Perceptions of Functioning in Worry and Generalized Anxiety Disorder

Abstract

Research has suggested that individuals with generalized anxiety disorder (GAD) may underestimate the quality of their cognitive and interpersonal functioning, raising the question of whether perceived impairments are widespread across life domains and distinguish GAD from other forms of severe worry. The present study addressed these questions by examining perceived and actual (grade point average and interviewer-rated) impairments in GAD worriers, non-GAD high worriers, and normal worriers. Elevated performance standards were examined as an explanation for perceived impairments. Participants were assigned to groups based on diagnostic interview and measures of worry. They completed measures of perceived functioning and performance standards. Both groups of worriers reported widespread impairments and preliminary evidence suggestive of elevated performance standards. Results suggest that both GAD and non-GAD worriers perceive themselves to be impaired across important life domains. However, grade point average does not show evidence of impairments and some amount of the impairment reported by both high worry groups may reflect elevated performance standards.

Appendix

Imagine that you are in your third year as a student at the [large Northeastern University]. You are living off-campus with two roommates who you are friendly with. You all get along well. There is some tension about household chores. You occasionally have mice in the kitchen because you allow dishes and trash to pile up when none of you feels like taking care of it. Your living situation is generally comfortable. Your neighborhood is noisy most nights and you are a light sleeper. You are awakened by street noise or parties at least a few times each week, but you are able to fall back to sleep within 30 min each time and rarely feel tired during the day. You spend two or three nights per week with your boyfriend/girlfriend, when he/she is not out with friends. You both enjoy having sex a few times per week, but about one night per week you don’t feel like it and then you just tell him/her that you are not in the mood. You enjoy cooking or watching movies at home either alone or with your roommates and you occasionally tag along with them when they go out on the weekends.

You love and appreciate your family very much and spend at least a couple of days with them each time you have a school break, but you have arguments almost every time you get together with them. Your parents pay your tuition and rent and give you spending money. You know that your parents’ jobs aren’t going as well as they used to because of the trouble with the economy. Even with your part time job, you find that money is a little tight. By the time you have taken care of all of your necessary expenses you usually have a little money left over to use on something fun.

You are generally a very quick learner and you have maintained a GPA of 3.3. You occasionally become absentminded, losing your keys, forgetting things at home, and having trouble concentrating or learning the rules of simple games that your friends play in bars. Every day after classes you work out for 30 min at the gym. You avoid any strenuous activities or sports because you feel very out of shape when you run. You generally enjoy your daily activities. You occasionally feel down for a day or two and lose interest. On these days, you are able to carry on with your day-to-day activities, but everything you do feels like an effort. These feelings usually pass within a few days. You are generally very productive. You have also been getting a terrible headache about once a month that is relieved within 3–4 h of taking a painkiller. During the headache, you have to lie down and cannot take care of any other tasks.