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