Anxiety Disorders, Obsessive Compulsive and Related Disorders, and Cultural Idioms of Illness

Anxiety disorders and obsessive-compulsive disorders (OCD) have a devastating impact on an individual’s ability to live, work, and conduct relationships. These disorders are often harder to identify than other conditions. Difficulty in diagnosis is compounded by the fact that expressions of anxiety differ widely from culture to culture. Anxiety is often co-occurring with depression and with OCD, as well as with trauma disorders. The boundaries between these illnesses can be blurred.

This week you examine those boundaries by analyzing a case from the anxiety and OCD spectrums. You also consider cultural idioms and the cultural formulation interview (CFI) of the DSM-5. The CFI is designed to help a social worker adapt diagnosis and treatment both to cultural variations and to the individual experience of a person within that culture. Given that anxiety may manifest in diverse ways due to cultural influences, you practice using the CFI to guide treatment conceptualization for anxiety.

Learning Objectives

Students will:

  • Analyze a case study focused on an anxiety disorder utilizing steps of differential diagnosis
  • Recommend an intervention for treating anxiety disorder
  • Role-play a client interaction to complete a Cultural Formulation Interview
  • Analyze cultural variables in mental health treatment planning

Learning Resources

Required Readings

Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.
Chapter 12, “Diagnosing Anxiety, Fear, Obsessions and Worry” (pp. 167–184)

American Psychiatric Association. (2013a). Anxiety disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm05

American Psychiatric Association. (2013l). Obsessive compulsive and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm06

American Psychiatric Association. (2013d). Cultural formulation. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.CulturalFormulation

Diáz, E., Añez, L. M., Silva, M., Paris, M., & Davidson, L. (2017). Using the cultural formulation interview to build culturally sensitive services. Psychiatric Services, 68(2), 112–114. doi:10.1176/appi.ps.201600440

Required Media

TEDx Talks. (2015, May 29). Living with #OCD | Samantha Pena | TEDxYouth@TCS [Video file]. Retrieved from https://www.youtube.com/watch?v=btO3kE2RrEY&feature=youtu.be

TEDx Talks. (2016a, October 11). My hidden OCD exposed | Anne Swanson | TEDxVermilionStreet [Video file]. Retrieved from https://www.youtube.com/watch?v=A3f4Gf5Q_2w

Optional Resources

American Psychiatric Association. (2013i). Glossary of cultural concepts of distress. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.GlossaryofCulturalConceptsofDistress

Dominguez, M. L. (2017). LGBTQIA people of color: Utilizing the cultural psychology model as a guide for the mental health assessment and treatment of patients with diverse identities. Journal of Gay & Lesbian Mental Health, 21(3), 203–220. doi:10.1080/19359705.2017.1320755