What is Generalized Anxiety Disorder?
Generalized anxiety disorder (GAD) has been recognized as the most common anxiety disorder within primary care, leading to a significant degree of impairment and disability within individuals (Watterson et al., 2017).
According to DSM-5, GAD is classified by:
● Excessive anxiety and worry occurring more days than not for at least 6 months, about a number of events or activities, and a difficulty controlling the worry
● An association with three or more of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months):
○ Restlessness or feeling on edge
○ Being easily fatigued
○ Difficulty concentrating or mind going blank
○ Irritability
○ Muscle tension
○ Sleep disturbance
● A disturbance which is not better explained by another mental disorder
● Anxiety, worry or physical symptoms which cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
● A disturbance which is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition
What may predispose an individual to develop GAD?
Even though the causes of GAD are not fully understood, there are some factors which have been considered as potential factors in the occurrence of anxiety disorders. These include traumatic life experiences, problems with conditioning, and differences in neurobiological functioning (Bandelow et al., 2013).
Genetic research done by Mishra & Varma (2023) has also suggested that genetics are implicated in the development of GAD in individuals such that if one family member has the disorder, there is a higher likelihood that another family member will also suffer from the disorder, or another form of anxiety.
Further, it has been found that certain individuals may be more at risk for developing this disorder, as well as other anxiety and mood disorders, than others. These risk factors include being of female sex, having low socioeconomic status, and having early exposure to adversity such as physical or sexual abuse, neglect, and alcoholism (Moreno-Peral et al., 2014).
Anxiety across age groups
There is compelling evidence stating that anxiety disorders, such as GAD, are the most common mental disorders in children and that they appear to be the earliest of all the kinds of psychopathology (Beesdo et al., 2011). Within children, GAD typically shows itself through recurring stomach pain and other somatic symptoms that may cause them to stay out of school (Stein & Sareen., 2015).
In general, characteristics of generalized anxiety disorder are similar within the different age groups such as a need for reassurance, as seeking reassurance can help reduce anxious feelings and uncertainty in many people. However, when comparing this need between children and adolescents, it was found to be more present in children, whereas brooding was more frequent in adolescents (Masi et al., 2004).
Another prominent trait found within the GAD population, regardless of age, is excessive worry. Although common amongst ages, it is important to note that the topics of worry are where we can see differences from person to person as well as between ages. For example, Goncalves & Byrne (2013) found that young adults were more likely to worry about interpersonal relationships, work, and other miscellaneous topics, whereas adults 65 and older worry more about the health of themselves and others but overall, worry less than younger adults.
Comparing women and men
One of the most widely reported findings is that women are significantly more likely to develop an anxiety disorder throughout their lifespan when compared to men (Becker & van Mens-Verhulst, 2007; Regier et al., 1990). Although it is not certain why this is, some results have reported that women have more meta worry than men, which is the state of worrying about worry (Bahrami & Yousefi, 2011). This then may contribute to beliefs that their worry is uncontrollable, ultimately affecting them more than their male counterparts.
Gender differences also extend to which other disorders are found to be comorbid with GAD. To expand on this, it has been found that men tend to have significantly higher rates of comorbid alcohol and drug use disorders, as well as antisocial personality disorder (Vesga-López et al., 2008). In comparison, women tend to have significantly higher rates of comorbid mood and anxiety disorders.
Treatment options
There have been many different methods developed to help manage or treat symptoms of anxiety disorders, some of which involve cognitive behavioural therapy and the use of medications.
The former treatment option refers to a wide range of intervention mechanisms which work to modify maladaptive cognitive processes, which are thought to contribute to disorders such as GAD. Together with a therapist, the patient focuses on modifying their emotional responses through the adjustment of thoughts, behaviours, or both (Kaczkurkin & Foa, 2015).
GAD, in addition to other anxiety disorders, may also be treated through medications such as selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors (Bandelow et al., 2013). Individuals with GAD may choose to solely use medications for treatment or they may continue to seek psychotherapy in addition to medication use.
Outside of therapy and medication, individuals with anxiety can also implement practices to their daily lives such as relaxation and stress-relieving techniques.
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Bahrami, F., & Yousefi, N. (2011). Females are more anxious than males: a metacognitive perspective. Iranian Journal of Psychiatry and Behavioral Sciences, 5(2), 83–90.
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Masi, G., Millepiedi, S., Mucci, M., Poli, P., Bertini, N., & Milantoni, L. (2004). Generalized Anxiety Disorder in Referred Children and Adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 43(6), 752–760. https://doi.org/10.1097/01.chi.0000121065.29744.d3
Mishra, A. K., & Varma, A. R. (2023). A Comprehensive Review of the Generalized Anxiety Disorder. Curēus (Palo Alto, CA), 15(9), e46115–e46115. https://doi.org/10.7759/cureus.46115
Moreno-Peral, P., Conejo-Cerón, S., Motrico, E., Rodríguez-Morejón, A., Fernández, A., García-Campayo, J., Roca, M., Serrano-Blanco, A., Rubio-Valera, M., & Ángel Bellón, J. (2014). Risk factors for the onset of panic and generalised anxiety disorders in the general adult population: A systematic review of cohort studies. Journal of Affective Disorders, 168, 337–348. https://doi.org/10.1016/j.jad.2014.06.021
Stein, M. B., & Sareen, J. (2015). CLINICAL PRACTICE. Generalized Anxiety Disorder. The New England Journal of Medicine, 373(21), 2059–2068. https://doi.org/10.1056/NEJMcp1502514
Watterson, R. A., Williams, J. V. A., Lavorato, D. H., & Patten, S. B. (2017). Descriptive Epidemiology of Generalized Anxiety Disorder in Canada. Canadian Journal of Psychiatry, 62(1), 24–29. https://doi.org/10.1177/0706743716645304
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