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