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Anxiety and Fear-Related Disorders: Generalized Anxiety Disorder

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Tasman’s Psychiatry

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Abstract

Generalized anxiety disorder (GAD) is an emotional disorder characterized by excessive and difficult-to-control worry about daily events and activities such as work/school, finances, minor matters, community affairs, and health/safety. Despite initial concerns surrounding its diagnostic validity, a vast literature now exists on the nature, course, assessment, and treatment of GAD. This chapter reviews the current state of the science of GAD. GAD is one of the most common forms of psychopathology, resulting in significant human and economic burden across the world. It is partly heritable, and a selective number of serotonergic and catecholaminergic genetic markers have been identified in recent years, albeit with small individual effects. Neuroimaging and neurophysiological studies of GAD also have identified abnormalities in structure, functional connectivity (e.g., between the amygdala and dorsolateral prefrontal cortex), and event-related potentials (e.g., error-related negativity). In addition, several psychological (e.g., intolerance of uncertainty) and environmental (e.g., stress, childhood adversity) factors have been linked to GAD onset, expression, and course. Research on the psychopathology of GAD underscores the complex neurobiological–psychological profile of the condition. Nevertheless, significant progress has been made in the development of reliable assessment tools and effective treatments. Several self-report questionnaires and semistructured clinical interviews can be used to assess GAD. In addition, meta-analytic evidence suggests that serotonergic pharmacological agents and cognitive–behavioral therapy are first-line treatments. As understanding of GAD continues to improve, efforts are needed to develop personalized treatment recommendations based on intervention(s) predicted to achieve optimal benefit.

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References

  • Abel, J. L., & Borkovec, T. D. (1995). Generalizability of DSM-III-R generalized anxiety disorder to proposed DSM-IV criteria and cross-validation of proposed changes. Journal of Anxiety Disorders, 9, 303–315.

    Article  Google Scholar 

  • Abelson, J. L., Glitz, D., Cameron, O. G., et al. (1991). Blunted growth hormone response to clonidine in patients with generalized anxiety disorder. Archives of General Psychiatry, 48, 157–162.

    Article  CAS  PubMed  Google Scholar 

  • Alloy, L. C., & Clements, C. M. (1992). Illusion of control: Invulnerability to negative affect and depressive symptoms after laboratory and natural stressors. Journal of Abnormal Psychology, 101, 234–245.

    Article  CAS  PubMed  Google Scholar 

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed., DSM-III). American Psychiatric Press.

    Google Scholar 

  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., Revised DSM-III-R). American Psychiatric Press.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed., DSM-IV). American Psychiatric Press.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text Revision, DSM-IV-TR). American Psychiatric Press.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., DSM-5). American Psychiatric Publishing.

    Google Scholar 

  • Andrews, G., & Hobbs, M. J. (2010). The effect of the draft DSM-5 criteria for GAD on prevalence and severity. Australian and New Zealand Journal of Psychiatry, 44, 784–790.

    Article  PubMed  Google Scholar 

  • Andrews, G., & Peters, L. (1998). The psychometric properties of the composite international diagnostic interview. Social Psychiatry and Psychiatric Epidemiology, 33, 80–88.

    Article  CAS  PubMed  Google Scholar 

  • Andrews, G., Hobbs, M. J., Borkovec, T. D., et al. (2010). Generalized worry disorder: A review of DSM-IV generalized anxiety disorder and options for DSM-5. Depression and Anxiety, 27, 134–147.

    Article  PubMed  Google Scholar 

  • Appel, H. B., Ai, A. L., Huang, B., et al. (2014). Detrimental effects of discrimination on mental health in Asian Americans: Counteracting roles of religious involvement. The International Journal for the Psychology of Religion, 24, 28–46.

    Article  Google Scholar 

  • Arch, J. J., Eifert, G. H., Davies, C., et al. (2012). Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders. Journal of Consulting and Clinical Psychology, 80, 750–765.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baldwin, D., Woods, R., Lawson, R., et al. (2011). Efficacy of drug treatments for generalized anxiety disorder: Systematic review and meta-analysis. BMJ, 342, 1–11.

    Article  Google Scholar 

  • Ballenger, J. C., Davidson, J. R. T., Lecrubier, Y., et al. (2001). Consensus statement on generalized anxiety disorder from the international consensus group on anxiety and depression. Journal of Clinical Psychiatry, 62, 53–58.

    PubMed  Google Scholar 

  • Bandoli, G., Campbell-Sills, L., Kessler, R. C., et al. (2017). Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: A test of the stress sensitization hypothesis. Psychological Medicine, 47, 2379–2392.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Barlow, D. H. (2002). The nature of anxious apprehension. In D. H. Barlow (Ed.), Anxiety and its disorders (2nd ed.). Guilford Press.

    Google Scholar 

  • Barlow, D. H., Blanchard, E. B., Vermilyea, J. A., et al. (1986). Generalized anxiety disorder: Description and reconceptualization. American Journal of Psychiatry, 143, 40–44.

    Article  CAS  PubMed  Google Scholar 

  • Barlow, D. H., Rapee, R. M., & Brown, T. A. (1992). Behavioral treatment of generalized anxiety disorder. Behavior Therapy, 23, 551–570.

    Article  Google Scholar 

  • Barlow, D. H., Farchione, T. J., Bullis, J. R., et al. (2017). The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA Psychiatry, 74, 875–884.

    Article  PubMed  PubMed Central  Google Scholar 

  • Barrett, P. M., Dadds, M. R., & Rapee, R. M. (1996). Family treatment of childhood anxiety: A controlled trial. Journal of Consulting and Clinical Psychology, 64, 333–342.

    Article  CAS  PubMed  Google Scholar 

  • Beck, A. T., Emery, G., & Greenberg, R. L. (1985). Anxiety disorders and phobias: A cognitive perspective. Basic Books.

    Google Scholar 

  • Beesdo, K., Hoyer, J., Jacobi, F., et al. (2009). Association between generalized anxiety levels and pain in a community sample: Evidence for diagnostic specificity. Journal of Anxiety Disorders, 23, 684–693.

    Article  PubMed  Google Scholar 

  • Beidel, D. C., Silverman, W., & Hammond-Laurence, K. (1996). Overanxious disorder: Subsyndromal state or specific disorder? A comparison of clinic and community samples. Journal of Clinical Child Psychology, 25, 25–32.

    Article  Google Scholar 

  • Bernstein, D. A., & Borkovec, T. D. (1973). Progressive relaxation training: A manual for helping professions. Research Press.

    Google Scholar 

  • Bienvenu, O. J., Hettema, J. M., Neale, M. C., et al. (2007). Low extraversion and high neuroticism as indices of genetic and environmental risk for social phobia, agoraphobia, and animal phobia. American Journal of Psychiatry, 164, 1714–1721.

    Article  PubMed  Google Scholar 

  • Blanchard, E. B., Scharff, L., Schwarz, S. P., et al. (1990). The role of anxiety and depression in the irritable bowel syndrome. Behaviour Research and Therapy, 28, 401–405.

    Article  CAS  PubMed  Google Scholar 

  • Bomyea, J., Ramsawh, H., Ball, T. M., et al. (2015). Intolerance of uncertainty as a mediator of reductions in worry in a cognitive behavioral treatment program for generalized anxiety disorder. Journal of Anxiety Disorders, 33, 90–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Borkovec, T. D. (1994). The nature, functions, and origins of worry. In G. C. L. Davey & F. Tallis (Eds.), Worrying: Perspectives on theory, assessment, and treatment. Wiley.

    Google Scholar 

  • Borkovec, T. D., & Costello, E. (1993). Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 61, 611–619.

