CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Anxiety is a psychological and physiological state characterized by physical, emotional, cognitive, and behavioural components. Anxiety disorder is an emotion which is characterized by feelings of worried thoughts, tension, and physical changes such as increased blood pressure [Alzahrani et al, 2017]. Anxiety disorders in young adults occur when anxious feelings are persistently intense, go on for weeks or even longer and are so distressing that they interfere with young people's learning, socializing and ability to carry out day to day activities [Craske, 2013]. Anxiety disorders among young adults are classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM, currently version V, American Psychiatric Association) or the International Classification of Diseases (ICD, currently version 10, World Health Organization) [Starcevic & Castle, 2016]. According to the DSM-5, anxiety disorders comprise 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]. Majority of this disorder share common clinical features such as extensive anxiety, physiological anxiety symptoms, and behavioural disturbances such as extreme avoidance of feared objects, and associated distress or impairment [Starcevic & Castle, 2016; Kessler et al, 2011; Bhandari & Adhikari, 2015]. Biopsychosocial dysfunctions have been shown globally to significantly impact on young adults ability to fulfil their potentials both in 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 rate of psychological disorders among adults is particularly elevated while prevalence of psychosocial dysfunctions among children and adolescents are yet to be extensively diagnosed (WHO, 2010). However, the burden of psychosocial disorders and mental illnesses have been reported to be about 75% higher among youths in the developing countries compared to youths in the developed countries (WHO, 2010). There are several variations in the epidemiology of anxiety disorders; however the lifetime prevalence of anxiety disorder in studies with children or young adults is about 15% to 20%. In fact, it has been opined that the most frequent disorders among children and young adults are separation anxiety disorder, with estimates of 2.8% and 8%, and specific and social phobias, with rates up to around 10% and 7%, respectively [Kessler et al, 2011; Bhandari & Adhikari, 2015; Becker et al, 2017]. It is pertinent to note that in the assessment of anxiety in children the core diagnostic criteria might present differently among them, requiring special assessment strategies. For instance, the differences in age of onset provide one important scenario for separating different types of anxiety disorders [Bhandari & Adhikari, 2015; Becker et al, 2017; Baxter et al, 2012; Beesdo et al, 2018]. Furthermore, the earliest age of onset has been consistently found for separation anxiety disorder and some types of specific phobias with most cases emerging in childhood before the age of 12 years, this is followed by the onset of social phobia with incidences in late childhood and throughout adolescence, with very few cases emerging after the age of 25. Panic disorder, agoraphobia, and GAD, in contrast, have their core periods for first onset in later adolescence with further first incidences in early adulthood [Bhandari & Adhikari, 2015]. It is estimated that current prevalence of anxiety ranged between 0.9% and 28.3% and past year prevalence was between 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, culture, conflict and economic status, and urbanization accounted for the greatest proportion of variability [Bhandari & Adhikari, 2015]. The global current prevalence of anxiety disorders ranged from 5.3% (3.5% - 8.1%) in African cultures to 10.4% (7.0 - 15.5%) in Euro/Anglo cultures [Becker et al, 2017; Baxter et al, 2012; Beesdo et al, 2018]. Anxiety disorders in young adults can be serious mental health problems since these young people are still developing. If left untreated, it can have long-term consequences for mental health and development. Generally, all anxiety disorders more frequently occur in females than males. Although sex differences may occur as early as childhood, they increase with age reaching ratios of 2:1 to 3:1 in young adults [Craske, 2013, Baxter et al, 2012]. Risk factors for anxiety disorders include genetic, personality, environmental or other factors like ongoing physical illness, most anxiety disorders respond well to treatment especially if the disorders are treated early. In Nigeria, awareness and knowledge of mental disorders is extremely low, making it difficult for people to access adequate and prompt medical attention [Reynolds & Richmond, 1978]. Furthermore, factors such as lack of health facilities, inadequately skilled mental health practitioners and low socioeconomic status increase the number of patients getting proper mental health care. In order to diagnose and manage anxiety disorders in young adults promptly and adequately, it is pertinent to know the dynamics of such an important problem in an environment. This paper therefore is a screening tool aimed at determining the pattern and spectrum and prevalence of anxiety disorders among young adults and also finding the biological, psychological and social causes of anxiety among young adults in Nigeria. At present, there is a dearth of knowledge on young adult’s anxiety level in the study locality, thus justifying the need for this study

1.2 STATEMENT OF THE PROBLEM

Anxiety is a feeling of unease, such as worry or fear that can be mild, moderate or severe. Everyone has feeling of anxiety at some point in their life. For example, you may feel worried and anxious about sitting for an exam or a job interview. Feeling anxious is sometimes perfectly normal however; people with severe form of anxiety find it had to control their worries. Their feeling of anxiety is more constant and often affects their performance or daily life. Many sources of anxiety have been reported for some time by young adults which are often times related to long hours of study among others. It has been observed that anxiety is a common phenomenon among young adults in Nigeria. It has also been noted that parents, peer groups, and society at large contribute to the alarming rate of anxiety among young adults. Anxiety has become a threat to the lives and success of the young adults. Anxiety disorders among young adults are serious and most neglected mental health problem. In Nigeria, knowledge of mental disorders is extremely low, making it difficult for people to access prompt medical attention. This study reveals that all the spectrum of anxiety disorders were present among young adults with associated factors.

1.3 OBJECTIVE OF THE STUDY

The main purpose of this study is to examine biopsychosocial approach to level of anxiety among young adults. The specific objectives are:

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

1.4RESEARCH 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 result of this research work will be useful to the public. Because it will create awareness on the biological, psychological and social consequences of anxiety disorder on young adults. The young adult themselves will benefit from this research work as it will enable them to identify the problems associated with anxiety level which is not solely a medical problem because resultant psychosocial consequences such as depression and societal stigmatisation have been reported. It will also benefit those in Public health because there is need for an intricate communal relationship between an individual and the environment and since anxiety affects the complete living experience both qualitatively and quantitatively it goes beyond individual problems to a societal problem. The result of this study will be of immense benefit to the young adult, parents etc. Stakeholders and members of the public, generally, should devote urgent and adequate attention to the alarming rate of anxiety disorder, especially among the 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 your body's natural response to stress. It's a feeling of fear or apprehension about what's to come. The first day of school, going to a job interview, or giving a speech may cause most people to feel fearful and nervous.

Psychological: Pertaining to the mind or to mental phenomena as the subject matter of psychology.

Biological:connected by direct genetic relationship rather than by adoption or marriage

Sociological: dealing with social questions or problems, especially focusing on cultural and environmental factors rather than on psychological or personal characteristics

Young Adult: Age Ranges. Depending on whom you ask, “Young adult” could refer to people aged 12 to 18, or it could refer to those aged 18 to 30. In general, young adults are people between the ages of 12 and 30.

Psychosocial: Relating to the interrelation of social factors and individual thought and behaviour. The psychosocial approach looks at individuals in the context of the combined influence that psychological factors and the surrounding social environment have on their physical and mental wellness and their ability to function. This approach is used in a broad range of helping professions in health and social care settings as well as by medical and social scientist