Advertisement

Generalisierte Angststörung

  • Eni Becker

Zusammenfassung

Die GAS ist eine häufige und sehr belastende Angststörung. Die Betroffenen leiden unter chronischer, anhaltender Angst, in deren Mittelpunkt ausgeprägte Sorgen stehen. Diese Sorgen sind ein wichtiger aufrechterhaltender Faktor der Störung, die der Emotionsregulation dienen. Neuere Ansätze zeichnen sich dadurch aus, dass sie eigens auf die GAS und ihre Bedingungsmodelle zugeschnitten werden. So wurden vor allem die Sorgen bzw. das Sorgenverhalten in das Zentrum der Behandlung gerückt. So wird ein eher verhaltenstherapeutisches konfrontatives Vorgehen vorgeschlagen, eine Kombination aus Konfrontation in sensu und in vivo. Aber auch die angewandte Entspannung ist erfolgreich in der Behandlung der GAS, oder achtsamkeitsbasierte Interventionen. Zum anderen gibt es Ansätze, die sich eher an der kognitiven Therapie orientieren, bei denen die Metakognitionen über die Sorgen im Mittelpunkt stehen. Voraussetzung für den Therapieerfolg ist eine gute Therapieplanung, die auch der hohen Komorbidität Rechnung trägt. Mit diesen verhaltenstherapeutischen Maßnahmen kann auch die chronische Störung der GAS erfolgreich und dauerhaft therapiert werden.