    Article  CAS  PubMed  Google Scholar 

  • Borkovec, T. D., & Hu, S. (1990). The effect of worry on cardiovascular response to phobic imagery. Behaviour Research and Therapy, 28, 69–73.

    Article  CAS  PubMed  Google Scholar 

  • Borkovec, T. D., & Mathews, A. M. (1988). Treatment of non-phobic anxiety disorders: A comparison of nondirective, cognitive, and coping desensitization therapy. Journal of Consulting and Clinical Psychology, 56, 877–884.

    Article  CAS  PubMed  Google Scholar 

  • Borkovec, T. D., & Roemer, L. (1995). Perceived functions of worry among generalized anxiety disorder subjects: Distraction from more emotionally distressing topics? Journal of Behavior Therapy and Experimental Psychiatry, 26, 25–30.

    Article  CAS  PubMed  Google Scholar 

  • Borkovec, T. D., Abel, J. L., & Newman, H. (1995). Effects of psychotherapy on comorbid conditions in generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 63, 479–483.

    Article  CAS  PubMed  Google Scholar 

  • Borkovec, T. D., Hazlett-Stevens, H., & Diaz, M. L. (1999). The role of positive beliefs about worry in generalized anxiety disorder and its treatment. Clinical Psychology and Psychotherapy, 6, 126–138.

    Article  Google Scholar 

  • Borkovec, T. D., Newman, M. G., Pincus, A. L., et al. (2002). A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems. Journal of Consulting and Clinical Psychology, 70, 288–298.

    Article  CAS  PubMed  Google Scholar 

  • Boschen, M. J. (2011). Generalized anxiety disorder in adults: Focus on pregabalin. Clinical Medicine Insights: Psychiatry, 4, 17–35.

    Google Scholar 

  • Brawman-Mintzer, O., Lydiard, R. B., Crawford, M. M., et al. (1994). Somatic symptoms in generalized anxiety disorder with and without comorbid psychiatric disorders. American Journal of Psychiatry, 150, 1216–1218.

    Google Scholar 

  • Brenes, G. A., Knudson, M., McCall, W. V., Williamson, J. D., Miller, M. E., & Stanley, M. A. (2008). Age and racial differences in the presentation and treatment of generalized anxiety disorder in primary care. Journal of Anxiety Disorders, 22(7), 1128–1136.

    Google Scholar 

  • Breslau, N., & Davis, G. C. (1985). Further evidence of the doubtful validity of generalized anxiety disorder. Psychiatry Research, 16, 177–179.

    Article  CAS  PubMed  Google Scholar 

  • Brown, T. A., & Barlow, D. H. (2005). Dimensional versus categorical classification of mental disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and beyond: Comment on the special section. Journal of Abnormal Psychology, 114, 551–556.

    Article  PubMed  Google Scholar 

  • Brown, T. A., & Barlow, D. H. (2014). Anxiety and related disorders interview schedule for DSM-5: Lifetime version (ADIS-5L). Oxford University Press.

    Google Scholar 

  • Brown, T. A., & Naragon-Gainey, K. (2013). Evaluation of the unique and specific contributions of dimensions of the triple vulnerability model to the prediction of DSM-IV anxiety and mood disorder constructs. Behavior Therapy, 44, 277–292.

    Article  PubMed  Google Scholar 

  • Brown, T. A., & Tung, E. S. (2018). The contribution of worry behaviors to the diagnosis of generalized anxiety disorder. Journal of Psychopathology and Behavioral Assessment, 40, 636–644.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brown, T. A., Antony, M. M., & Barlow, D. H. (1992). Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample. Behaviour Research and Therapy, 30, 33–38.

    Article  CAS  PubMed  Google Scholar 

  • Brown, T. A., Moras, K., Zinbarg, R. E., et al. (1993). Diagnostic and symptom distinguishability of generalized anxiety disorder and obsessive–compulsive disorder. Behaviour Research and Therapy, 24, 227–240.

    Article  Google Scholar 

  • Brown, T. A., Marten, P. A., & Barlow, D. H. (1995). Discriminant validity of the symptoms constituting the DSM-III-R and DSM-IV associated symptoms criterion of generalized anxiety disorder. Journal of Anxiety Disorders, 9, 317–328.

    Article  Google Scholar 

  • Brown, T. A., Chorpita, B. F., & Barlow, D. H. (1998). Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. Journal of Abnormal Psychology, 107, 179–192.

    Article  CAS  PubMed  Google Scholar 

  • Brown, T. A., Campbell, L. A., Lehman, C. L., et al. (2001a). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110, 585–599.

    Article  CAS  PubMed  Google Scholar 

  • Brown, T. A., Di Nardo, P. A., Lehman, C. L., et al. (2001b). Reliability of DSM-IV anxiety and mood disorders: Implications for classification of emotional disorders. Journal of Abnormal Psychology, 110, 49–58.

    Article  CAS  PubMed  Google Scholar 

  • Bruce, S. E., Yonkers, K. A., Otto, M. W., et al. (2005). Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: A 12-year prospective study. American Journal of Psychiatry, 162, 1179–1187.

    Article  PubMed  Google Scholar 

  • Buhr, K., & Dugas, M. J. (2002). The intolerance of uncertainty scale: Psychometric properties of the English version. Behaviour Research and Therapy, 40, 931–946.

    Article  CAS  PubMed  Google Scholar 

  • Burkhouse, K. L., Woody, M. L., Owens, M., et al. (2015). Influence of worry on sustained attention to emotional stimuli: Evidence from the late positive potential. Neuroscience Letters, 588, 57–61.

    Article  CAS  PubMed  Google Scholar 

  • Campbell, L. A., Brown, T. A., & Grisham, J. R. (2003). The relevance of age of onset to the psychopathology of generalized anxiety disorder. Behavior Therapy, 34, 31–48.

    Article  Google Scholar 

  • Carl, E., Witcraft, S. M., Kauffman, B. Y., et al. (2020). Psychological and pharmacological treatments for generalized anxiety disorder (GAD): A meta-analysis of randomized controlled trials. Cognitive Behaviour Therapy, 49, 1–21.

    Article  PubMed  Google Scholar 

  • Chambers, J. A., Power, K. G., & Durham, R. C. (2004). The relationship between trait vulnerability and anxiety and depressive diagnoses at long-term follow-up of generalized anxiety disorder. Journal of Anxiety Disorders, 18, 587–607.

    Article  PubMed  Google Scholar 

  • Chmielewski, M., Clark, L. A., Bagby, R. M., et al. (2015). Method matters: Understanding diagnostic reliability in DSM-IV and DSM-5. Journal of Abnormal Psychology, 124, 764–769.

    Article  PubMed  PubMed Central  Google Scholar 

  • Clark, T. T., Salas-Wright, C. P., Vaughn, M. G., et al. (2015). Everyday discrimination and mood and substance use disorders: A latent profile analysis with African Americans and Caribbean blacks. Addictive Behaviors, 40, 119–125.

    Article  PubMed  Google Scholar 

  • Cole, D. A., & Turner, J. E. (1993). Models of cognitive mediation and moderation in child depression. Journal of Abnormal Psychology, 102, 271–281.

    Article  CAS  PubMed  Google Scholar 

  • Coles, M. E., Mennin, D. S., & Heimberg, R. G. (2001). Distinguishing obsessive features and worries: The role of thought–action fusion. Behaviour Research and Therapy, 39, 947–959.

    Article  CAS  PubMed  Google Scholar 

  • Comer, J. S., Pincus, D. B., & Hofmann, S. G. (2012). Generalized anxiety disorder and the proposed associated symptoms criterion change for DSM-5 in a treatment-seeking sample of anxious youth. Depression and Anxiety, 29, 994–1003.

