A produção social dos transtornos de ansiedade: reflexões a partir da Psicologia HistóricoCultural

Abstract

According to recent data from the World Health Organization (WHO), anxiety disorders are among the most commom in the world population, reaching about 264 million people. In relation to Brazil, the country is referred to as ‘the most anxious in the world’. In view of this, science, especially medical-psychiatric and psychological, has been dedicated to researching the ‘pathological anxiety’, according to the proposition of its signs and symptoms, the definition of classification criteria, increasing diversification into subtypes of disorders, the prevalence in certain groups and the statistical correlations with risk factors, thus configuring a predominantly descriptive and presenteeist approach – which contributes to the ontologization of the disease and the secondaryization of the centrality of people and the processes of the social totality in which their lives are implicated. With this, the appearance of the phenomenon is taken as its essence, pari passu to the veiling of its most radical determinations. Based on this work, then, based on the assumptions of Historical-Cultural Psychology and the Theory of Social Determination of the Health-Disease Process, we intend to problematize the hegemonic conceptions, and their possible consequences, regarding anxiety, specified in subtypes of disorder. Therefore, we built a chronological-comparative panorama between the first and the last edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) – considered one of the main compendia of world psychiatry – and the changes that have taken place in the capitalist mode of production since 1950, the date of the first version of the book. We denote, therefore, that the crises of the system, especially the one that occurred in the 1970s, they intensify the mechanisms of exploitation and subordinate workers to the most strenuous workloads, increasing their illness and feeding back the need to broaden the diagnostic spectrum to encompass more individuals in types/subtypes of anxiety disorders. Then, we carried out a bibliographic review, aiming to extract, from the most current scientific productions, what has been postulated about the etiology of anxiety and its disorders. From this task, we inferred the massive linkage of the research to the assumptions of the DSM: from empirical investigations, the association of variables with symptoms stands out, focusing on intervention proposals in the pharmacological and behavioral field, despite allowing certain relief from suffering. Indepth discussions about the etiology of anxiety, taking into account psychosocial profiles and conditions, are scarce, as are theoretical formulations and/or hypothetical models that guide new studies, aimed at investigating the more general determinations of suffering. In turn, a genetic-causal approach is neglected, which delves into the unveiling of the links of this psychophysical process (as a synthesis of multiple determinations), always singular, with the social totality and particular mediations. In view of the above, in the third chapter of this dissertation, we discuss the indispensability of studies that reveal the radical determinations, causality, extension and intensification of anxious states in the population, with emphasis on the particularities by groups, taking as principles the individual-society dialectic and the social as: source: health-disease processes, including psychological distress, within the scope of the psychophysical unit; of personality development; and also the constraints experienced as pressures on the activity-consciousness-personality system. We will thus advance in the construction of a praxis that overcomes the biomedical hegemony in the countryside, so functional to capitalist social reproduction.