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generalized anxiety disorder definition and diagnosis

Definition and diagnosis

Generalized anxiety disorder is diagnosed using DSM IV (APA 1994) criteria if the following are seen:

1Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least six months, about a number of events or activities (such as work or school performance).

2The person finds it difficult to control the worry.

3The anxiety and worry are associated with three (or more) of the following symptoms: restlessness or feeling keyed up and on edge, easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension and sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep).

4The focus of the worry is not confined to another ‘Axis I’ disorder, for example, worry is not about having a panic attack as in panic disorder, being contaminated as in obsessive-compulsive disorder, or being embarrassed in public as in social phobia.

5The anxiety or worry should cause clinically significant distress or impairment in social, occupational or other important areas of functioning.

6The anxiety or worry is not due to the physical effects of a substance or general medical condition.

Wells (1997) suggests that GAD should be seen primarily as a disorder of worrying and that two types of worry should be distinguished: Type 1 worries and Type 2 worries. Type 1 worries are those that may be seen to reflect normal concerns, that may be voluntarily initiated and may have some value in helping solve problems. Type 2 worry is seen as ‘worry about worry’ (Wells 1997: 202), and reflects an individual’s appraisal of the process of worrying itself. Examples given include, ‘My worries are uncontrollable’, ‘Worrying is harmful’, ‘I could go crazy with worrying’ (ibid.).

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