    Article  PubMed  PubMed Central  Google Scholar 

  • Covin, R., Ouimet, A. J., Seeds, P. M., et al. (2008). A meta-analysis of CBT for pathological worry among clients with GAD. Journal of Anxiety Disorders, 22, 108–116.

    Article  PubMed  Google Scholar 

  • Craske, M. G., Rapee, R. M., Jackel, L., et al. (1989). Qualitative dimensions of worry in DSM-III-R generalized anxiety disorder subjects and nonanxious controls. Behaviour Research and Therapy, 27, 397–402.

    Article  CAS  PubMed  Google Scholar 

  • Craske, M. G., Barlow, D. H., & Meadows, E. (2000). Mastery of your anxiety and worry. Oxford University Press.

    Google Scholar 

  • Crits-Cristoph, P., Newman, M. G., Rickels, K., et al. (2011). Combined medication and cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 25, 1087–1094.

    Article  Google Scholar 

  • Cuijpers, P., Sijbrandij, M., Koole, S., et al. (2014). Psychological treatment of generalized anxiety disorder: A meta-analysis. Clinical Psychology Review, 34, 130–140.

    Article  PubMed  Google Scholar 

  • Davidson, J. R., DuPont, R. L., Hedges, D., et al. (1999). Efficacy, safety, and tolerability of venlafaxine extended release and buspirone in outpatients with generalized anxiety disorder. Journal of Clinical Psychiatry, 60, 528–535.

    Article  CAS  PubMed  Google Scholar 

  • DeBellis, M. D., Casey, B. J., Dahl, R. E., et al. (2000). A pilot study of amygdala volumes in pediatric generalized anxiety disorder. Biological Psychiatry, 48, 51–57.

    Article  CAS  Google Scholar 

  • Denicoff, K. D., Joffe, R. T., Lakshmanan, M. C., et al. (1990). Neuropsychiatric manifestations of altered thyroid state. American Journal of Psychiatry, 147, 94–99.

    Article  CAS  PubMed  Google Scholar 

  • Di Nardo, P. A., Moras, K., Barlow, D. H., et al. (1993). Reliability of DSM-III-R anxiety disorder categories. Using the Anxiety Disorders Interview Schedule-Revised (ADIS-R). Archives of General Psychiatry, 50, 251–256.

    Article  PubMed  Google Scholar 

  • Di Nardo, P. A., Brown, T. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV: Lifetime version (ADIS-IV-L). Oxford University Press.

    Google Scholar 

  • Diefenbach, G. J., Stanley, M. A., & Beck, J. G. (2001). Worry content reported by older adults with and without generalized anxiety disorder. Aging and Mental Health, 5, 269–274.

    Article  CAS  PubMed  Google Scholar 

  • Diefenbach, G. J., Hopko, D. R., Feigon, S., et al. (2003). “Minor GAD”: Characteristics of subsyndromal GAD in older adults. Behaviour Research and Therapy, 41, 481–487.

    Article  PubMed  Google Scholar 

  • Dugas, M. J., Gagnon, F., Ladouceur, R., et al. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model. Behaviour Research and Therapy, 36, 215–226.

    Article  CAS  PubMed  Google Scholar 

  • Dugas, M. J., Marchand, A., & Ladouceur, R. (2005). Further validation of a cognitive-behavioral model of generalized anxiety disorder: Diagnostic and symptom specificity. Journal of Anxiety Disorders, 19, 329–343.

    Article  PubMed  Google Scholar 

  • Dunn, E. C., Sofer, T., Gallo, L. C., et al. (2017). Genome-wide association study of generalized anxiety symptoms in the Hispanic Community Health Study/Study of Latinos. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 174, 132–143.

    Article  Google Scholar 

  • Durgam, S., Gommoll, C., Forero, G., et al. (2016). Efficacy and safety of vilazodone in patients with generalized anxiety disorder: A randomized, double-blind, placebo-controlled, flexible-dose trial. Journal of Clinical Psychiatry, 77, 1687–1694.

    Article  PubMed  Google Scholar 

  • Dyck, I. R., Phillips, K. A., Warshaw, M. G., et al. (2001). Patterns of personality pathology in patients with generalized anxiety disorder, panic disorder with and without agoraphobia, and social phobia. Journal of Personality Disorders, 15, 60–71.

    Article  CAS  PubMed  Google Scholar 

  • Eisen, A. R., & Silverman, W. K. (1998). Prescriptive treatment for generalized anxiety disorder in children. Behavior Therapy, 29, 105–121.

    Article  Google Scholar 

  • First, M. B., Williams, J. B., Karg, R. S., et al. (2015). Structured clinical interview for DSM-5 disorders, clinician version (SCID-5-CV). American Psychiatric Association.

    Google Scholar 

  • Fisher, A. J., & Newman, M. G. (2013). Heart rate and autonomic response to stress after experimental induction of worry versus relaxation in healthy, high-worry, and generalized anxiety disorder individuals. Biological Psychology, 93, 65–74.

    Article  PubMed  Google Scholar 

  • Flannery-Schroeder, E. C., & Kendall, P. C. (2000). Group and individual cognitive-behavioral treatments for youth with anxiety disorders: A randomized clinical trial. Cognitive Therapy and Research, 24, 251–278.

    Article  Google Scholar 

  • Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20–35.

    Article  CAS  PubMed  Google Scholar 

  • Francis, J. L., Moitra, E., Dyck, I., et al. (2012). The impact of stressful life events on relapse of generalized anxiety disorder. Depression and Anxiety, 29, 386–391.

    Article  PubMed  PubMed Central  Google Scholar 

  • Friedman, B. H., & Thayer, J. F. (1998). Autonomic balance revisited: Panic anxiety and heart rate variability. Journal of Psychosomatic Research, 44, 133–151.

    Article  CAS  PubMed  Google Scholar 

  • Gambi, F., De Berardis, D., Campanella, D., et al. (2005). Mirtazapine treatment of generalized anxiety disorder: A fixed dose, open label study. Journal of Psychopharmacology, 19, 483–487.

    Article  CAS  PubMed  Google Scholar 

  • Gammans, R. E., Stringfellow, J. C., Hvizdos, A. J., et al. (1992). Use of buspirone in patients with generalized anxiety disorder and coexisting depressive symptoms: A meta-analysis of eight randomized, controlled trials. Neuropsychobiology, 25, 193–201.

    Article  CAS  PubMed  Google Scholar 

  • Gelenberg, A. J., Lydiard, R. B., Rudolph, R. L., et al. (2000). Efficacy of venlafaxine extended-release capsules in nondepressed outpatients with generalized anxiety disorder. JAMA, 283, 3082–3088.

    Article  CAS  PubMed  Google Scholar 

  • Gentes, E. L., & Ruscio, A. M. (2011). A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive–compulsive disorder. Clinical Psychology Review, 31, 923–933.

    Article  PubMed  Google Scholar 

  • Germine, M., Goddard, A. W., Woods, S. W., et al. (1992). Anger and anxiety responses to m-chlorophenylpiperazine in generalized anxiety disorder. Biological Psychiatry, 32, 457–461.

    Article  CAS  PubMed  Google Scholar 

  • Goncalves, D. C., & Byrne, G. J. (2012). Interventions for generalized anxiety disorder in older adults: Systematic review and meta-analysis. Journal of Anxiety Disorders, 26, 1–11.

    Article  PubMed  Google Scholar 

  • Goodman, W. K., Bose, A., & Wang, Q. (2005). Treatment of generalized anxiety disorder with escitalopram: Pooled results from double-blind, placebo-controlled trials. Journal of Affective Disorders, 87, 161–167.

