Generalized Anxiety Disorder

Starčević, Vladan; Portman, Michael E.; Beck, Aaron T.

doi:10.1097/nmd.0b013e318263f947

Cited by 31 publications

(9 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A key dilemma in DSM classification is that the definition of GAD does not include specific features that differentiate it from closely neighboring conditions such as mood disorders (Starcevic, Portman, & Beck, 2012). Although worry behaviors were common in patients with mood disorders (62.6% met the worry behaviors criterion), these features were significantly more prevalent in patients with GAD.…”

Section: Discussionmentioning

confidence: 99%

The Contribution of Worry Behaviors to the Diagnosis of Generalized Anxiety Disorder

Brown

Tung

2018

J Psychopathol Behav Assess

View full text Add to dashboard Cite

Worry behaviors (i.e., overt acts to avoid or cope with worry-induced distress) have been recognized as being important in the psychopathology and treatment of generalized anxiety disorder (GAD). This study evaluated the worry behaviors criterion proposed for DSM-5 GAD, but was ultimately not adopted due to insufficient evidence. In 800 outpatients with emotional disorders (366 with GAD), most patients with GAD (92.6%) met the proposed worry behaviors criterion, which was at a rate significantly higher than other patient groups (e.g., patients with mood disorders). Patients who met the worry behaviors criterion had more severe GAD than patients who did not. The worry behaviors criterion, and 3 of its 4 constituent behaviors, were associated with no better than “fair” interrater reliability. Diagnostic reliability of GAD was not improved in cases where both interviewers agreed the worry behaviors criterion was met. The worry behaviors criterion significantly predicted DSM-5 GAD holding core GAD features constant (e.g., excessive worry), but this contribution was weak and did not appreciably improve the classification accuracy of GAD diagnostic status. Mixed support was obtained for the discriminant validity of the worry behaviors criterion in relation to mood disorders. Raising the proposed threshold of the criterion (requiring 2 instead of 1 behaviors) did not result in a substantial improvement in reliability, prediction, and classification accuracy. Although additional research is warranted (e.g., importance of worry behaviors in the treatment and natural course of GAD), the results raise questions about the role of worry behaviors in the diagnostic classification of GAD.

show abstract

Section: Discussionmentioning

confidence: 99%

The Contribution of Worry Behaviors to the Diagnosis of Generalized Anxiety Disorder

Brown

Tung

2018

J Psychopathol Behav Assess

View full text Add to dashboard Cite

show abstract

“…Evidence is needed to show whether the pharmacological and counseling strategies used to treat threshold mental health conditions also benefit subthreshold ones, if they are to be prescribed [72-74]. To save healthcare resources, studies propose stepwise treatment algorithms of increasingly intensive interventions for subthreshold conditions; starting with ‘watchful waiting’ and self-help strategies (life-style changes, appropriate self-medication); working through to primary care and specialist care when symptoms persist or increase [73].…”

Section: Discussionmentioning

confidence: 99%

The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review

et al. 2014

View full text Add to dashboard Cite

BackgroundTo review the prevalence and impact of generalized anxiety disorder (GAD) below the diagnostic threshold and explore its treatment needs in times of scarce healthcare resources.MethodsA systematic literature search was conducted until January 2013 using PUBMED/MEDLINE, PSYCINFO, EMBASE and reference lists to identify epidemiological studies of subthreshold GAD, i.e. GAD symptoms that do not reach the current thresholds of DSM-III-R, DSM-IV or ICD-10. Quality of all included studies was assessed and median prevalences of subthreshold GAD were calculated for different subpopulations.ResultsInclusion criteria led to 15 high-quality and 3 low-quality epidemiological studies with a total of 48,214 participants being reviewed. Whilst GAD proved to be a common mental health disorder, the prevalence for subthreshold GAD was twice that for the full syndrome. Subthreshold GAD is typically persistent, causing considerably more suffering and impairment in psychosocial and work functioning, benzodiazepine and primary health care use, than in non-anxious individuals. Subthreshold GAD can also increase the risk of onset and worsen the course of a range of comorbid mental health, pain and somatic disorders; further increasing costs. Results are robust against bias due to low study quality.ConclusionsSubthreshold GAD is a common, recurrent and impairing disease with verifiable morbidity that claims significant healthcare resources. As such, it should receive additional research and clinical attention.

show abstract

“…In the build-up to the 2013 revision of the Diagnostic and Statistical Manual (DSM-5; American Psychiatric Association, 2013), as for most disorders, there had been work groups, field studies, expert consensus and articles considering possible changes for GAD under DSM-5. There was a great deal of discussion (see Starcevic et al, 2012;Starcevic and Portman, 2013) but eventually very little changed. However, there was a very interesting proposal, namely that there may be some GAD-specific behaviours.…”

Section: Understanding Behaviour In Response To Uncertaintymentioning

confidence: 99%

Towards a model of uncertainty distress in the context of Coronavirus (COVID-19)

Freeston

Tiplady²,

Mawn

et al. 2020

tCBT

152

126

View full text Add to dashboard Cite

Abstract The paper forms part of a series of papers outlining the theoretical framework for a new model of uncertainty distress (this paper), treatment implications arising from the model, and empirical tests of the model. We define uncertainty distress as the subjective negative emotions experienced in response to the as yet unknown aspects of a given situation. In the first paper we drawn on a robust body of research on distinct areas including: threat models of anxiety, perceived illness uncertainty and intolerance of uncertainty. We explore how threat and uncertainty are separable in anxiety and how we can understand behaviours in response to uncertainty. Finally, we propose a clinically, theoretically, and empirically informed model for uncertainty distress and outline how this model can be tested. Caveats, clinical applications and practitioner key points are briefly included, although these are more fully outlined in the treatment implications article. While we outline this model in the context of novel coronavirus (Covid-19), the model has broader applications to both mental and physical health care settings.

show abstract

Generalized Anxiety Disorder

Cited by 31 publications

References 44 publications

The Contribution of Worry Behaviors to the Diagnosis of Generalized Anxiety Disorder

The Contribution of Worry Behaviors to the Diagnosis of Generalized Anxiety Disorder

The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review

Towards a model of uncertainty distress in the context of Coronavirus (COVID-19)

Contact Info

Product

Resources

About