Category: Cultural Diversity / Vulnerable Populations
Background: Generalized Anxiety Disorder (GAD) in adolescents is associated with feelings of tension, apprehension, the need for reassurance, negative self-image, and physical complaints. Maladaptive perfectionism, including self-oriented (SOP) and socially-prescribed (SPP), is a construct gaining attention in its link to GAD. Despite recent increased attention on studying perfectionism and anxiety disorders, much of the research is based largely on Caucasian youth. It has been shown that Latinos have the highest prevalence of anxiety, and it has been suggested that perceptions of how well they are meeting their family’s expectations and standards is predictive of anxiety, depression, and deflated self-esteem. The purpose of this study was to identify predictors of GAD in Latino adolescents receiving cognitive behavioral group therapy at pre- and post-treatment. Perfectionism, depression, and self-perception were selected as predictor variables given the established theoretical, cultural, and empirical links identified.
Methods: Fifty middle school students with elevated symptoms of anxiety were selected to participate in an eight week, CBT-based coping skills group intervention at an urban, bilingual (English and Spanish) charter school in the Mid-Atlantic region. Participants were between the ages 11 to 14, with nearly twice as many females (n = 33) as males (n = 17). Self-report measures of anxiety, perfectionism, self-perception, and depression were administered at pre- and post-treatment. Overall effectiveness of the treatment was analyzed, and then multiple regressions analyses were conducted to explore how pre-treatment SOP, SPP, Behavioral Self-Perception (BSP), and Depressive Anhedonia (DA) can predict GAD symptoms at pre-and post-treatment.
Results: A paired samples t-test revealed a significant decrease in GAD symptoms (Mpre=8.4, Mpost= 7.1), t(44)=2.55, p < .05. A multiple regression was conducted at pre-treatment, and the model was significant, F(4,35) = 8.098, p < .001 and indicated that 71.5% of the variance in pre-treatment GAD was explained by SOP, SPP, DA, and BSP. However, only SPP (β=.287, t=2.037, p=.05) and SOP (β=.421, t=2.518, p < .05) were significant predictors. At post-treatment, the model was significant, F(2,40) = 10.804, p < .001 and indicated that 31.3% of the variance in post-treatment GAD was explained by SOP and SPP. However, only pre-treatment SOP was a significant predictor of post-treatment GAD (β=.432, t=3.20, p < .01).
Conclusions: While there appears to be significant correlation between SOP, SPP, DA, BSP, and GAD symptoms, SPP and SOP appear to be significant predictors at pre-treatment. Additionally, SOP significantly predicted GAD symptoms at post-treatment, despite there being a significant reduction of GAD symptoms after treatment. This may suggest that targeting maladaptive perfectionism in GAD may better serve overall treatment outcome for this sub-group of anxious adolescents. Culture-specific theories related to the development of anxiety in Latino will be discussed in the context of these findings.