    Article  CAS  PubMed  Google Scholar 

  • Gordon, D., & Heimberg, R. G. (2011). Reliability and validity of DSM-IV generalized anxiety disorder features. Journal of Anxiety Disorders, 25, 813–821.

    Article  PubMed  Google Scholar 

  • Gorka, S. M., Katie, L., Burkhouse, K. A., & Luan Phan, K. (2017). Error-related brain activity and internalizing disorder symptom dimensions in depression and anxiety. Depression and Anxiety, 34, 985–995.

    Article  PubMed  Google Scholar 

  • Gottschalk, M. G., & Domschke, K. (2017). Genetics of generalized anxiety disorder and related traits. Dialogues in Clinical Neuroscience, 19, 159–168.

    Article  PubMed  PubMed Central  Google Scholar 

  • Grant, B. F., Stinson, F. S., Dawson, D. A., et al. (2004). Prevalence and co-occurrence of substance abuse disorders and independent mood and anxiety disorders. Archives of General Psychiatry, 61, 807–816.

    Article  PubMed  Google Scholar 

  • Grant, B. F., Hasin, D. S., Stinson, F. S., et al. (2005a). Prevalence, correlates, co-morbidity, and comparative disability of DSM-IV generalized anxiety disorder in the US: Results from the National Epidemiologic Survey on alcohol and related conditions. Psychological Medicine, 35, 1747–1759.

    Article  PubMed  Google Scholar 

  • Grant, B. F., Hasin, D. S., Stinson, F. S., et al. (2005b). Co-occurrence of 12-month mood and anxiety disorders and personality disorders in the US: Results from the national epidemiologic survey on alcohol and related conditions. Journal of Psychiatric Research, 39, 1–9.

    Article  PubMed  Google Scholar 

  • Greer, S., Ramsay, I., & Bagley, C. (1973). Neurotic and thyrotoxic anxiety: Clinical, psychological and physiological measurements. British Journal of Psychiatry, 122, 549–554.

    Article  CAS  Google Scholar 

  • Hall, J., Kellett, S., Berrios, R., et al. (2016). Efficacy of cognitive behavioral therapy for generalized anxiety disorder in older adults: Systematic review, meta-analysis, and meta-regression. The American Journal of Geriatric Psychiatry, 24, 1063–1073.

    Article  PubMed  Google Scholar 

  • Haller, H., Cramer, H., Lauche, R., et al. (2014). The prevalence and burden of subthreshold generalized anxiety disorder: A systematic review. BMC Psychiatry, 14, 128.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hallion, L. S., & Ruscio, A. M. (2013). Should uncontrollable worry be removed from the definition of GAD? A test of incremental validity. Journal of Abnormal Psychology, 122, 369–375.

    Article  PubMed  Google Scholar 

  • Hamilton, M. (1959). The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 50–55.

    Article  CAS  PubMed  Google Scholar 

  • Hamilton, S. P. (2009). Linkage and association studies of anxiety disorders. Depression and Anxiety, 26, 976–983.

    Article  CAS  PubMed  Google Scholar 

  • Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press.

    Google Scholar 

  • Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press.

    Google Scholar 

  • Hayes-Skelton, S. A., Orsillo, S. M., & Roemer, L. (2013). An acceptance-based behavioral therapy for individuals with generalized anxiety disorder. Cognitive and Behavioral Practice, 20(3), 264–281.

    Article  PubMed  Google Scholar 

  • Hazlett, R. L., McLeod, D. R., & Hoehn-Saric, R. (1994). Muscle tension in generalized anxiety disorder: Elevated muscle tonus or agitated movement? Psychophysiology, 31, 189–195.

    Article  CAS  PubMed  Google Scholar 

  • Hettema, J. M., Neale, M. C., & Kendler, K. S. (2001). A review and meta-analysis of the genetic epidemiology of anxiety disorders. Archives of General Psychiatry, 158, 1568–1578.

    CAS  Google Scholar 

  • Hettema, J. M., Prescott, C. A., & Kendler, K. S. (2004). Genetic and environmental sources of covariation between generalized anxiety disorder and neuroticism. Archives of General Psychiatry, 161, 1581–1587.

    Google Scholar 

  • Hettema, J. M., Prescott, C. A., Myers, J. M., et al. (2005). The structure of genetic and environmental risk factors for anxiety disorders in men and women. Archives of General Psychiatry, 62, 182–188.

    Article  PubMed  Google Scholar 

  • Hettema, J. M., Neale, M. C., Myers, J. M., et al. (2006). A population-based twin study of the relationship between neuroticism and internalizing disorders. American Journal of Psychiatry, 163, 857–864.

    Article  PubMed  Google Scholar 

  • Hettema, J. M., Verhulst, B., Chatzinakos, C., et al. (2020). Genome-wide association study of shared liability to anxiety disorders in Army STARRS. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 183, 197–207.

    Article  CAS  Google Scholar 

  • Himmelfarb, S., & Murrell, S. A. (1984). The prevalence and correlates of anxiety symptoms in older adults. Journal of Psychology, 116, 159–167.

    Article  CAS  PubMed  Google Scholar 

  • Hinton, D. E., Nickerson, A., & Bryant, R. A. (2011). Worry, worry attacks, and PTSD among Cambodian refugees: A path analysis investigation. Social Science & Medicine, 72, 1817–1825.

    Article  Google Scholar 

  • Hirschtritt, M. E., Olfson, M., & Kroenke, K. (2021). Balancing the risks and benefits of benzodiazepines. JAMA, 325, 347–348.

    Article  CAS  PubMed  Google Scholar 

  • Hoehn-Saric, R., McLeod, D. R., & Zimmerli, W. D. (1988). Differential effects of alprazolam and imipramine in generalized anxiety disorder: Somatic versus psychic complaints. Journal of Clinical Psychiatry, 49, 293–301.

    CAS  PubMed  Google Scholar 

  • Hoehn-Saric, R., McLeod, D. R., & Zimmerli, W. D. (1989). Somatic manifestations in women with generalized anxiety disorder. Psychophysiological responses to psychological stress. Archives of General Psychiatry, 46, 1113–1119.

    Article  CAS  PubMed  Google Scholar 

  • Hoehn-Saric, R., McLeod, D. R., Funderburk, F., et al. (2004). Somatic symptoms and physiologic responses in generalized anxiety disorder and panic disorder. Archives of General Psychiatry, 61, 913–921.

    Article  PubMed  Google Scholar 

  • Hoffman, D. L., Dukes, E. M., & Wittchen, H. U. (2008). Human and economic burden of generalized anxiety disorder. Depression and Anxiety, 25, 72–90.

    Article  PubMed  Google Scholar 

  • Hoge, E. A., Tamrakar, S. M., & Christian, K. M. (2006). Cross-cultural differences in somatic presentation in patients with generalized anxiety disorder. Journal of Nervous and Mental Disease, 194, 962–966.

    Article  PubMed  Google Scholar 

  • Hoppen, T. H., & Chalder, T. (2018). Childhood adversity as a transdiagnostic risk factor for affective disorders in adulthood: A systematic review focusing on biopsychosocial moderating and mediating variables. Clinical Psychology Review, 65, 81–151.

    Article  PubMed  Google Scholar 

  • Joormann, J., & Stöber, J. (1999). Somatic symptoms of generalized anxiety disorder for the DSM-IV: Associations with pathological worry and depression symptoms in a nonclinical sample. Journal of Anxiety Disorders, 13, 491–503.

    Article  CAS  PubMed  Google Scholar 

  • Kane, M. T., & Kendall, P. C. (1989). Anxiety disorders in children: A multiple-baseline evaluation of a cognitive-behavioral treatment. Behavior Therapy, 20, 499–508.

