When poverty is looked at as a series of problems that must continuously be solved, the worry, one would presume, is continuous. It may very well be
extreme, and disruptive. It might even go so far, the data suggests, as to be pathological.
Anxiety seen in poor mothers is caused by poverty itself, not mental illness.
"If you have a genuine problem that you can't solve, that's not actually an anxiety disorder," says Margaret Wehrenberg, Psy.D., author of three books on
anxiety management.
And yet, when Fragile Families administered a standard diagnostic interview for Generalized Anxiety Disorder (GAD), it found that the psychological
condition was extremely common among the poorest mothers represented in its sample. This piqued the interest of Judith Baer, Ph.D., an Associate Professor
of Social Work at Rutgers University. How was it, she asked, that the women having the most financial difficulty were the most likely to be diagnosed with
GAD? She wondered: do these women truly have the disorder?
Baer took Fragile Families' data and subjected it to a secondary statistical analysis that looked specifically at the relationship
between poverty and diagnosis. Her results indicated that mothers who received free food had a 2.5 times greater chance of being diagnosed as having the
mental disorder. Odds were 2.44 times higher for mothers who had problems paying their utilities, and 1.9 who those who had, out of necessity, moved in
with others.
She and her team of researchers concluded that the anxiety seen in poor mothers is caused by poverty itself, not mental illness.
GAD is defined by the Diagnostic and Statistical Manual (the
soon-to-be updated DSM-IV-TR, last revised in 2000) as "excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6
months, about a number of events or activities (such as work or school performance)." Diagnosis requires the presence of three or more symptoms from a list
comprised of: restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance.
As one public health outlet offering counsel to sufferers of GAD says it, "You may
feel like your worries come from the outside -- from other people, events that stress you out, or difficult situations you're facing. But, in fact,
worrying is self-generated. The trigger comes from the outside, but an internal running dialogue maintains the anxiety itself."
In a "radical conceptual shift" from the former DSM-III criteria, claims Baer's article, this definition failed to include "an evaluation of the social
contextual environment in which symptoms occurred." This means that when the mothers surveyed by Fragile Families were diagnosed in accordance with the DSM
standards, their social and economic backgrounds were not taken into account.