Generalized Anxiety Disorder

Criterion A

Persistent, diffuse worry

• Worry unproductive

• 6 month duration

Criterion B

Worry is difficult to control

Criterion C

3 or more of: restlessness/feeling keyed up, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance

Who gets GAD?

• Early and gradual onset

• One year prevalence: 0.3%

• Lifetime prevalence: 5.7%

• Gender breakdown: 3:1 female

• Perhaps culturally bound

• More common in elderly

Biological Theory

• Genetic tie-in

• Same as with phobia: likelihood if you have GAD is low a first degree relative will have it

• Autonomic restriction: higher baseline level of physiological arousal, due to increased anxiety levels

• During periods of anxiety, autonomic response is lower

• Chronic muscle tension

Biological Treatment

• Benzodiazepines (e.g., Xanax, Valium)

• SSRI’s

• SNRI’s

• 5-HT1a agonists

• Not great research to support it

• 60% of people get better

Psychodynamic Theory & Treatment

• Ego fears breakthrough of Id and/or superego

• Result: “unattached” (free-floating) anxiety

• Basic Freudian conception of neurosis

• Unclear findings- people do tend to get better after psychoanalysis

Learning Theory & Treatment

• Begin with physiological findings

• Brain activity concentrated in left hemisphere: more linguistic activity and little image activity

• Frantic, intense thought process without accompanying images

• Avoid negative effect associated with threat, learn to worry consistently

• Chronic worry in absence of “processing” effect

• Worrying allows you to avoid dealing with the thing

Treatment: Cognitive-Behavior Therapy

• Evoke worry and process images and affect

• Not bad (but not as good as other anxiety disorders)

• 60-70% of people get better, but not an enjoyable process

• 80-95% of kids do better, less likely to relapse

• Valuable to catch the disorder early