    Article  Google Scholar 

  • Kelly, C. B., & Cooper, S. J. (1998). Differences and variability in plasma noradrenaline between depressive and anxiety disorders. Journal of Psychopharmacology, 12, 161–167.

    Article  CAS  PubMed  Google Scholar 

  • Kendall, P. C. (1994). Treating anxiety disorders in children: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 62, 100–110.

    Article  CAS  PubMed  Google Scholar 

  • Kendall, P. C., Flannery-Schroeder, E., Panichelli-Mindel, S. M., et al. (1997). Therapy for youths with anxiety disorders: A second randomized clinical trial. Journal of Consulting and Clinical Psychology, 65, 366–380.

    Article  CAS  PubMed  Google Scholar 

  • Kendler, K. S., Neale, M. C., Kessler, R. C., et al. (1992). Major depression and generalized anxiety disorder. Same genes, (partly) different environments? Archives of General Psychiatry, 49, 716–722.

    Article  CAS  PubMed  Google Scholar 

  • Kessler, R. C., Abelson, J., Demler, O., et al. (2004). Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) composite international diagnostic interview (WMHCIDI). International Journal of Methods in Psychiatric Research, 13, 122–139.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., et al. (2005a). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., et al. (2005b). Prevalence, severity, comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kessler, R. C., Brandenburg, N., Lane, M., et al. (2006). Rethinking the duration requirement for generalized anxiety disorder: Evidence from the National Comorbidity Survey Replication. Psychological Medicine, 35, 1073–1082.

    Article  Google Scholar 

  • Kolesar, T. A., Bilevicius, E., Wilson, A. D., et al. (2019). Systematic review and meta-analyses of neural structural and functional differences in generalized anxiety disorder and healthy controls using magnetic resonance imaging. NeuroImage: Clinical, 24, 102016.

    Article  PubMed  Google Scholar 

  • Kubarych, T. S., Aggen, S. H., Hettema, J. M., et al. (2005). Endorsement frequencies and factor structure of DSM-III-R and DSM-IV generalized anxiety disorder symptoms in women: Implications for future research, classification, clinical practice, and comorbidity. International Journal of Methods in Psychiatric Research, 14, 69–81.

    Article  PubMed  Google Scholar 

  • Lader, M. H., & Bond, A. J. (1998). Interaction of pharmacological and psychological treatments of anxiety. British Journal of Psychiatry, 17, 42–48.

    Article  Google Scholar 

  • Ladouceur, R., Blais, F., Freeston, M. H., et al. (1998). Problem solving and problem orientation in generalized anxiety disorder. Journal of Anxiety Disorders, 12, 139–152.

    Article  CAS  PubMed  Google Scholar 

  • Ladouceur, R., Dugas, M. J., Freeston, M. H., et al. (1999). Specificity of generalized anxiety disorder symptoms and processes. Behavior Therapy, 30, 191–207.

    Article  Google Scholar 

  • Ladouceur, R., Dugas, M. J., Freeston, M. H., et al. (2000). Efficacy of a cognitive-behavioral treatment for generalized anxiety disorder: Evaluation in a controlled clinical trial. Journal of Consulting and Clinical Psychology, 68, 957–964.

    Article  CAS  PubMed  Google Scholar 

  • Langlois, F., Freeston, M. H., & Ladouceur, R. (2000). Differences and similarities between obsessive intrusive thoughts and worry in a non-clinical population: Study 1. Behaviour Research and Therapy, 38, 157–173.

    Article  CAS  PubMed  Google Scholar 

  • Lawrence, A. E., Liverant, G. I., Rosellini, A. J., et al. (2009). Generalized anxiety disorder within the course of major depressive disorder: Examining the utility of the DSM-IV hierarchy rule. Depression and Anxiety, 26, 909–916.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee, S., Tsang, A., Chui, H., Kwok, K., & Cheung, E. (2007). A community epidemiological survey of generalized anxiety disorder in Hong Kong. Community Mental Health Journal, 43, 305–319.

    Article  PubMed  Google Scholar 

  • Lee, S., Wu, J., Ma, Y. L., et al. (2009). Irritable bowel syndrome is strongly associated with generalized anxiety disorder: A community study. Alimentary Pharmacology & Therapeutics, 30, 643–651.

    Article  CAS  Google Scholar 

  • Litwin, H., & Meir, A. (2013). Financial worry among older people: Who worries and why? Journal of Aging Studies, 27, 113–120.

    Article  PubMed  Google Scholar 

  • Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the Beck depression and anxiety inventories. Behaviour Research and Therapy, 33, 335–343.

    Article  CAS  PubMed  Google Scholar 

  • Mahoney, A. E., Hobbs, M. J., Newby, J. M., et al. (2016). The worry behaviors inventory: Assessing behavioral avoidance associated with generalized anxiety disorder. Journal of Affective Disorders, 203, 256–264.

    Article  PubMed  Google Scholar 

  • Marcus, S. C., Olfson, M., Pincus, H. A., et al. (1997). Self-reported anxiety, general medical conditions, and disability bed days. American Journal of Psychiatry, 154, 1766–1768.

    Article  CAS  PubMed  Google Scholar 

  • Marques, L., Robinaugh, D. J., LeBlanc, N. J., & Hinton, D. (2011). Cross-cultural variations in the prevalence and presentation of anxiety disorders. Expert Review of Neurotherapeutics, 11(2), 313–322.

    Google Scholar 

  • Marten, P. A., Brown, T. A., Barlow, D. H., et al. (1993). Evaluation of the ratings compromising the associated symptoms criterion of DSM-III-R generalized anxiety disorder. Journal of Nervous and Mental Disease, 181, 676–682.

    Article  CAS  PubMed  Google Scholar 

  • Martens, E. J., de Jonge, P., Na, B., et al. (2010). Scared to death? Generalized anxiety disorder and cardiovascular events in patients with stable coronary heart disease: The heart and soul study. Archives of General Psychiatry, 67, 750–758.

    Article  PubMed  Google Scholar 

  • Massion, A. O., Dyck, I. R., Shea, M. T., et al. (2002). Personality disorders and time to remission in generalized anxiety disorder, social phobia, and panic disorder. Archives of General Psychiatry, 59, 434–440.

    Article  PubMed  Google Scholar 

  • Mathew, R. J., Ho, B. T., & Taylor, D. T. (1982). Dopamine beta-hydroxylase response to epinephrine injection in anxious patients and normals. Biological Psychiatry, 17, 393–397.

    CAS  PubMed  Google Scholar 

  • McClure, E. B., Monk, C. S., Nelson, E. E., et al. (2007). Abnormal attentional modulation of fear circuit function in pediatric generalized anxiety disorder. Archives of General Psychiatry, 64, 97–106.

    Article  PubMed  Google Scholar 

  • McEvoy, P. M., & Mahoney, A. E. (2012). To be sure, to be sure: Intolerance of uncertainty mediates symptoms of various anxiety disorders and depression. Behavior Therapy, 43, 533–545.

    Article  PubMed  Google Scholar 

  • McLaughlin, K. A., Conron, K. J., Koenen, K. C., et al. (2010). Childhood adversity, adult stressful life events, and risk of past-year psychiatric disorder: A test of the stress sensitization hypothesis in a population-based sample of adults. Psychological Medicine, 40, 1647–1658.

    Article  CAS  PubMed  Google Scholar 

  • Meichenbaum, D. S., & Jaremko, M. E. (Eds.). (1983). Stress reduction and prevention. Plenum Press.

