Generalized worry disorder: a review of DSM-IV generalized anxiety disorder and options for DSM-V

Abstract

Background: Generalized anxiety disorder (GAD) has undergone a series of substantial classificatory changes since its first inclusion in DSM-III. The majority of these revisions have been in response to its poor inter-rater reliability and concerns that it may lack diagnostic validity. This article provides options for the revision of the DSM-IV GAD criteria for DSM-V. Method: First, searches were conducted to identify the evidence that previous DSM Work Groups relied upon when revising the DSM-III-R GAD and the overanxious disorder classifications. Second, the literature pertaining to the DSM-IV criteria for GAD was examined. Conclusions: The review presents a number of options to be considered for DSM-V. One option is for GAD to be re-labeled in DSM-V as generalized worry disorder. This would reflect its hallmark feature. Proposed revisions would result in a disorder that is characterized by excessive anxiety and worry generalized to a number of events or activities for 3 months or more. Worry acts as a cognitive coping strategy that manifests in avoidant behaviors. The reliability and validity of the proposed changes could be investigated in DSM-V validity tests and field trials. Depression and Anxiety 27:134-147, 2010.

Efficacy of Cognitive Behavioral Therapy for Generalized Anxiety Disorder in Older Adults: Systematic Review, Meta-Analysis, and Meta-Regression

“…11 Inclusion of a greater number of trials, and increased specificity (in terms of trials reviewed and the measurement of treatment outcomes), has increased the validity of results compared to previous work. In comparison to a waitlist, CBT was found to produce a large effect with respect to reduced tendency to worry immediately following treatment.…”

“…10 Cognitive behavioral therapy (CBT) uses this neuroanatomical evidence to justify targeting uncontrolled and excessive worry during treatment. 11 Services are frequently faced with the challenge of treating older adult GAD, with patients preferring psychotherapy when offered treatment choice. 12 This review sought to quantify and synthesize the older adult evidence for the treatment of GAD with CBT in order to provide contemporary guidance to clinicians concerning effective treatment options.…”

Metacognitive, Emotional, and Avoidance Predictors of Generalized Anxiety Disorder

“…The cardinal feature of GAD is long-lasting, pervasive, and uncontrollable worrying (Andrews, Hobbs, Borkovec, Beesdo, & Craske, 2010).…”

Special Education a Provision and an Adjacent System – Exemplified Through Test Anxiety

“…The scientific construct of TA does not define specific norms, or establish any thresholds, inflection points or standards, even though some scales offer cut-off points or group individuals into categories of high and low TA based on standard deviation. TA is equally not a formal clinical diagnosis in the DSM, although it was considered for inclusion as a form or sub-type of social anxiety disorder (SAD) or general anxiety disorder (GAD) or as a type of specific phobia (SP) in the revision of the DSM-IV (Andrews et al, 2010;Bögels et al, 2010).…”

“…Due to fact that a likely biological disposition (i.e., already high levels of general anxiety) will be exacerbated during evaluations, the general preference is that GAD be assigned (Andrews et al, 2010;Bögels et al, 2010). In line with this, in the DSM-5, a set of associated symptoms are listed to distinguish individuals with GAD from high worries (Comer, Pincus, & Hofmann, 2012).…”