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What is Generalized anxiety disorder?

Generalized anxiety disorder (GAD) is characterized by apprehensive worry and physical symptoms of restlessness, fatigue, impaired concentration, irritability, muscle tension and/or insomnia. The main cognitive symptom of worry is defined by Wells and Butler: ‘Worry occurs as a chain of thoughts, which have a negative affect component. It is concerned with future events where there is uncertainty over outcome’.

While worrying can be the cause of clinical concern it is important to recognize that it may be seen to serve a useful purpose, such as adaptive, problem-focused coping and information seeking. Some evidence for the adaptive functions of worry was found by Borkovec and Roemer who, studying college students, found that motivational, preparation for the worst and avoidance/prevention of negative outcomes statements were rated as functions of worry across both GAD and nonGAD groups. The GAD group differed in their ratings of worrying as serving a function of distraction from more emotional topics.

Barlow’s definition of anxiety includes ‘anxious apprehension’, which incorporates the idea that anxiety is a ‘future-oriented’ mood state and clearly differentiates anxiety from panic or fear. From this perspective the type of thinking that characterizes GAD is seen as the core cognitive processes across many of the anxiety disorders. GAD has a lifetime prevalence of 3.8–5.1 per cent and is twice as common among women as men. The course of GAD is generally persistent and is associated with impairments in role functioning, social life and life satisfaction.

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