    Google Scholar 

  • Meyer, T. J., Miller, M. L., Metzger, R. L., et al. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495.

    Article  CAS  PubMed  Google Scholar 

  • Meyer, A., Hajcak, G., Torpey-Newman, D. C., et al. (2015). Enhanced error-related brain activity in children predicts the onset of anxiety disorders between the ages of 6 and 9. Journal of Abnormal Psychology, 124, 266–274.

    Article  PubMed  PubMed Central  Google Scholar 

  • Meyer, A., Nelson, B., Perlman, G., et al. (2018). A neural biomarker, the error-related negativity, predicts the first onset of generalized anxiety disorder in a large sample of adolescent females. Journal of Child Psychology and Psychiatry, 59, 1162–1170.

    Article  PubMed  Google Scholar 

  • Miloyan, B., Bienvenu, O. J., Brilot, B., et al. (2018). Adverse life events and the onset of anxiety disorders. Psychiatry Research, 259, 488–492.

    Article  PubMed  Google Scholar 

  • Mitte, K. (2005). Meta-analysis of cognitive-behavioral treatments for generalized anxiety disorder: A comparison with pharmacotherapy. Psychological Bulletin, 131, 785–795.

    Article  PubMed  Google Scholar 

  • Moras, K., Di Nardo, P. A., & Barlow, D. H. (1992). Distinguishing anxiety and depression: Reexamination of the reconstructed Hamilton scales. Psychological Assessment, 4, 224–227.

    Article  Google Scholar 

  • Muris, P., Merckelbach, H. M., Meesters, C., et al. (2002). Cognitive development and worry in normal children. Cognitive Therapy and Research, 26, 775–785.

    Article  Google Scholar 

  • Naragon-Gainey, K., Gallagher, M. W., & Brown, T. A. (2013). Stable “trait” variance of temperament as a predictor of the temporal course of depression and social phobia. Journal of Abnormal Psychology, 122, 611–623.

    Article  PubMed  PubMed Central  Google Scholar 

  • Newman, M. G., Zuellig, A. R., Kachin, K. E., et al. (2002). Preliminary reliability and validity of the GAD-Q-IV: A self-report diagnostic measure of generalized anxiety disorder. Behavior Therapy, 33, 215–233.

    Article  Google Scholar 

  • Oathes, D. J., Ray, W. J., Yamasaki, A. S., et al. (2008). Worry, generalized anxiety disorder, and emotion: Evidence from the EEG gamma band. Biological Psychology, 79, 165–170.

    Article  PubMed  PubMed Central  Google Scholar 

  • Olvet, D. M., & Hajcak, G. (2008). The error-related negativity (ERN) and psychopathology: Toward an endophenotype. Clinical Psychology Review, 28, 1343–1354.

    Article  PubMed  PubMed Central  Google Scholar 

  • Orsillo, S. M., Roemer, L., & Barlow, D. H. (2003). Integrating acceptance and mindfulness into existing cognitive-behavioral treatments for GAD. Cognitive and Behavioral Practice, 10, 222–230.

    Article  Google Scholar 

  • Osório, F. L., Loureiro, S. R., Hallak, J. E., et al. (2019). Clinical validity and intrarater and test–retest reliability of the Structured Clinical Interview for DSM-5–Clinician Version (SCID-5-CV). Psychiatry and Clinical Neurosciences, 73, 754–760.

    Article  PubMed  Google Scholar 

  • Otowa, T., Hek, K., Lee, M., et al. (2016). Meta-analysis of genome-wide association studies of anxiety disorders. Molecular Psychiatry, 21, 1391–1399.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pae, C.-U., Wang, S.-M., Han, C., et al. (2015). Vortioxetine, a multimodal antidepressant for generalized anxiety disorder: A systematic review and meta-analysis. Journal of Psychiatric Research, 64, 88–98.

    Article  PubMed  Google Scholar 

  • Pluess, M., Conrad, A., & Wilhelm, F. H. (2009). Muscle tension in generalized anxiety disorder: A critical review of the literature. Journal of Anxiety Disorders, 23, 1–11.

    Article  PubMed  Google Scholar 

  • Power, K., Simpson, R., Swanson, V., et al. (1990). A controlled comparison of cognitive-behavior therapy, diazepam, and placebo, alone and in combination, for the treatment of generalized anxiety disorder. Journal of Anxiety Disorders, 4, 267–292.

    Article  Google Scholar 

  • Rachman, S. J. (1973). Some similarities and differences between obsessional ruminations and morbid preoccupations. Canadian Psychiatric Association Journal, 18, 71–74.

    Article  CAS  PubMed  Google Scholar 

  • Rachman, S. J. (1993). Obsessions, responsibility and guilt. Behaviour Research and Therapy, 31, 149–154.

    Article  CAS  PubMed  Google Scholar 

  • Rapee, R. M. (1991). Generalized anxiety disorder: A review of clinical features and theoretical concepts. Clinical Psychology Review, 11, 419–440.

    Article  Google Scholar 

  • Ray, W. J., Molnar, C., Aikins, D., et al. (2009). Startle response in generalized anxiety disorder. Depression and Anxiety, 26, 147–154.

    Article  PubMed  PubMed Central  Google Scholar 

  • Regier, D. A., Narrow, W. E., Clarke, D. E., et al. (2013). DSM-5 field trials in the United States and Canada, part II: Test–retest reliability of selected categorical diagnoses. American Journal of Psychiatry, 170, 59–70.

    Article  PubMed  Google Scholar 

  • Rickels, K., Downing, R., Schweizer, E., et al. (1993). Antidepressants for the treatment of generalized anxiety disorder: A placebo-controlled comparison of imipramine, trazodone, and diazepam. Archives of General Psychiatry, 50, 884–895.

    Article  CAS  PubMed  Google Scholar 

  • Rickels, K., Zanielli, R., McCafferty, J., et al. (2003). Paroxetine treatment of generalized anxiety disorder: A double-blind, placebo-controlled study. American Journal of Psychiatry, 160, 749–756.

    Article  PubMed  Google Scholar 

  • Rickels, K., Etemad, B., Khalid-Khan, S., et al. (2010). Time to relapse after 6 and 12 months’ treatment of generalized anxiety disorder with venlafaxine extended release. Archives of General Psychiatry, 67, 1274–1281.

    Article  CAS  PubMed  Google Scholar 

  • Roemer, L., Molina, S., Litz, B. T., et al. (1996). Preliminary investigation of the role of previous exposure to potentially traumatizing events in generalized anxiety disorder. Depression and Anxiety, 4, 134–138.

    Article  PubMed  Google Scholar 

  • Roemer, L., Orsillo, S. M., & Barlow, D. H. (2002). Generalized anxiety disorder. In D. H. Barlow (Ed.), Anxiety and its disorders (2nd ed.). Guilford Press.

    Google Scholar 

  • Roest, A. M., Martens, E. J., de Jonge, P., et al. (2010). Anxiety and risk of incident coronary heart disease: A meta-analysis. Journal of the American College of Cardiology, 56, 38–46.

    Article  PubMed  Google Scholar 

  • Ruscio, A. M., Lane, M., Roy-Byrne, P., et al. (2005). Should excessive worry be a requirement for a diagnosis of generalized anxiety disorder? Results from the National Comorbidity Survey Replication. Psychological Medicine, 35, 1761–1772.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ruscio, A. M., Chiu, W. T., Roy-Byrne, P., et al. (2007). Broadening the definition of generalized anxiety disorder: Effects on prevalence and associations with other disorders in the National Comorbidity Survey Replication. Journal of Anxiety Disorders, 21, 662–676.

