A Little Bit Nervous”
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! MORE THAN “A LITTLE BIT NERVOUS”: UNDERSTANDING THE EXPERIENCES OF YOUNG WOMEN WITH ANXIETY DURING SECONDARY SCHOOL by Vita-Marie Ross A thesis submitted to the Faculty of Education in conformity with the requirements for Degree of Master of Education Queen’s University Kingston, Ontario, Canada September, 2015 Copyright © Vita-Marie Ross, 2015 ! ABSTRACT In recent years, there has been greater recognition of the importance of examining and improving the mental health of Canadian youth, in that approximately 50% of mental health problems surface during adolescence (Mental Health Commission of Canada, 2013). One of the most debilitating mental health issues facing young people is anxiety (Canadian Mental Health Association, 2014; Rockhill et al., 2010). The ability of anxiety to impair the daily functioning of students at school is becoming an increasing concern for Canadian teachers (Canadian Teachers’ Federation, 2012). The purpose of this study was to understand the experiences of six young women between 18 and 22 years of age who self-reported having anxiety during secondary school. Semi-structured interviews were used to assist in further understanding these women’s experiences. An inductive approach was employed to analyze the data. Data analysis revealed four primary themes: (1) experience of anxiety, (2) triggers of anxiety, (3) effects of anxiety, and (4) coping with anxiety. All participants’ experience of anxiety included physiological and cognitive symptoms. For some of these young women, a lack of awareness of their anxiety and stigma were additionally encountered. Participants identified academic, teacher, social, family, and future triggers that caused them to feel anxious at school, as well as academic, social, and emotional effects of anxiety. The young women used talk strategies, academic coping strategies, personal coping strategies, pharmacotherapy, and avoidance to manage anxiety. Two secondary themes additionally emerged across these primary themes: (1) fear of the future and (2) perfectionism. Further to these young women’s experiences was a fear of uncertainty in things to come, as well as a need to control outcomes through ! ii perfectionism and high academic standards. Finally, while no participant approached their teachers for assistance in coping, these young women suggested teachers could help anxious students by using specific teaching strategies, by being approachable, and by talking about mental health at school. While there were many similarities across participants’ experiences, the phenomenon of having anxiety during secondary school is complex – unique to each individual, personal circumstances, and life events. Keywords: adolescence, anxiety, trait anxiety, anxiety disorder, generalized anxiety disorder (GAD), secondary school ! iii ACKNOWLEDGMENTS First, I would like to acknowledge John Freeman, my supervisor. John, you have been my north star throughout this journey – a journey I could not have made without your enduring guidance. Thank you for your listening ear, for your counsel and advice, and most of all, for challenging me personally and academically. I would like to recognize my committee member Ben Bolden. Ben, thank you for your encouragement and support. The care you have shown for my work, but also for me as a person is deeply appreciated. This thesis would not have been possible without you. To my participants, thank you for sharing your experiences with me, and for opening up to me so genuinely and generously. Thank you for trusting me to tell your stories, and for helping me to understand the intricacies and complexities of what it is like to have anxiety during secondary school. To the staff at the Vitality Counselling Centre and Queen’s Health Counselling and Disability Services, thank you for your help, and for ultimately assisting in making this research a reality. To old friends and new friends I have made along the way, thank you for the endless encouragement and for always keeping me grounded in positivity. Finally, I would like to thank my family. Mom, you have always been my number one supporter. Thank you for believing in me and encouraging me to follow my dreams. To my dad Stefano, thank you for pushing me to live life to its fullest, and for loving me unconditionally. Lastly, I would not be the person I am today without my grandparents. Vita and Joe, thank you for showing me what selfless love is, and that nothing in life comes without hard work and perseverance. Ti voglio bene! ! iv TABLE OF CONTENTS ABSTRACT ........................................................................................................................ ii! ACKNOWLEDGMENTS ................................................................................................. iv! TABLE OF CONTENTS .................................................................................................... v! LIST OF TABLES .............................................................................................................. x! CHAPTER 1: INTRODUCTION ....................................................................................... 1! Purpose!......................................................................................................................................................!1! Rationale!...................................................................................................................................................!3! Understanding!Anxiety!.......................................................................................................................!3! Types!of!Anxiety!...............................................................................................................................!4! Gender!and!Anxiety!.........................................................................................................................!7! Importance!of!Addressing!Anxiety!in!Adolescence!...........................................................!8! Overview!of!Thesis!...............................................................................................................................!9! CHAPTER 2: REVIEW OF THE LITERATURE ........................................................... 10! Experience!of!Anxiety!.......................................................................................................................!10! Cognitive!Manifestations!of!Anxiety!.....................................................................................!10! Physiological!Manifestations!of!Anxiety!..............................................................................!11! Behavioural!Manifestations!of!Anxiety!................................................................................!12! Personal!Awareness!and!Mental!Health!Literacy!............................................................!13! Stigma!.................................................................................................................................................!14! Triggers!of!Anxiety!............................................................................................................................!15! School!Context!................................................................................................................................!15! ! v Relationships!with!Teachers!....................................................................................................!18! Relationships!with!Peers!............................................................................................................!19! Relationships!with!Parents!.......................................................................................................!22! Life!Events!........................................................................................................................................!23! Effects!of!Anxiety!................................................................................................................................!24! Academic!Effects!............................................................................................................................!25! Psychosocial!Effects!.....................................................................................................................!27! Emotional!Effects!...........................................................................................................................!28! Coping!with!Anxiety!..........................................................................................................................!29! Avoidant!Coping!.............................................................................................................................!30! Approach!Coping!...........................................................................................................................!33! Teacher!Support!............................................................................................................................!39! Summary!................................................................................................................................................!43! CHAPTER 3: METHODOLOGY .................................................................................... 45! Choice!of!Research!Method!............................................................................................................!45! Procedures!............................................................................................................................................!46!