Literatur

Zitierte Literatur

  1. APA (American Psychiatric Association). (2000). DSM-IV-TR: Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Washington, DC.Google Scholar
  2. APA (American Psychiatric Association). (2013). DSM-5: Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Washington, DC.Google Scholar
  3. Arndt, A., Patzelt, J., Andor, T., Hoyer, J. & Gerlach, A. (2011). Validierung der deutschsprachigen Kurzversion des Metakognitionsfragebogens (MKF-30). Zeitschrift für Klinische Psychologie und Psychotherapie, 40, 107–114.Google Scholar
  4. Barlow, D. H. (1988). Anxiety and its disorders: The nature and treatment of anxiety and panic. New York: The Guilford Press.Google Scholar
  5. Becker, E. S. (1995). Ätiologie und Therapie des generalisierten Angstsyndroms. Verhaltenstherapie, 5, 207–215.Google Scholar
  6. Becker, E. S. & Margraf, J. (1995). Kognitive Therapie von Angsterkrankungen. In S. Kasper & H. J. Möller (Eds.), Praxis der Angsterkrankungen. (S. 412–431). Jena: Fischer.Google Scholar
  7. Becker, E. S. & Margraf, J. (2003). Generalisierte Angststörung: Kognitive Verhaltenstherapie. In B. Bandelow (Ed.), Angst-und Panikerkrankungen (pp. 99–102). Bremen: Uni-Med Verlag.Google Scholar
  8. Becker, E. S. & Margraf, J. (2016). Generalisierte Angststörung: Ein Therapieprogramm. 3. Auflage, Weinheim: Beltz.Google Scholar
  9. 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 (pp. 5–33). Oxford, England: Wiley.Google Scholar
  10. Borkovec, T. D., Alcaine, O. M. & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. In R. G. Heimberg, C. L. Turk & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 77–108). New York, NY: Guilford.Google Scholar
  11. Borkovec, T. D. & Hu, S. (1990). The effect of worry on cardiovascular response to phobic imagery. Behaviour Research and Therapy, 28, 69–73.Google Scholar
  12. Borkovec, T. D., Lyonfields, J. D., Wiser, S. L. & Deihl, L. (1993). The role of worrisome thinking in the suppression of cardiovascular response to phobic imagery. Behaviour Research and Therapy, 31, 321–324.Google Scholar
  13. Borkovec, T. D. & Ruscio, A. M. (2001). Psychotherapy for generalized anxiety disorder. Journal of Clinical Psychiatry, 62 (Supl. 11), 37–45.Google Scholar
  14. Borkovec, T. D. & Whisman, M. A. (1996). Psychosocial treatment for generalized anxiety disorder. In M. R. Mavissakalian & R. F. Prien (Eds.), Long-term Treatment for the Anxiety disorders (pp. 171–199). Washington, DC: American Psychiatric Press.Google Scholar
  15. Chambless, D. L. & Gillis, M. M. (1993). Cognitive therapy of anxiety disorders. Journal of Consulting and Clinical Psychology, 61, 248–260.Google Scholar
  16. Clark, D. A., Steer, R. A. & Beck, A. T. (1994). Common and specific dimensions of self-reported anxiety and depression: Implications for the cognitive and tripartite models. Journal of Abnormal Psychology, 103, 645–654.Google Scholar
  17. Cuijpers, P., Sijbrandij, M., Koole, S., Huibers, M., Berking, M. & Andersson, G. (2014). Psychological treatment of generalized anxiety disorder: A meta-analysis. Clinical Psychology Review, 34, 130–140. DOI: 10.1016/j.cpr.2014.01.002
  18. Durham, R. C., Fisher, P. L., Treliving, L. R., Hau, C. M., Richard, K. & Stewart, J. B. (1999). One year follow-up of cognitive therapy, analytic psychotherapy and anxiety management training for generalized anxiety disorder: symptom change, medication usage and attitudes to treatment. Behavioural and Cognitive Psychotherapy, 27, 19–35.Google Scholar
  19. Fisher, P. L. & Durham, R. C. (1999). Recovery rates in generalized anxiety disorder following psychological therapy: An analysis of clinically significant change in the STAI-T across outcome studies since 1990. Psychological Medicine, 29, 1425–1434.Google Scholar
  20. Freeston, M. H. & Ladouceur, R. (1993). Appraisal of cognitive intrusions and response style: Replication and extension. Behaviour Research and Therapy, 31, 185–191.Google Scholar
  21. Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299.Google Scholar
  22. Hettema, J. M., Neale, M. C. & Kendler, K. S. (2001). A review and metaanalysis of the genetic epidemiology of anxiety disorders. American Journal of Psychiatry,158, 1568–1578.Google Scholar
  23. Hoyer, J. (o.J.) Generalisierter Angst-Fragebogen (Übersetzung des GAD-Q-IV von Newman).https://www.zpid.de/psychologie/PSYNDEX.php?search=psychauthors&id=9006631.
  24. Hoyer, J. & Gräfe, K. (1999). Meta-Kognitions-Fragebogen. Unveröffentlichtes Manuskript: Technische Universität Dresden.Google Scholar
  25. Hoyer, J., Becker, E. S. & Margraf, J. (2002). Generalized anxiety disorder and clinical worry episodes in a representative sample of young women. Psychological Medicine, 32, 1227–1237.Google Scholar
  26. Hoyer, J., Becker, E. S. & Roth, W. T. (2001). Characteristics of worry in GAD patients, social phobics, and controls. Anxiety and Depression, 13, 89–96.Google Scholar
  27. Hoyer, J., Beesdo, K., Gloster, A. T., Runge, J., Hofler, M. & Becker, E. S. (2009). Worry exposure versus applied relaxation in the treatment of generalized anxiety disorder. Psychotherapy and Psychosomatics, 78, 106–115.Google Scholar
  28. Hudson, J. L. & Rapee, R. M. (2001). Behaviour Research and Therapy. Parent-child interactions and anxiety disorders: an observational study. Volume: 39. Issue: 12. Pages: 1411–1427. Published: December.Google Scholar
  29. Jacobson, E. (1938). Progressive relaxation. Chicago: University of Chicago Press.Google Scholar
  30. Joormann, J. & Stober, J. (1997). Measuring facets of worry: a lisrel analysis of the Worry Domains Questionnaire. Personality and Individual Differences, 23(5), 827–837.Google Scholar
  31. Kabat-Zinn, J. (2013). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Revised and Updated Edition. New York: Bantam/Random House.Google Scholar
  32. Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W. & Herzberg, P. Y. (2008). Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Medicinical Care,46, 266–274.Google Scholar
