GAD Flashcards
True or false: SAD and GAD are similar to one another and have much comorbidity with mood disorders like depression
True
How was GAD represented in the DSM-II
Lumped into the broad category of anxiety neurosis
What happened to GAD in the DSM-III
It was broken out into a residual category
How was GAD categorized in the DSM-III-R
It changed to have more of its own identity
- worry begins to play a larger role
- pathological worry is emphasized: has to be about everyday situations not just about another disorder
- worry about everything, intensely, all the time
True or false: with GAD there is no difficulty with differential diagnosis
False: there is difficulty with differential diagnosis
How was GAD characterized in the DSM-IV
Recall that DSM-IV is the first to include exclusion/inclusion, duration and # of symptoms
Simplified the criteria
- excessive worry and anxiety, more days than not, for 6 months, about multiple events, activities, objects, difficult to control the worry and cannot occur exclusively during a mood episode
How many symptoms are needed for a DSM diagnosis of GAD and what are these symptoms
Need at least 3/6 symptoms
Symptoms: restlessness/feeling on edge, easily fatigued, difficulty concentrating/mind going blank, irritability (the desire to control people/things around you), muscle tension, sleep disturbances
What are some examples of the symptomatic overlap between GAD and depression?
Restlessness or psychomotor agitation
Fatigue or psychomotor retardation
Sleep disturbances
What is controversial about GAD
It’s almost always comorbid with something else - more than other disorders
Maybe due to increased NA as a vulnerability marker playing a mechanistic role
What is the lifetime and 12-months prevalence for GAD
Lifetime: 5-6%
12-month: 3.1%
Is GAD more common in females or in males
Females
True or false: GAD is the least commonly diagnosed Axis I disorder in primary care
False, it is the most common
How do people usually present in primary care who get diagnosed with GAD
Common symptoms are stomach problems, headaches and migraines
As many as ______ of diagnosed cases of GAD meet the criteria for another disorder and as many as ______ of diagnosed cases meet the criteria for a mood disorder
90% and 80%
What are problems associated with GAD
Increased health care utilization - more frequent doctor visits
Increased health care costs - greater chance of concurrent physical illness
Significant social, academic and vocational impairment - days lost at school/work, damage to relationships etc.
When do symptoms of GAD become evident
Adolescence or earlier
Often don’t remember when it started
What is the median age of onset of GAD
30s
True or false: GAD has a median age of onset but it can realistically onset at any time and it has a gradual onset
True
What is a big difference between the onset of GAD and the onset of Panic
GAD onset is gradual and panic onset is very abrupt
What is the course of GAD - elaborate
Chronic
In a 12-year follow up study, the recovery rate was 58% and of those who recover the recurrence rate is high
What can we say about GAD and familial transmission
Trait anxiety is highly familial
There is a strong additive genetic component
GAD runs in families
What have family studies on GAD found
Increased rates of GAD in families of probands with GAD
Higher rates than in probands with panic disorder
Suggest some specificity
What is the main difference between prototypical anxiety disorder and GAD
Prototypical anxiety disorders will have a discrete feared object like in phobias
GAD will not have a discrete feared object - the feared object tends to be negative emotions and thoughts, the fear is not external to the person
True or false: people with GAD are worried about worrying and are intolerant to uncertainty
True
