L5 - Generalised Anxiety Disorder

Question 1

What are some of the somatic symptoms of GAD (generalise anxiety disorder)?

≥ 3 necessary for diagnosis.

Answer 1

• Restlessness
• Fatigue
• Difficulty concentrating
• Irritability
• Muscle tension
• Sleep disturbances

Question 2

What are some of the other criteria for GAD?

Answer 2

• duration ≥ 6 months.
• effect daily functioning.
• not due to drugs/medication.
• need to distinguish from other disorders including excessive worry.

Question 3

What is the epidemiology of GAD?

Answer 3

• 2 x as many women than men, in balanced clinical samples.

- 4% of general population.

Question 4

How can normal worry be useful?

Answer 4

• Motivate actions
• Problem solving
• Avoid negative outcomes
• Distract from more distressing topics

Question 5

What are the 4 aspects of social problem solving, and which 2 are problematic for high worriers? (D’Zurilla & Maydeu-Olivares, 1995)

Answer 5

• Problem definition
• Generation of alternative solutions
• Solution Evaluation (+/-)
• Solution Selection

Solution evaluation and selection are problematic for excessive worriers.

Question 6

What is Borkovec’s (1994) Avoidance Theory?

Answer 6

Worry causes relatively more verbal thought than imagery.

As images of possible negative events are aversive, and anxiety causing, people switch to verbal thought.

This reduces imagery, and in turn anxiety.

Worry = cognition avoidance.

Question 7

What emotion regulations are difficult for worriers?

Answer 7

• Identifying emotions
• Tolerating emotions
• Modulating emotions

Question 8

What is the Intolerance of Uncertainty Theory (Ladouceur et al., 2000)?

Answer 8

Uncertainty reflects badly on a person -> causes frustration/stress -> prevents action.

Worry to reduce anxiety -> preoccupation with details.
Worriers aim to reduce uncertainty to zero (impossible).

Question 9

Define worry and meta-worry:

Answer 9

There are two types of metacognitive worry.

Type 1: Worry

• perception of treat.
• positive belief about worry.
• worry -> cope with threat.

Type 2: Meta-worry:

• worry and negative beliefs about worry.
• meta-worry -> ineffective self control -> increased anxiety & worry.

Question 10

What are the treatments of GAD? (dependent on problem).

Answer 10

• Biased threat perception: probability & cost training.
• Problem solving issues: structure problem solving training.
• Avoidance: exposure (to images, experience, uncertainty).
• Meta-cognitive: challenging beliefs about worry (+/-).

Question 11

What are the success rates of treatment?

Answer 11

Treatment effects have been modest - about 50 to 60% improvement at follow-up.