TR

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