et al. (2021) compared the prevalence of anxiety among school students in urban and rural areas. Traditional Indian culture fosters strong bonds across tight-knit village communities, but city life promotes individualism. Consistent with this, the risk of anxiety was found to be 79% higher in urban youth lacking such communal support systems. Tight familial and societal bonds form the bedrock of Indian identity, so disrupted social ties can induce distress (Kirubasankar et al., 2021). Fast-paced urbanization strains these networks, exacerbating disorders. This highlights the culture-bound nature of mental illnesses shaped by underlying socio-ecological structures.

Parenting also culturally determines anxiety perceptions in India. Sahithya and Raman (2021) investigated links between parenting, personality, and childhood anxiety. Authoritative parenting aligning with paternalistic cultural ideals correlated with lower rates, as children internalize societal expectations through guidance-based upbringings. However, authoritarian tactics paradoxically increased anxiety by wielding control without warmth, contradicting cultural norms of compassion (Sahithya & Raman, 2021). Parental personalities also played a role - neurotic mothers susceptible to worries transmit traits increasing vulnerability in offspring. Their parenting similarly deviated from prescribed nurturing cultural scripts. These studies showcase that collective cultural frameworks form the schema through which anxiety manifests and can be addressed in India.

Comparison and Contrast of the Cultural Similarities and Differences Across the Countries

There are both similarities and differences in the cultural influences on anxiety disorders across the United States, China, and India. A key similarity is the significant stigma surrounding mental health issues in all three cultures due to beliefs about weakness, loss of control, or disrupting societal norms . This acts as a barrier to help-seeking. There are also differences in the precise social factors that shape anxiety. While American culture emphasizes individualism, personal responsibility, and resistance to change, Chinese and Indian cultures are more collective and prioritize family/community bonds and social harmony. Disrupting these interpersonal relationships can thus trigger anxiety . Chinese conceptions emphasize collective well-being, social roles, and hierarchies more than the Indian focus on guidance-based parenting styles and communal village life versus individualistic cities. Understanding common stigmas and unique cultural frameworks across societies is vital for effective anxiety interventions.

UNSDG Integration

Cultural factors strongly influence how anxiety disorders are experienced and expressed across different societies. As revealed through the cross-cultural literature review, societal norms, values, and interpersonal relationships shaped by culture can act as risk factors or buffers for the development of anxiety. They also guide acceptable ways of discussing mental well-being. UNSDG 3.4 aims to promote mental health worldwide by 2030 by reducing mortality from non-communicable diseases and encouraging the prevention and treatment of disorders. To successfully achieve this, global efforts must consider cultural lenses that refract experiences of anxiety and other mental illnesses. Without a nuanced understanding of sociocultural frameworks, interventions will not effectively reach all communities and may even perpetuate stigmas by disregarding local conceptions.

Recommendations

For the US, interventions should address access to affordable healthcare limitations and promote open discussion to counter individualist stigma. Community-led awareness campaigns could normalize seeking support through popular forums like social media, fitting Americans' emphasis on free expression. Public figures sharing their mental healthcare journeys could inspire others (Saint & Moscovitch, 2021). On a policy front, further expanding Medicaid eligibility and regulating costs for diagnosed disorders per the Affordable Care Act can significantly curb anxiety rates while still respecting autonomy.

For China, family and community-oriented programs realigning with filial and communal cultural strengths may prove most effective. Village committees or women's groups could facilitate psychoeducation and screening of new mothers, leveraging practical support systems. School mental wellness initiatives involving parents may curb disorder rates by addressing intergenerational risk factors. Curriculum reform acknowledging socioemotional learning alongside academic pressure can nurture balance. At a structural level, integrating mental wellness into China's healthcare reforms and expanding insurance coverage recognizes its integral role in public health envisaged under Healthy China 2030.

In India, network interventions capitalizing on collectivism through local faith/civic organizations promoting village welfare could convey helpful resources with cultural relatability. Training community health workers may establish approachable first points of contact. Parenting programs adhering to indigenous constructs of authoritative guidance versus control address key risk factors (Sahithya & Raman, 2021). Ensuring mental healthcare provision at primary care levels, as envisioned under India's National Mental Health Program, will make support universally accessible while preserving social integrity. Addressing gaps requires culturally appropriate, multi-level strategies.

Conclusion

This literature review highlights the substantial role of culture in shaping the experience, expression, and societal responses to anxiety disorders worldwide. Across the US, China, and India, unique socio-cultural frameworks differentially influence risk and protective factors as well as help-seeking patterns for these common mental illnesses. Addressing cultural components through community-based, strengths-aligned interventions is imperative to make meaningful progress in achieving UNSDG 3.4’s goal of promoting global mental well-being and reducing mortality related to such disorders by 2030.

References

Gong, Y., Zhou, H., Zhang, Y., Zhu, X., Wang, X., Shen, B., ... & Ding, Y. (2021). Validation of the 7-item Generalized Anxiety Disorder scale (GAD-7) as a screening tool for anxiety among pregnant Chinese women. Journal of affective disorders, 282, 98-103.

Huang, C. W., Wee, P. H., Low, L. L., Koong, Y. L. A., Htay, H., Fan, Q., ... & Seng, J. J. B. (2021). Prevalence and risk factors for elevated anxiety symptoms and anxiety disorders in chronic kidney disease: A systematic review and meta-analysis. General Hospital Psychiatry, 69, 27-40.

Kirubasankar, A., Nagarajan, P., Kandasamy, P., & Kattimani, S. (2021). More students with anxiety disorders in urban schools than in rural schools: A comparative study from Union Territory, India. Asian Journal of Psychiatry, 56, 102529.

Sahithya, B. R., & Raman, V. (2021). Parenting style, parental personality, and child temperament in children with anxiety disorders—A clinical study from India. Indian Journal of Psychological Medicine, 43(5), 382-391.

Saint, S. A., & Moscovitch, D. A. (2021). Effects of mask-wearing on social anxiety: an exploratory review. Anxiety, Stress, & Coping, 34(5), 487-502.

Zhang, X., Yang, H., Zhang, J., Yang, M., Yuan, N., & Liu, J. (2021). Prevalence of and risk factors for depressive and anxiety symptoms in a large sample of Chinese adolescents in the post-COVID-19 era. Child and adolescent psychiatry and mental health, 15(1), 1-8.