    Article  PubMed  Google Scholar 

  • Ruscio, A. M., Hallion, L. S., Lim, C. C., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., … & Scott, K. M. (2017). Cross-sectional comparison of the epidemiology of DSM-5 generalized anxiety disorder across the globe. JAMA Psychiatry, 74(5), 465–475.

    Google Scholar 

  • Rutter, L. A., & Brown, T. A. (2015). Reliability and validity of the dimensional features of generalized anxiety disorder. Journal of Anxiety Disorders, 29, 1–6.

    Article  PubMed  Google Scholar 

  • Rynn, M. A., Siqueland, L., & Rickels, K. (2001). Placebo-controlled trial of sertraline in the treatment of children with generalized anxiety disorder. American Journal of Psychiatry, 158, 2008–2014.

    Article  CAS  PubMed  Google Scholar 

  • Rynn, M. A., Riddle, M. A., Yeung, P. P., et al. (2007). Efficacy and safety of extended-release venlafaxine in the treatment of generalized anxiety disorder in children and adolescents: Two placebo-controlled trials. American Journal of Psychiatry, 164, 290–300.

    Article  PubMed  Google Scholar 

  • Sanderson, W. C., & Barlow, D. H. (1990). A description of patients diagnosed with DSM-III-R generalized anxiety disorder. Journal of Nervous and Mental Disease, 178, 588–591.

    Article  CAS  PubMed  Google Scholar 

  • Sanderson, W. C., & Wetzler, S. (1991). Chronic anxiety and generalized anxiety disorder: Issues in comorbidity. In R. M. Rapee & D. H. Barlow (Eds.), Chronic anxiety: Generalized anxiety disorder and mixed anxiety-depression. Guilford Press.

    Google Scholar 

  • Sanderson, W. C., Wetzler, S., Beck, A. T., & Betz, F. (1994). Prevalence of personality disorders among patients with anxiety disorders. Psychiatry Research, 51, 167–174.

    Article  CAS  PubMed  Google Scholar 

  • Sawa, A., Berenbaum, H., & Okazaki, S. (2013). Influences of personal standards and perceived parental expectations on worry for Asian American and white American college students. Anxiety, Stress, & Coping, 26, 187–202.

    Article  Google Scholar 

  • Schwartz, S. H., & Melech, G. (2000). National differences in micro and macros worry: Social, economic, and cultural explanations. In E. Diener & E. M. Suh (Eds.), Culture and subjective well-being (pp. 219–256). The MIT Press.

    Google Scholar 

  • Scott, E. L., Eng, W., & Heimberg, R. G. (2002). Ethnic differences in worry in a nonclinical population. Depression and Anxiety, 15, 79–82.

    Article  PubMed  Google Scholar 

  • Shankman, S. A., Funkhouser, C. J., Klein, D. N., et al. (2018). Reliability and validity of severity dimensions of psychopathology assessed using the Structured Clinical Interview for DSM-5 (SCID). International Journal of Methods in Psychiatric Research, 27, e1590.

    Article  PubMed  Google Scholar 

  • Sheehan, D. V. (1999). Venlafaxine extended release (XR) in the treatment of generalized anxiety disorder. Journal of Clinical Psychiatry, 60, 23–28.

    CAS  PubMed  Google Scholar 

  • Silverman, W. K., & Eisen, A. R. (1992). Age differences in the reliability of parent and child reports of child anxious symptomatology using a structured interview. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 117–124.

    Article  CAS  PubMed  Google Scholar 

  • Simon, N. M., Blacker, D., Korbly, N. B., et al. (2002). Hypothyroidism and hyperthyroidism in anxiety disorders revisited: New data and literature review. Journal of Affective Disorders, 69, 209–217.

    Article  PubMed  Google Scholar 

  • Slade, T., & Andrews, G. (2001). DSM-IV and ICD-10 generalized anxiety disorder. Social Psychiatry and Psychiatric Epidemiology, 36, 45–51.

    Article  CAS  PubMed  Google Scholar 

  • Spitzer, R. L., Kroenke, K., Williams, J. B. W., et al. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166, 1092–1097.

    Article  PubMed  Google Scholar 

  • Stanley, M. A., Beck, J. G., Novy, D. M., et al. (2003). Cognitive-behavioral treatment of late-life generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 71, 309–319.

    Article  PubMed  Google Scholar 

  • Stefan, S., Cristea, I. A., Szentagotai Tatar, A., et al. (2019). Cognitive-behavioral therapy (CBT) for generalized anxiety disorder: Contrasting various CBT approaches in a randomized clinical trial. Journal of Clinical Psychology, 75, 1188–1202.

    Article  PubMed  Google Scholar 

  • Steketee, G., & Barlow, D. H. (2002). Obsessive–compulsive disorder. In D. H. Barlow (Ed.), Anxiety and its disorders (2nd ed.). Guilford Press.

    Google Scholar 

  • Strawn, J. R., Prakash, A., Zhang, Q., et al. (2015). A randomized, placebo-controlled study of duloxetine for the treatment of children and adolescents with generalized anxiety disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 54, 283–293.

    Article  Google Scholar 

  • Strawn, J. R., Geracioti, L., Rajdev, N., et al. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: An evidence-based treatment review. Expert Opinion on Pharmacotherapy, 19, 1057–1070.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sykes, M. A., Blanchard, E. B., Lackner, J., et al. (2003). Psychopathology in irritable bowel syndrome: Support for a physiological model. Journal of Behavioral Medicine, 26, 361–372.

    Article  PubMed  Google Scholar 

  • Szkodny, L. E., Newman, M. G., & Goldfried, M. R. (2014). Clinical experiences in conducting empirically supported treatments for generalized anxiety disorder. Behavior Therapy, 45, 7–20.

    Article  PubMed  Google Scholar 

  • Tallis, F., Eysenck, M. W., & Mathews, A. (1992). A questionnaire for the measurement of nonpathological worry. Personality and Individual Differences, 13, 161–168.

    Article  Google Scholar 

  • Taylor, S. E., & Brown, J. D. (1994). Positive illusions and well-being revisited: Separating fact from fiction. Psychological Bulletin, 116, 21–27.

    Article  CAS  PubMed  Google Scholar 

  • Taylor, S. E., Kemeny, M. E., Reed, G. M., et al. (2000). Psychological resources, positive illusions, and health. The American Psychologist, 55, 99–109.

    Article  CAS  PubMed  Google Scholar 

  • Thayer, J. F., Friedman, B. H., & Borkovec, T. D. (1996). Autonomic characteristics of generalized anxiety disorder. Biological Psychiatry, 39, 255–266.

    Article  CAS  PubMed  Google Scholar 

  • Tiihonen, J., Kuikka, J., Rasanen, P., et al. (1997). Cerebral benzodiazepine receptor binding and distribution in generalized anxiety disorder: A fractal analysis. Molecular Psychiatry, 2, 463–471.

    Article  CAS  PubMed  Google Scholar 

  • Tolin, D. F., Wootton, B. M., Bowe, W., Bragdon, L. B., Davis, E. C., Gilliam, C. M., & Worden, B. (2013). Diagnostic interview for anxiety, mood, and OCD and related disorders (DIAMOND). Hartford, CT: Institute of Living/Hartford HealthCare Corporation.

    Google Scholar 

  • Tolin, D. F., Gilliam, C., Wootton, B. M., et al. (2018). Psychometric properties of a structured diagnostic interview for DSM-5 anxiety, mood, and obsessive-compulsive and related disorders. Assessment, 25, 3–13.

    Article  PubMed  Google Scholar 

  • Toner, B. B., Segal, Z. V., Emmott, S. D., et al. (2000). Cognitive-Behavioral treatment of irritable bowel syndrome: The brain–gut connection. Guilford Press.

