Generalized anxiety disorder is a psychiatric disorder in which the individual experiences significant anxiety and worry about a number of events or activities and this anxiety occurs repeatedly i.e. it is chronic.
Specific and observable criteria for generalized anxiety disorder are provided in the Diagnostic and Statistical Manual , 4th Edition, (DSM-IV) of the American Psychiatric Society. The DSM-IV criteria include the following:
A large epidemiological US survey found a lifetime prevalence for generalized anxiety disorder of 5.7% putting it as the tenth most frequent psychiatric disorder and the fourth most frequent anxiety disorder in this study (Kessler et al, 2005).
There is considerable evidence for a genetic contribution to the aetiology of generalized anxiety disorder (Fung at al, 2010). My own clinical experience leads me to the conclusion that childhood trauma (codependence, complex PTSD) can also be causative or at least, a contributing factor to the development of generalized anxiety disorder.
Indeed there is research to support this clinical observation (Safren et al, 2002). I have also found clinically, that alcohol abuse and/or dependence is frequently associated with generalized anxiety disorder. While much of alcohol use can be an attempt to reduce the anxiety, the effect is short lived and its long term effect increases anxiety and sensitivity to environmental stressors.
There are important reasons to make sure that persons with generalized anxiety disorder receive adequate treatment. Firstly, those with this condition frequently also have other mental disorders and or somatic conditions. That is, pure generalized anxiety disorder is infrequent and it is usually accompanied by various other psychiatric and physical conditions.
This high rate of co-morbidity generally makes generalized anxiety disorder as debilitating as that experienced by those with major depressive disorder (Katzman, 2009).
Secondly, the less obvious and less severe symptoms of generalized anxiety disorder probably caused it to be less recognized and treated.
Thirdly, persons with generalized anxiety may resort to maladaptive strategies to reduce their anxiety e.g. alcohol abuse or dependence, tranquilizer addiction, or a behavioral addiction of some kind e.g. distraction with computer games.
A variety of treatment approaches are available for generalized anxiety disorder including the following:
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders. (4th ed., text rev.) Washington, DC: Author.
Dugas, M. J., & Koerner, N. (2005). Cognitive-Behavioral Treatment for Generalized Anxiety Disorder: Current Status and Future Directions. Journal of Cognitive Psychotherapy, 19(1), 61-81.
Fung, W. L. A., McEvilly, R., Fong, J., Silversides, C., Chow, E., & Bassett, A. (2010). Elevated prevalence of generalized anxiety disorder in adults with 22q11.2 deletion syndrome. The American Journal of Psychiatry, 167(8), 998.
Herring, M. P., Jacob, M. L., Suveg, C., Dishman, R. K., & O'Connor, P. J. (2011). Feasibility of exercise training for the short-term treatment of generalized anxiety disorder: A randomized controlled trial. Psychotherapy and Psychosomatics, 81(1), 21-28.
Katzman, M. A. (2009). Current considerations in the treatment of generalized anxiety disorder. CNS Drugs, 23(2), 103-120.
Kessler, Ronald C., Berglund, Patricia, Demler, Olga, Jin, Robert, Merikangas, K. R., Walters, Ellen E., (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, Vol. 62(6), 593-602.
Lader, M. (2011). Benzodiazepines revisited—Will we ever learn? Addiction, 106(12), 2086-2109.
Nutt, D. J., Ballenger, J. C., Sheehan, D., & Wittchen, H.-U. (2002). Generalized anxiety disorder: Comorbidity, comparative biology and treatment. International Journal of Neuropsychopharmacology, 5(4), 315-325.
Safren, S. A., Gershuny, B. S., Marzol, P., Otto, M. W., & Pollack, M. H. (2002). History of childhood abuse in panic disorder, social phobia, and generalized anxiety disorder. Journal of Nervous and Mental Disease, 190(7), 453-456.