CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Anxiety is a psychological and physiological state characterized by physical, mental, cognitive and behavioral components. Anxiety disorder is an emotion that is characterized by feelings of anxiety, stress, and physical changes, such as elevated blood pressure [Alzahrani et al, 2017]. Anxiety disorders in young adults arise when anxious feelings are persistently strong, continue for weeks or even longer, and are so distressing that they interfere with the learning, socialization and ability of young people to conduct day-to-day activities [Craske, 2013]. Anxiety disorders in young adults are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM, current version V, American Psychiatric Association) or the International Classification of Diseases (ICD, current version 10, World Health Organization) [Starcevic & Castle, 2016]. According to DSM-5, anxiety disorders include the following conditions: panic disorder, agoraphobia, social anxiety disorder (social phobia), specific phobia, generalized anxiety disorder (GAD), separation anxiety disorder, and selective mutism [Starcevic & Castle, 2016]. The majority of this condition has typical clinical features such as extensive anxiety, physiological anxiety symptoms, and behavioral disruptions such as extreme avoiding feared objects, and related discomfort or disability [Starcevic & Castle, 2016; Kessler et al, 2011; Bhandari & Adhikari, 2015]. Globally, biopsychosocial disorder has been shown to have a substantial effect on young adults' ability to achieve their potential in both academic and other areas of life (Andrade, Brown and Tannock, 2014; Bakare, Ubochi, Ebigbo and Orovwigbo, 2010; Cortina, Sodha, Fazel, Ramchandani, 2012). In sub-Saharan Africa, the incidence of psychological disorders among adults is especially high, while the prevalence of psychosocial illness among children and adolescents is still commonly diagnosed (WHO, 2010). However the prevalence of psychosocial problems and mental illness has been reported to be around 75% higher among youth in developing countries compared to youth in developed countries (WHO, 2010). There are many differences in the epidemiology of anxiety disorders; however, the lifetime incidence of anxiety disorder in children or young adults is between 15% and 20%. In fact, it has been argued that the most common disorders among children and young adults are separation anxiety disorders, estimated at 2.8% and 8%, and specific and social phobias, with rates at around 10% and 7%, respectively [Kessler et al, 2011; Bhandari & Adhikari, 2015; Becker et al, 2017]. It is appropriate to remember that the key diagnostic criteria can be different in the assessment of anxiety in adolescents, requiring special assessment techniques. For example, age differences provide a significant scenario for distinguishing various forms of anxiety disorders [Bhandari & Adhikari, 2015; Becker et al, 2017; Baxter et al, 2012; Beesdo et al, 2018]. In addition, the early age of onset has been reliably established for separation anxiety disorder and some forms of particular phobies, most of which occur in childhood before the age of 12, accompanied by the onset of social phobia with late childhood and adolescence incidences, with relatively few cases occurring after the age of 25. Panic disorder, agoraphobia, and GAD, on the other hand, have their main stages of onset in later adolescence, with more first incidences in early adulthood [Bhandari & Adhikari, 2015]. It is estimated that the current prevalence of anxiety ranged from 0.9% to 28.3% and last year the prevalence ranged from 2.4% to 29.8% [Bhandari & Adhikari, 2015; Becker et al, 2017; Baxter et al, 2012; Beesdo et al, 2018]. Substantive factors such as gender, age, community, conflict and economic status and urbanization accounted for the greatest variability [Bhandari & Adhikari, 2015]. The global prevalence of anxiety disorders ranged from 5.3 per cent (3.5 per cent-8.1 per cent) in African cultures to 10.4 per cent (7.0-15.5 per cent) in Euro/Anglo cultures [Becker et al, 2017; Baxter et al, 2012; Beesdo et al, 2018]. Anxiety disorders in young adults may be severe mental health issues as these young people begin to grow. If left untreated, it can have long-term implications for mental health and development. Generally, all anxiety disorders occur more often in females than in males. While gender disparities can occur as early as childhood, young adults have increased their age-to-age ratios from 2:1 to 3:1 [Craske, 2013, Baxter et al, 2012]. Risk factors for anxiety disorders include genetic, personality, environmental or other factors such as ongoing physical illness, most anxiety disorders respond well to therapy, particularly if they are treated early. In Nigeria, understanding and knowledge of mental illness is extremely poor, making it impossible for people to have access to appropriate and timely medical care [Reynolds & Richmond, 1978]. In addition, factors such as lack of health services, inadequately trained mental health providers and poor socio-economic status increase the number of patients seeking appropriate mental health care. In order to easily and properly identify and treat anxiety disorders in young adults, it is appropriate to know the complexities of such an important issue in the community. This paper is therefore a screening tool aimed at identifying the trend and scope and prevalence of anxiety disorders among young adults, as well as the biological, psychological and social causes of anxiety among young adults in Nigeria. At present, there is a lack of awareness of the anxiety level of young adults in the study area, thus justifying the need for this study.

