Generalized Anxiety Disorder

Diagnostic Criteria From DSM5

  • Excessive anxiety and worry occurring more days than not for at least 6 months

  • Difficulty controlling the worry

  • Anxiety and worry associated with other physical symptoms

  • Anxiety causes clinically significant distress or impairment

  • Not due to substance use or medical condition

  • Not better explained by another mental disorder

Clinical Description

  • Shift from possible crisis to crisis

  • Worry about minor, everyday concerns   * Job, family, chores, appointments

  • Accompanied by symptoms such as sleep disturbance and irritability

  • Leads to behaviors like procrastination, overpreparation

  • GAD in children   * Need only one physical symptom   * Worry = academic, social, athletic performance

  • Statistics   * 3.1% (year)   * 5.7% (lifetime)   * Similar rates worldwide   * Insidious onset     * Early adulthood   * Chronic course

  • GAD in the elderly   * Worry about failing health, loss   * Up to 10% prevalence   * Use of minor tranquilizers: 17 to 50%     * Sometimes prescribed for medical problems or sleep problems     * Increase risk for falls and cognitive impairments

Causes of GAD

  • Inherited tendency to become anxious

  • Neuroticism

  • Less responsiveness   * “Autonomic restrictors”

  • Threat sensitivity

  • Frontal lobe activation   * Left vs. right

Treatments of GAD

  • Pharmacological   * Benzodiazepines     * Risks versus benefits   * Antidepressants

  • Psychological   * Similar benefits to drugs and better long-term results   * Cognitive-behavioral treatments     * Exposure to worry process     * Confronting anxiety-provoking images     * Coping strategies   * Acceptance   * Meditation

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