    Google Scholar 

  • Treanor, M., Erisman, S. M., Salters-Pedneault, K., et al. (2011). Acceptance-based behavioral therapy for GAD: Effects on outcomes from three theoretical models. Depression and Anxiety, 28, 127–136.

    Article  PubMed  Google Scholar 

  • Tully, P. J., Cosh, S. M., & Baune, B. T. (2013). A review of the affects of worry and generalized anxiety disorder upon cardiovascular health and coronary heart disease. Psychology, Health & Medicine, 18, 627–644.

    Article  Google Scholar 

  • Turner, S. M., Beidel, D. C., & Stanley, M. A. (1992). Are obsessional thoughts and worry different cognitive phenomena? Clinical and Psychology Review, 12, 257–270.

    Article  Google Scholar 

  • Tyrer, P., Tyrer, H., Yang, M., & Guo, B. (2016). Long-term impact of temporary and persistent personality disorder on anxiety and depressive disorders. Personality and Mental Health, 10, 76–83.

    Article  PubMed  Google Scholar 

  • van der Heiden, C., Muris, P., & van der Molen, H. T. (2012). Randomized controlled trial on the effectiveness of metacognitive therapy and intolerance-of-uncertainty therapy for generalized anxiety disorder. Behaviour Research and Therapy, 50, 100–109.

    Article  PubMed  Google Scholar 

  • Vargas, S. M., Cabassa, L. J., Nicasio, A., et al. (2015). Toward a cultural adaptation of pharmacotherapy: Latino views of depression and antidepressant therapy. Transcultural Psychiatry, 52, 244–273.

    Article  PubMed  Google Scholar 

  • Vesga-López, O., Schneier, F. R., Wang, S., et al. (2008). Gender differences in generalized anxiety disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Journal of Clinical Psychiatry, 69, 1606–1616.

    Article  PubMed  Google Scholar 

  • Weinberg, A., Kotov, R., & Proudfit, G. H. (2015). Neural indicators of error processing in generalized anxiety disorder, obsessive-compulsive disorder, and major depressive disorder. Journal of Abnormal Psychology, 124(1), 172.

    Google Scholar 

  • Weisberg, R. B., Brown, T. A., & Wincze, et al. (2001). Causal attributions and male sexual arousal: The impact of attributions for a bogus erectile difficulty on sexual arousal, cognitions, and affect. Journal of Abnormal Psychology, 110, 324–334.

    Article  CAS  PubMed  Google Scholar 

  • Wells, A. (1994). A multi-dimensional measure of worry: Development and preliminary validation of the anxious thoughts inventory. Anxiety, Stress, and Coping, 6, 289–299.

    Article  Google Scholar 

  • Wells, A. (2002). GAD, meta-cognition, and mindfulness: An information processing analysis. Clinical Psychology: Science and Practice, 9, 95–100.

    Google Scholar 

  • Wisocki, P. A. (1988). Worry as a phenomenon relevant to the elderly. Behavior Therapy, 19, 369–379.

    Article  Google Scholar 

  • Wittchen, H. U., Zhao, S., Kessler, R. C., et al. (1994). DSM-III-R generalized anxiety disorder in the National Comorbidity Survey. Archives of General Psychiatry, 51, 355–364.

    Article  CAS  PubMed  Google Scholar 

  • World Health Organization. (1994). International classification of diseases for mortality and morbidity statistics (10th Revision). World Health Organization.

    Google Scholar 

  • World Health Organization. (2018). International classification of diseases for mortality and morbidity statistics (11th Revision). World Health Organization.

    Google Scholar 

  • Wu, J. C., Buchsbaum, M. S., Hershey, T. G., et al. (1991). PET in generalized anxiety disorder. Biological Psychiatry, 29, 1181–1199.

    Article  CAS  PubMed  Google Scholar 

  • Yassa, M. A., Hazlett, R. L., Stark, C. E. L., et al. (2012). Functional MRI of the amygdala and bed nucleus of the stria terminalis during conditions of uncertainty in generalized anxiety disorder. Journal of Psychiatric Research, 46, 1045–1052.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yonkers, K. A., Bruce, S. E., Dyck, I. R., et al. (2003). Chronicity, relapse, and illness – Course of panic disorder, social phobia, and generalized anxiety disorder: Findings in men and women from 8 years of follow-up. Depression and Anxiety, 17, 173–179.

    Article  PubMed  Google Scholar 

  • Zhang, Y., Young, D., Lee, S., et al. (2002). Chinese Taoist cognitive psychotherapy in the treatment of generalized anxiety disorder in contemporary China. Transcultural Psychology, 39, 115–129.

    Article  Google Scholar 

  • Zimmerman, M., & Chelminski, I. (2003). Generalized anxiety disorder in patients with major depression: Is DSM-IV’s hierarchy correct? American Journal of Psychiatry, 160, 504–512.

    Article  PubMed  Google Scholar 

  • Zinbarg, R. E., Mineka, S., Bobova, L., et al. (2016). Testing a hierarchical model of neuroticism and its cognitive facets: Latent structure and prospective prediction of first onsets of anxiety and unipolar mood disorders during 3 years in late adolescence. Clinical Psychological Science, 4, 805–824.

    Article  Google Scholar 

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Authors and Affiliations

  1. Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA

    Anthony J. Rosellini & Timothy A. Brown

Authors
  1. Anthony J. Rosellini
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  2. Timothy A. Brown
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Corresponding author

Correspondence to Anthony J. Rosellini .

Editor information

Editors and Affiliations

  1. Department of Psychiatry, University of Louisville, Louisville, KY, USA

    Allan Tasman

  2. Department of Psychiatry, University of Michigan Rogel Cancer Cent, Ann Arbor, MI, USA

    Michelle B. Riba

  3. Mayo Clinic College of Medicine, Oakland, CA, USA

    Renato D. Alarcón

  4. Columbia University Medical Center, New York, USA

    César A. Alfonso

  5. Kyushu University, Fukuoka, Japan

    Shigenobu Kanba

  6. Department of Psychiatry, University of Nairobi, Nairobi, Kenya

    David M. Ndetei

  7. Malaysian Research Inst on Ageing, Universiti Putra Malaysia, Selangor, Malaysia

    Chee H. Ng

  8. Department of Psychiatry, University of Munich, München, Bayern, Germany

    Thomas G. Schulze

  9. Serbian Academy of Sciences and Arts, Belgrade, Serbia

    Dusica Lecic-Tosevski

Section Editor information

  1. Department of Psychiatry, University of Melbourne, Melbourne, Australia

    Chee H. Ng

  2. Department of Medical Sciences, Serbian Academy of Sciences and Arts, Belgrade, Serbia

    Dusica Lecic-Tosevski

  3. Department of Psychiatry, Columbia University Medical Center, New York, NY, USA

    César A. Alfonso

  4. Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Cheras, Kuala Lumpur, Malaysia

    César A. Alfonso

  5. Department of Psychiatry, Universitas Indonesia, Jakarta, Indonesia

    César A. Alfonso

  6. Department of Psychiatry, Prince of Songkla University, Songhkla, Thailand

    César A. Alfonso

  7. Department of Neuroscience, University of Texas Rio Grande Valley School of Medicine, HARLINGEN, FL, USA

    Ihsan M. Salloum

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Rosellini, A.J., Brown, T.A. (2023). Anxiety and Fear-Related Disorders: Generalized Anxiety Disorder. In: Tasman, A., et al. Tasman’s Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-42825-9_74-1

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  • DOI: https://doi.org/10.1007/978-3-030-42825-9_74-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-42825-9

  • Online ISBN: 978-3-030-42825-9

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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