Glasofer, D. R. (2021, February 15). How Is Generalized Anxiety Disorder Diagnosed Using the DSM-5? Verywell Mind. https://www.verywellmind.com/dsm-5-criteria-for-generalized-anxiety-disorder-1393147. 

DSM-5 GAD Diagnosis

Hall, J., Kellett, S., Kaur Bains, M., Stonebank, H., & Scott, S. (2020). The acceptability and feasibility of group cognitive behavioural therapy for older adults with generalised anxiety disorder. Behavioural and Cognitive Psychotherapy, 48(5), 621-625. http://dx.doi.org/10.1017/S1352465820000235

The acceptability and feasibility of group cognitive
behavioural therapy for older adults with generalised
anxiety disorder

Breedlove, S. & Watson, N. (2017). Behavioral neuroscience, eighth edition. Oxford University Press.

Behavioral Neuroscience 8th Edition

Katzman, M. A. (2009). Current considerations in the treatment of generalized anxiety disorder. CNS drugs, 23, 103-120. https://doi.org/10.2165/00023210-200923020-00002 

Current considerations in the treatment of generalized anxiety disorder

Cuijpers, P., Sijbrandij, M., Koole, S., Huibers, M., Berking, M., & Andersson, G. (2014). Psychological treatment of generalized anxiety disorder: a meta-analysis. Clinical psychology review, 34(2), 130-140. https://doi.org/10.1016/j.cpr.2014.01.002

Psychological treatment of generalized anxiety disorder: A meta-analysis

Michigan State University

Generalized Anxiety Disorder (GAD) is characterized by a persistent and relatively continuous state of excessive, uncontrollable, and often pointless worry and apprehension. Individuals with this disorder typically worry about routine, everyday matters, such as health, finances, or the safety of family members, without any justified reason. For a diagnosis, this diffuse worrying must occur more days than not for a period of at least six months, not be attributable to another disorder, and be accompanied by at least three of the following symptoms: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep difficulties.

Generalized Anxiety Disorder

Anxiety is a common mental health factor studied after exposure to natural disasters and the research shows that greater exposure to natural disasters is linked to more symptoms of anxiety-related disorders.

Anxiety and Natural Disaster Exposure

- Feeling Restless
- Fatigued 
- Difficulty Concentrating
- Mind "going blank"
- Irritability
- Muscle Tension
- Difficulty Controlling Feelings of Worry
- Sleep Problems
- Restlessness
- Persistent Worry/Anxiety
- Overthinking
- Difficulty Handling Uncertainty
- Indecisiveness
- Inability to Relax
- Trembling 
- Nervousness
- Sweating
- Nausea
- Diarrhea 
- Obessive Thoughts

Symptoms of Generalized Anxiety Disorder

Older adults tend to prefer therapy over medication in the treatment of GAD, so it's very important to investigate whether treatments like CBT are effective and feasible.  Group therapy is an efficient method of treatment, so it warrants testing for efficacy.

Group cognitive behavioral therapy (CBT) for older adults with generalized anxiety disorder (GAD)

- Psychological treatment 
- Medication
- A combination of Psychotherapy and Medication

Treatment options for Generalized Anxiety Disorder (GAD) in Adults

References for Generalized Anxiety Disorder

Reference for An increase in GAD research

Reference for Conditioned Fear Reactions

Conditioned fear reactions are learned associations between internal or external cues and feelings of severe anxiety.

Conditioned Fear Reactions 

Reference for Managing Anxiety with Nutrition

An alternative strategy for alleviating anxiety is to address the underlying metabolic pathologies that are linked to anxiety. Examples of such metabolic pathologies are microbiome imbalance and inflammation. Interventions aimed at improving nutrition may help alleviate anxiety by reducing inflammation and microbiome imbalance.

Managing Anxiety with Nutrition

A person named Alex illustrates the symptoms of Generalized Anxiety Disorder through his constant and pervasive worrying. His anxieties span multiple areas of life, including fears about his children's safety, potential household disasters like fires, his husband's job security, and minor health issues escalating into severe conditions. This chronic worrying significantly impacts his daily functioning, causing tension, irritability, and difficulty in making decisions. His tendency to catastrophize is highlighted by an incident where he contacted the police after his husband and son were only 45 minutes late, assuming they had been in a serious car accident.

Example of Generalized Anxiety Disorder: Alex's Worries

The diffuse and pervasive worrying characteristic of Generalized Anxiety Disorder was described by Sigmund Freud as 'free-floating anxiety.' This term highlights that the apprehension is not connected to a specific threat or situation but is instead a general and persistent state of concern that attaches to various aspects of everyday life.

Free-Floating Anxiety in GAD

In the United States, it is estimated that approximately 5.7% of the population will experience symptoms of Generalized Anxiety Disorder at some point in their lives.

Prevalence of Generalized Anxiety Disorder

There is a notable gender disparity in the occurrence of Generalized Anxiety Disorder, with females being twice as likely as males to develop the condition.

Gender Differences in Generalized Anxiety Disorder

Generalized Anxiety Disorder frequently co-occurs with other mental health conditions, showing a high rate of comorbidity with both mood disorders and other types of anxiety disorders.

Comorbidity of Generalized Anxiety Disorder

Generalized Anxiety Disorder is often a chronic condition, meaning it tends to be long-lasting and persistent over time for those who experience it.

Chronicity of Generalized Anxiety Disorder

Generalized Anxiety Disorder may pose significant physical health risks, as it has been shown to increase the likelihood of experiencing heart attacks and strokes, particularly for individuals who have pre-existing heart conditions.

Health Risks Associated with Generalized Anxiety Disorder

Based on a summary of family and twin studies, genetic factors are understood to play a modest role in the development of Generalized Anxiety Disorder. However, the heritability of the disorder has not been extensively investigated.

Genetic Factors in Generalized Anxiety Disorder

Cognitive theories propose that the characteristic worry in Generalized Anxiety Disorder acts as a mental strategy to avoid confronting more powerful and distressing negative emotions. This avoidance mechanism may originate from earlier unpleasant or traumatic life experiences.

Cognitive Theory of GAD: Worry as an Avoidance Strategy

Based on the scenario provided, identify the psychological condition that best explains the individual's symptoms. Justify your choice by connecting specific details from the text to the defining characteristics of the condition.

Clinical Scenario Analysis

Although Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders, research regarding its diagnosis, symptoms, and potential treatments has historically been severely lacking compared to other anxiety disorders. However, in the last decade, there has been an increased interest in research focusing on GAD.

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