  33. Mennin, D. S. (2004). Emotion regulation therapy for generalized anxiety disorder. Clinical Psychology and Psychotherapy, 11(1), 17–29.Google Scholar
  34. Mennin, D. S., Heimberg, R. G., Turk, C. L. & Fresco, D. M. (2005). Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder. Behaviour Research and Therapy, 43(10), 1281–1310.Google Scholar
  35. Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., Przeworski, A., Erickson, T. & Cashman-McGrath, L. (2002). Preliminary Reliability and Validity of the Generalized Anxiety Disorder Questionnaire-IV: Revised Self-Report Diagnostic Measure of Generalized Anxiety Disorder. Behavior therapy,33, 215–233.Google Scholar
  36. Newman, M. G. & Llera, S. J. (2011). A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry. Clinical Psychology Review, 31, 371–382.Google Scholar
  37. Nisita, C., Petracca, A., Akiskal, H. S., Galli, L., Gepponi, I. & Cassano, G. B. (1990). Delimitation of generalized anxiety disorder: Clinical comparisons with panic and major depressive disorders. Comprehensive Psychiatry, 31, 409–415.Google Scholar
  38. Noyes, R., Woodman, C., Garvey, M. J., Cook, B. L., Suelzer, M., Clancy, J., et al. (1992). Generalized anxiety disorder vs. panic disorder. Distinguishing characteristics and patterns of comorbidity. Journal of Nervous and Mental Disease, 180, 369–379.Google Scholar
  39. Öst, L.-G. (1987). Applied relaxation: Description of a coping technique and review of controlled studies. Behaviour Research and Therapy, 25, 397–409.Google Scholar
  40. Öst, L.-G. (1993). Applied relaxation, exposure in vivo and cognitive methods in the treatment of panic disorder with agoraphobia. Behaviour Research and Therapy, 31, 383–394.Google Scholar
  41. Öst, L.-G. & Breitholtz, E. (2000). Applied relaxation vs. cognitive therapy in the treatment of generalized anxiety disorder. Behaviour Research and Therapy, 38, 777–790.Google Scholar
  42. Öst, L.-G. & Sterner, U. (1987). Applied tension. Behaviour Research and Therapy, 25, 25–29.Google Scholar
  43. Ruhmland, M. & Margraf, J. (2001). Effektivität psychologischer Therapien von generalisierter Angststörung und sozialer Phobie: Meta-Analysen auf Störungsebene. Verhaltenstherapie, 11, 27–40.Google Scholar
  44. Roemer, L. & Orsillo, S. M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models. Clinical Psychology: science and practice, 9 (1), 54–68. DOI: 10.1093/clipsy/9.1.54
  45. 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 (pp. 119–135). New York: Guilford.Google Scholar
  46. Schneider, S. & Margraf, J. (2011). DIPS: Diagnostisches Interview bei psychischen Störung (4 Aufl.). Heidelberg: Springer.Google Scholar
  47. Segal, Z. V., Williams, M. & Teasdale, J. D. (2013). Mindfullness-based Cognitive Therapy for Depression: a new approach to preventing relapse , 2. ed. New York: The Guildford PressGoogle Scholar
  48. Shores, M. M., Glubin, T., Cowley, D. S., Dager, S. R., Roy-Byrne, P. P. & Dunner, D. L. (1992). The relationship between anxiety and depression: A clinical comparison of generalized anxiety disorder, dysthymic disorder, panic disorder, and major depressive disorder. Comprehensive Psychiatry, 33, 237–244.Google Scholar
  49. Silove, D., Parker, G., Hadzi-Pavlovic, D., Manicavasagar, V. & Blaszczynski, A. (1991). Parental representations of patients with panic disorder and generalised anxiety disorder. British Journal of Psychiatry, 159, 835–841.Google Scholar
  50. Stöber, J. (1995). Besorgnis: Ein Vergleich dreier Inventare zur Erfassung allgemeiner Sorgen. Zeitschrift für Differentielle und Diagnostische Psychologie, 16, 50–63.Google Scholar
  51. Turk, D. C. & Okifuji, A. (2002). Psychological factors in chronic pain: Evolution and revolution. Journal of Counseling and Clinical Psychology, 70 (3), 678–690.Google Scholar
  52. Wegner, D. M. (1989). White bears and other unwanted thoughts. New York: Viking.Google Scholar
  53. Wegner, D. M. (1994). Ironic processes of mental control. Psychological Review, 101, 34–52.Google Scholar
  54. Wegner, D. M. & Zanakos, S. (1994). Chronic thought suppression. Journal of Personality and Social Psychology, 62, 615–640.Google Scholar
  55. Wells, A. (1997). Cognitive therapy of anxiety disorders. A practice manual and conceptual guide. Chichester: Wiley.Google Scholar
  56. Wells, A. (1999). A metacognitive model and therapy for generalized anxiety disorder. Clinical Psychology and Psychotherapy, 6, 86–95.Google Scholar
  57. Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. New York, NY, Wiley.Google Scholar
  58. Wells, A. & Matthews, G. (1996). Modelling cognition in emotional disorder: The S-REF model. Behaviour Research and Therapy, 34, 881–888.Google Scholar
  59. Wittchen, H.-U. & Boyer, P. (1998). Screening for anxiety disorders: Sensitivity and specificity of the anxiety screening questionnaire (ASQ-15). British Journal of Psychiatry, 173, 10–17.Google Scholar
  60. Wittchen, H. U., Zhao, S., Kessler, R. C. & Eaton, W. W. (1994). DSM-III-R generalized anxiety disorder in the national comorbidity survey. Archives of General Psychiatry, 51, 355–364.Google Scholar
  61. Zinbarg, R. E., Craske, M. G. & Barlow, D. H., (1993). Mastery of your anxiety and worry. San Antonio: Graywind.Google Scholar
  62. Zinbarg, R. E., Craske, M. G. & Barlow, D. H. (1993b). Therapist guide. San Antonio: Graywind.Google Scholar

Weiterführende Literatur

  1. Becker, E. S. & Margraf, J. (2016). Generalisierte Angststörung: Ein Therapieprogramm. Weinheim: Beltz.Google Scholar
  2. Becker, E. S. & Hoyer, J. (2005). Generalisierte Angststörung. In D. Schulte, K. Grawe, K. Hahlweg & D. Vaitl (Hrsg.), Fortschritte der Psychotherapie. Göttingen: Hogrefe.Google Scholar
  3. Wells, A. (2000). Emotional disorders and metacognition. Innovative cognitive therapy. Chichester: Wiley.Google Scholar
  4. Zinbarg, R. E., Craske, M. G. & Barlow, D. H. (1993). Therapist guide. San Antonio: Graywind.Google Scholar

Copyright information

© Springer-Verlag GmbH Deutschland 2018

Authors and Affiliations

  1. 1.Behavioural Science InstituteRadboud University NijmegenNijmegenDeutschland

Personalised recommendations