1.2 STATEMENT OF THE PROBLEM

Anxiety is a feeling of unease, such as worry or anxiety that may be mild, moderate, or extreme. At some point in their lives, everybody has a feeling of anxiety. For example, you may feel worried and nervous about sitting for an exam or a job interview. Feeling nervous is often perfectly common, however; people with a serious form of anxiety find it important to control their concerns. Their feeling of anxiety is more constant and frequently affects their success or their everyday lives. Many causes of anxiety have been identified for some time by young adults, often correlated with long hours of research, among others. Anxiety has been found to be a prevalent phenomenon among young adults in Nigeria. It has also been noted that parents, peer groups and society at large are contributing to the alarming rate of anxiety among young adults. Anxiety has become a threat to young adults' lives and progress. Anxiety disorders in young adults are severe and most overlooked mental health issues. In Nigeria, awareness of mental illness is extremely poor, making it impossible for people to get timely medical attention. This study shows that all the spectrum of anxiety disorders among young adults with related factors was present.

1.3 OBJECTIVE OF THE STUDY

The main goal of this research is to explore the biopsychosocial response to the level of anxiety among young adults. The basic goals are as follows:

1. Determine the prevalence of anxiety disorders among young adults

2. Identify the biopsychosocial approach and its impact on the level of anxiety among young adults.

3. To explore the causes of anxiety in young adults.

4. To determine the trend and factors associated with anxiety disorders in young adults

5. To examine the effect of the biopsychosocial approach on the level of anxiety among young adults.

6. To recommend solutions to anxiety disorders in relation to the biopsychosocial approach

1.4RESEARCH QUESTIONS

1.  To determine the prevalence of anxiety disorders among young adults

2.  To identify biopsychosocial approach and its effects on the level of anxiety among young adults.

3.   To examine the causes of anxiety among young adults.

4.  To determine pattern and factors associated with anxiety disorders among young adults

5.  To examine the impact of biopsychosocial approach on the level of anxiety among young adults.

6.  To recommend solutions to the problems of anxiety in relation to biopsyschosocial approach

1.5 RESEARCH HYPOTHESIS

HO: There is no significant impact of biopsychosocial approach on the level of anxiety among young adults

H1: There is a significant impact of biopsychosocial approach on the level of anxiety among young adults.

1.6 SIGNIFICANCE OF THE STUDY

The outcome of this research work would be of interest to the public. That it would make young adults conscious of the biological, psychological and social implications of anxiety disorder. Young adults themselves will benefit from this research work as it will allow them to recognise issues associated with anxiety, which is not only a medical issue and the resulting psychosocial effects, such as depression and social stigmatization, have been documented. It would also help those in public health because there is a need for an intricate communal relationship between the person and the environment, and because anxiety affects the entire living experience, both qualitatively and quantitatively, it goes beyond individual issues to a systemic problem. The outcome of this study would be of great value to young people, parents, etc. Stakeholders and members of the public, in general, should devote urgent and adequate attention to the alarming rate of anxiety disorder, particularly among youth and young adults who will be our future leaders.

1.7 SCOPE OF THE STUDY

The study is based on biopsychosocial approach to level of anxiety among young adults

1.8 LIMITATION OF THE STUDY

Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

1.9 DEFINITION OF TERMS

Anxiety: is the normal reaction of the body to stress. It's a sense of anxiety or uncertainty about what's coming. On the first day of school going to a job interview or speaking, most people may feel frightened and anxious.

Psychological: relating to the mind or to mental phenomena as a matter of psychology.

Biological: connected by a clear genetic association rather than by acceptance or marriage

Sociological: coping with social concerns or problems, concentrating in particular on cultural and environmental causes rather than on psychological or personal characteristics.

Young Adult: the age group. Depending on whom you ask, "Young adult" may refer to people between 12 and 18 years of age or may refer to people between 18 and 30 years of age. Young adults are usually individuals between the ages of 12 and 30.

Psychosocial: related to the interrelation between social influences and individual thinking and behaviour. The psychosocial approach focuses on people in the light of the combined impact that psychological factors and the surrounding social environment have on their physical and mental well-being and their ability to work. This approach is used in a wide variety of health and social assistance professions, as well as in medical and social sciences.