Generalized Anxiety Disorder (GAD) – Key Vocabulary

Vocabulary flashcards summarizing diagnostic criteria, symptoms, epidemiology, risk factors, theoretical models, and treatments for Generalized Anxiety Disorder.

Generalized Anxiety Disorder (GAD)

An anxiety disorder marked by excessive, pervasive, and hard-to-control worry about multiple life areas for at least six months, causing distress or impairment.

Excessive Worry

Persistent apprehensive expectations that are disproportionate to actual likelihood or impact of feared events.

Restlessness / Feeling on Edge

A core physical symptom of GAD involving heightened psychomotor agitation or inability to relax.

Muscle Tension

Prolonged contraction or tightness of muscles frequently reported by individuals with GAD.

Sleep Disturbance

Difficulty falling asleep, staying asleep, or experiencing non-restorative sleep associated with GAD.

Hierarchical Exclusion Rule

DSM guideline stating GAD should not be diagnosed if worry occurs exclusively during depressive, bipolar, or psychotic disorders.

Excessive & Impairing Worry

Worry that overwhelms, interferes with daily life, and is difficult to control—distinguishing GAD from normal anxiety.

Pervasive & Chronic Worry

Worry that is frequent, long-lasting, and often trigger-less, characteristic of GAD.

Broad Scope of Worry

GAD tendency to involve multiple domains such as finances, health, work, and family safety.

Somatic Symptoms

Physical manifestations of anxiety (e.g., sweating, nausea, diarrhea) common in GAD.

Exaggerated Startle Response

Heightened reaction to unexpected stimuli often observed in GAD sufferers.

Prevalence of GAD

Approximately 0.9 % in U.S. adolescents and 2.9 % in adults; women are affected twice as often as men.

Behavioral Inhibition

Temperamental tendency toward withdrawal from unfamiliar situations, a risk factor for GAD.

Negative Affectivity (Neuroticism)

Dispositional tendency to experience negative emotions; linked to higher GAD risk.

Intolerance of Uncertainty

Disposition to find uncertain or ambiguous situations distressing; central to one theoretical model of GAD.

Avoidance Behaviors

Strategies (e.g., excessive preparation, procrastination, reassurance-seeking) used to reduce uncertainty but maintain GAD.

Avoidance Model of Worry

Theory positing worry functions as cognitive avoidance of distressing images, emotions, or somatic sensations.

Intolerance of Uncertainty Model

Model suggesting worry arises to reduce distress about uncertain outcomes, paradoxically increasing anxiety.

Metacognitive Model

Framework distinguishing Type 1 (external) worry and Type 2 (worry about worry), driven by beliefs about the usefulness and danger of worrying.

Type 1 Worry

Concern focused on external problems or events (e.g., finances, safety).

Type 2 Worry (Metaworry)

Worry about the act of worrying itself, fueling a self-reinforcing cycle in GAD.

Emotion Dysregulation Model

View that worry is an ineffective emotion-regulation strategy emerging from heightened emotional intensity and poor understanding of emotions.

Cognitive Fusion

ACT concept in which individuals treat thoughts (e.g., worries) as literal facts, becoming ‘hooked’ by them.

Cognitive Defusion

ACT technique of distancing from thoughts, seeing them as transient mental events rather than truths.

Acceptance and Commitment Therapy (ACT)

An acceptance-based approach encouraging openness to internal experiences and commitment to values, effective for GAD.

Cognitive-Behavioral Therapy (CBT)

Treatment focused on identifying and restructuring maladaptive thoughts and behaviors; less effective for GAD compared to other anxiety disorders.

Struggle Switch

ACT metaphor illustrating how resisting internal experiences (e.g., anxiety) intensifies suffering; turning the switch off involves acceptance.

Functional Consequences of GAD

Slowed task performance, impaired parenting, and moderate-to-severe disability in social and occupational areas.

Comorbidity

High co-occurrence of GAD with other anxiety disorders and unipolar depression; substance use disorders more common among men with GAD.

DSM History of GAD

Evolved from a residual category (pre-DSM-III-R) to a defined disorder emphasizing worry; retains lower interrater reliability.

Cultural Variations in GAD

Differences in somatic versus cognitive symptom focus and worry content across cultural contexts.

Lifetime Course of GAD

Typically chronic with waxing-waning severity, median onset at age 30, and low spontaneous remission rates.

Heritability of GAD

Approximate genetic contribution estimated at one-third (≈33 %).

Over-Diagnosis in Children

GAD may be diagnosed too readily in youth due to high general anxiety and overlapping symptoms.

Stress-Related Conditions

Physical ailments (e.g., IBS, headaches, TMJ) that can accompany chronic GAD.

Acceptance-Based Therapy

Interventions (e.g., ACT) targeting acceptance of uncertainty and mindfulness rather than solely cognitive change.