Dynamical Modeling And Application Of Complex Viscoelastic Structure
Siegfried Kasper, Johan A. den Boer, J. M. Ad Sitsen in Handbook of Depression and Anxiety, 2003
An example of the diagnostic confusion is the criteria for GAD and dysthymia. Both require long-term symptoms (6 months for GAD and 2 years for dysthymia). GAD requires anxiety and cognitive worry as its core symptoms, associated with restlessness, fatigue, poor concentration, irritability, muscle tension, and sleep disturbance. These associated symptoms are also part of the criteria for dysthymia, which requires sadness and anhedonia as its core symptoms. However, many patients are unable to report whether anxiety or sadness at an emotional level are their core experiences and clinicians may have difficulty distinguishing the worry of GAD from depressive ruminations; this raises questions about the reliability of such distinctions. Such conceptual confusion has implications. Thus, recent genetic studies suggest that the genetic vulnerability for GAD and MDD is the same [2]. That may be so, or the unity of genetic factors may be the result of an inability to clinically separate the two conditions with validity.
Diagnosis and Assessment
Melisa Robichaud, Naomi Koerner, Michel J. Dugas in Cognitive Behavioral Treatment for Generalized Anxiety Disorder, 2019
In order to be formally diagnosed with GAD, clients need to endorse at least three of the following six associated symptoms: restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, and sleep disturbance. Identified symptoms must also be experienced chronically, for at least 6 months, in order to satisfy GAD diagnostic criteria. As noted earlier, other than the experience of muscle tension, all of the GAD-associated symptoms can be found among the criteria for other mental health disorders. This is particularly the case for depressive disorders, where a client with major depressive disorder or persistent depressive disorder (i.e., dysthymia) might endorse concentration difficulties, fatigue, and sleep disturbance. Because of this, it is a good idea for clinicians to question clients further about these symptoms to determine whether they are in fact GAD-related. For example, when querying about muscle tension, clients can be asked: “Do you find that most of the muscle tension is in your neck and shoulders?” Since chronic anxiety often leads to tension in that part of the body, individuals with GAD will usually endorse this symptom. In addition, specifying a particular location of tension gives clients the feeling that they are “in the right place.” That is, that they are speaking with someone who really understands their specific difficulties.
Generalized Anxiety Disorder (GAD)
Judy Z. Koenigsberg in Anxiety Disorders, 2020
Does generalized anxiety disorder (GAD) occur with other emotional disorders, and which emotional disorders are likely to occur with GAD? GAD is highly comorbid with other emotional disorders (Carter, Wittchen, Pfister & Kessler, 2001; Timulak & McElvaney, 2018). Generally, individuals with one anxiety disorder tend to encounter another anxiety disorder either at the same time or at another time in their lives (Comer, 2015; Rodriguez et al., 2004). The anxiety disorder that is most likely to occur with GAD is social anxiety disorder (Borkovec, Abel, & Newman, 1995). There is quite a bit of overlap between the mood and anxiety disorders (Barlow, Allen, & Choate, 2004), and depression tends to occur with high frequency in both younger adults and the elderly with anxiety disorders (Wolitzky-Taylor et al., 2010).
Cognitive Behavioral Therapy, Mindfulness, and Hypnosis as Treatment Methods for Generalized Anxiety Disorder
Published in American Journal of Clinical Hypnosis, 2018
Carolyn Daitch
Generalized anxiety disorder (GAD) is a multifaceted condition that creates problems on three levels: cognitive, physical, and emotional. Cognitively, GAD results in excessive, unrealistic worry, often with a focus on issues such as health, finances, career, and the well-being of loved ones (Daitch & Lorberbaum, 2016). In addition, there is intolerance of uncertainty reflected in difficulty with decision making. There are often chronic physical discomforts—such as gastrointestinal upsets, headaches, or fatigue—that have no other medical explanation (Daitch & Lorberbaum, 2016). Physical symptoms result from the chronically high levels of stress hormones released through worrying (Daitch & Lorberbaum, 2012). On the emotional level, individuals with GAD may describe themselves as “on edge”: tense, irritable, and inescapably vulnerable to a world of distressing possibilities (Daitch, 2011). This article proposes that an integrative model, incorporating approaches from mindfulness, hypnosis, and cognitive therapy, provides an efficacious method of treatment for GAD. The treatment approach is demonstrated in a clinical case example.
Symptoms of generalized anxiety disorder as a risk factor for substance use among adults living with HIV
Published in AIDS Care, 2021
Zachary L. Mannes, Eugene M. Dunne, Erin G. Ferguson, Robert L. Cook, Nicole Ennis
Among the most commonly reported symptoms of GAD in this sample were worrying and feelings of anxiety. Given this, it is critical that appropriate anxiety management recommendations are provided, which may include cognitive behavioral therapy and/or psychotropic medications (Stefan et al., 2019). Cognitive behavioral therapy with a focus on exposure and response prevention strategies is effective for patients with anxiety disorders and has promising results in the context of comorbid substance use concerns (Lee & Oei, 1993). An integrated cognitive behavioral therapy approach specifically adapted for patients living with HIV demonstrated a reduction in anxiety symptoms while improving HIV medication adherence (Brandt et al., 2017). Regarding psychotropic medication, common medications used to treat anxiety disorders include benzodiazepines, venlafaxine, and buspirone (American Psychiatric Association, 2012). However, it is critical that prescribing clinicians consider drug-drug interactions and potential side effects if such psychotropic medications are prescribed. Finally, collaborative care models or co-location of services, in which medical, mental health, and other ancillary services (e.g., substance use treatment, case management) partner to provide care, may be useful to address anxiety and substance use among PLWH (Mizuno et al., 2019). This is supported by the Ryan White HIV/AIDS Program AIDS Education and Training Centers (AETCs) National Curriculum, which emphasizes the necessity of clinician screening efforts and integration of mental health care into HIV primary care (Budak & Cournos, 2020).
The psychometric properties of the Generalized Anxiety Disorder scale (GAD-7) among Korean university students
Published in Psychiatry and Clinical Psychopharmacology, 2019
Boram Lee, Yang Eun Kim
Since GAD is accompanied by symptoms of both an autonomic/physical and cognitive-emotional nature, which are included as diagnostic criteria for GAD-7, a one-dimensional approach to the construct may have implications for screening in community samples as well [19]. Accordingly, an independent assessment of items of a somatic/physical and cognitive-emotional nature related to the experience of GAD could be a way to identify and ensure proper treatment of this problem in the university setting [19]. Despite the encouraging psychometric results when the GAD-7 has been applied with various populations, the measure has remained untested with Korean university students. Give the high prevalence of anxiety and of comorbid anxiety plus depression in university students, and the need for briefer instruments that efficiently evaluate these symptoms in university students, the GAD-7 may be a particularly useful instrument for this population. Furthermore, GAD has been found to develop at a relatively early age and functions as a risk factor or a gateway for other anxiety disorders [8]. Accordingly, the aims of the present study were to examine and compare the fit of previously suggested models of the GAD-7, i.e. the original one-dimensional model and a two-factor model (composed of somatic and cognitive-emotional latent factors). An additional aim was to investigate the associations between the GAD-7 and other psychiatric instruments designed to measure the same constructs. Therefore, the evaluation of the psychometric properties encompassed factor structure, internal consistency, and convergent validity.
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