Fundamentals of Mental Health

Fundamentals of Mental Health

Concept of sub-threshold anxiety (non-clinical anxiety): by ground theory methodology

Document Type : Research Paper

Authors
1 MS, in psychology, Educational Sciences and Psychology Department, University of Isfahan, Isfahan, Iran
2 PhD. in psychology, Assistant Professor in psychology, Educational Sciences and Psychology Faculty, University of Isfahan, Isfahan, Iran
3 PhD. in psychology, Associate Professor in psychology, Educational Sciences and Psychology Department, University of Tehran, Tehran, Iran
Abstract
Introduction: Although sub-threshold disorders do not receive clinical diagnosis, they can lead to dysfunction in individuals. Sub-threshold anxiety is one of the different types of sub-threshold disorders. Attaining a pervasive, thorough, and comprehensive definition of Sub-threshold Anxiety is the crucial pre-requisite of diagnosis, treatment and further researches on the disorder. Accordingly, all researches done on sub-threshold anxiety were analyzed.
Materials and Methods: This research is done based on ground theory methodology (GT). In this method, discoveries are noted in three stages: open coding, axial coding, and selective coding. Eventually, a pervasive and relatively comprehensive model of sub-threshold anxiety is developed.
Results: Substandard anxiety was identified in a model of a disorder, which consists of the process of evolution and sexuality, risk factors, the prevalence rate, detection symptoms, comorbidity, and detection and cure.
Conclusion: Although duration and intensity of sub-threshold anxiety does not show anxiety disorders, and on the other hand physical problems and suicide are indicative of the probable infliction to a complete disorder, it needs prevention and intervention.
Keywords

  1. Gadit, A. Subthreshold Mental Disorders. Journal of Pakistan Medical Association. 2008; 53: 42-44.
  2. Helmchen H. Subthreshold psychological disorders. Nervenarzt 2001; 72(3): 181-9.
  3. Goldberg, D. Plato vs. Aristotle: categorical and dimensional models for common mental disorders. Comprehensive Psychiatry 2000; 41: 8-13.
  4. Karsten, J. On the threshold of disorder: definition and course of subthreshold depression and subthreshold anxiety. Aula Academiegebouw Rijksuniversiteit Groningen.

Retrieved from: https://www.umcg.nl/EN/corporate/Agenda/Doctorates/Paginas/On_the_threshold_of_disorder_definition_and_course_of_subthreshold_depression_and_subthreshold_anxiety.aspx

  1. Haller H, Cramer H, Lauche R, Gass F, Dobos GJ. The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review. BMC Psychiatry 2014; 14:128.1-13
  2. Karsten, J. Penninx, B. W. J. H. Verboom, C. E.Nolen, W. A.  Hartman, C. A. Course and risk factors of functional impairment in subthreshold depression and anxiety. Depression and Anxiety 2013; 30, 4, 386-394
  3. Karsten, J.  Nolen ,W.A.  Penninx , B. W.J.H. Hartman ,C.A. Subthreshold anxiety better defined by symptom self-report than by diagnostic interview. Journal of Affective Disorders 2011; 129(1-3): 236-43
  4. Kanuri N,Taylor CB, Cohen JM, Newman MG. Classification models for subthreshold generalized anxiety disorder in a college population: Implications for prevention. Journal of Anxiety Disorder 2015; 43-52
  5. Balázs J, Miklósi M,Keresztény A, Hoven CW, Carli V, Wasserman C, et al. Adolescent subthreshold-depression and anxiety: psychopathology, functional impairment and increased suicide risk. Journal of Child Psychology and Psychiatry 2013, 54(6):670-7
  6. Grenier S, Preville M, Boyer R, O’Connor K, Beland SG, Potvin O, Hudon C, Brassard J, Scientific Committee of the ESAS. The impact of DSM-IV symptom and clinical significance criteria on the prevalence estimates of subthreshold and threshold anxiety in the older adult population. Am J Geriatr Psychiatry 2011; 19 (4): 316-326
  7. Papassotiropoulos , A. Heun, R .Detection of subthreshold depression and subthreshold anxiety in the elderly. geriatric psychiatry 1999;14, 8.  643–650
  8. Carter, R. M. Wittchen, H.U. Pfister, H. Kessler, R. C. One-year prevalence of subthreshold and threshold DSM-IV generalized anxiety disorder in a nationally representative sample. Depression and Anxiety 2001; 13, 78-88
  9. Lewinsohn PM,Shankman , SA. Gau , JM.  Klein , DN.The prevalence and co-morbidity of subthreshold psychiatric conditions. Psychol Med 2004 ;34(4):613-22
  10. Helmchen, H. Linden, Subthreshold disorders in psychiatry: clinical reality, methodological artifact, and the double-threshold problem. Compr Psychiatry 2000;41(2 Suppl 1):1-7
  11. Glaser, B. Strauss, A. The Discovery of the Grounded Theory Strategies for Qualitative Research, New York; 1- 271
  12. Mays, N. and pope, G. Assessing quality in qualitative research. British Medical Journal; 2002; 320, 50-54
  13. Corbin,J. Strauss, A. Grounded Theory Research: Procedures, Canons, and Evaluative Criteria. Qualitative Sociology 1990; 13, 1. 3-22
  14. Lee SP , Sagayadevan V, Vaingankar JA , Chong SA , Subramaniam M . Subthreshold and threshold DSM-IV generalized anxiety disorder in Singapore: Results from a nationally representative sample. J Anxiety Disord2015; 32: 73-80
  15. Karsten J, Hartman CA, Smit JH, Zitman FG, Beekman AT, Cuijpers P, van der Does AJ, Ormel J, Nolen WA, Penninx BW. Psychiatric history and subthreshold symptoms as predictors of the occurrence of depressive or anxiety disorder within 2 years. Br J Psychiatry2011; 198(3): 206-12.
  16. Bosman RC , Ten Have M , de Graaf R , Muntingh AD , van Balkom AJ , Batelaan NM. Prevalence and course of subthreshold anxiety disorder in the general population: A three-year follow-up study. J Affect Disord2019; 247: 105-13.
  17. Lucchetti G , Peres MF, Lucchetti AL, Mercante JP, Guendler VZ, Zukerman E. Generalized anxiety disorder, subthreshold anxiety and anxiety symptoms in primary headache. Psychiatry Clin Neurosci2013; 67(1): 41-9.
  18. Burstein M, Beesdo-Baum K, He JP, Merikangas KR. Threshold and subthreshold generalized anxiety disorder among US adolescents: prevalence, sociodemographic, and clinical characteristics. Psychol Med.2014; 44(11): 2351-62
  19. Angst J , Merikangas KR, Preisig M. Subthreshold syndromes of depression and anxiety in the community. J Clin Psychiatry1997; 58(Suppl 8): 6-10.
  20. Gilmour H. Threshold and subthreshold Generalized Anxiety Disorder (GAD) and suicide ideation. Health Rep.2016; 27(11): 13-21.
  21. Miloyan B , Byrne GJ , Pachana NA . Threshold and subthreshold generalized anxiety disorder in later life. Am J Geriatr Psychiatry2015; 23(6): 633-41.