Anxiety disorders and PTSD

Abstract

INTRODUCTION This chapter reviews the literature on the prevalence and etiology of anxiety disorders, including posttraumatic stress disorder (PTSD), following disasters. We highlight that there is relatively little information about anxiety disorders other than PTSD; the paucity of data is due to the challenge of the shared phenomenology of these disorders and the difficulty of defining their boundaries. A further challenge is explored, namely, how disasters interact with background morbidity in a community. In considering the etiology of anxiety disorders, the differential role of threat is hypothesized to be differentiated from the more enduring effect of the losses sustained in disasters. Anxiety disorders have an enduring effect in the aftermath of disasters, and many issues remain to be examined in future research, especially in expanding beyond PTSD. To begin, however, it is important to understand the settings in which disasters occur and the anticipations that abound following these events, as these have the potential to bias a rational appraisal of the challenges that will impact the affected community. Managing the psychological impact of disasters is a critical public-health challenge in the aftermath of these events. Informed prevalence and incidence estimates are critical to effective service planning. Unfortunately, there is often dramatization of disaster impact immediately afterward, with fears expressed about the capacity of the population to function and manage effectively (de Ville de Goyet, 2007).