scholarly journals The history of generalized anxiety disorder as a diagnostic category

2017 ◽  
Vol 19 (2) ◽  
pp. 107-116 ◽  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Diagnostic Category ◽  
Panic Attacks ◽  
Biological Research ◽  
Generalized Anxiety ◽  
Potential Threat ◽  
Anxiety Neurosis ◽  
Mental Symptoms ◽  
Research Domain

From the 19th century into the 20th century, the terms used to diagnose generalized anxiety included “pantophobia” and “anxiety neurosis.” Such terms designated paroxysmal manifestations (panic attacks) as well as interparoxysmal phenomenology (the apprehensive mental state). Also, generalized anxiety was considered one of numerous symptoms of neurasthenia, a vaguely defined illness. Generalized anxiety disorder (GAD) appeared as a diagnostic category in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980, when anxiety neurosis was split into GAD and panic disorder. The distinct responses these two disorders had to imipramine therapy was one reason to distinguish between the two. Since the revised DSM-III (DSM-III-R), worry about a number of life circumstances has been gradually emphasized as the distinctive symptom of GAD. Thus, a cognitive aspect of anxiety has become the core criterion of GAD. The validity of GAD as an independent category has been questioned from DSM-III up to preparation of DSM-5. Areas of concern have included the difficulty to establish clear boundaries between GAD and (i) personality dimensions, (ii) other anxiety-spectrum disorders, and (iii) nonbipolar depression. The National Institute of Mental Health has recently proposed the Research Domain Criteria (RDoC), a framework destined to facilitate biological research into the etiology of mental symptoms. Within the RDoC framework, generalized anxiety might be studied as a dimension denominated “anxious apprehension” that would typically fit into the research domain called “negative valence systems” and the more specific construct termed “potential threat.”

scholarly journals Brain Functional Connectivity Correlates of Response in the 7.5% CO2 Inhalational Model of Generalized Anxiety Disorder: A Pilot Study

2020 ◽  
Vol 23 (4) ◽  
pp. 268-273
Author(s):  
Nathan T M Huneke ◽  
M John Broulidakis ◽  
Angela Darekar ◽  
David S Baldwin ◽  
Matthew Garner
Keyword(s):  
Anxiety Disorder ◽  
Functional Connectivity ◽  
Generalized Anxiety Disorder ◽  
Interaction Analysis ◽  
Generalized Anxiety ◽  
Affective Valence ◽  
Potential Threat ◽  
Midcingulate Cortex ◽  
Psychophysiological Interaction ◽  
Co2 Challenge

Abstract Background The 7.5% CO2 inhalational model can be used to explore potential treatments for generalized anxiety disorder. However, it is unknown how inter-individual variability in the functional architecture of negative affective valence systems might relate to anxiogenic response in this model. Methods A total of 13 healthy volunteers underwent functional magnetic resonance imaging during a passive emotional face perception task. We explored task-evoked functional connectivity in the potential threat system through generalized psychophysiological interaction analysis. Within 7 days, these participants underwent prolonged 7.5% CO2 inhalation, and results from the generalized psychophysiological interaction analysis were correlated with CO2 outcome measures. Results Functional connectivity between ventromedial prefrontal cortex and right amygdala positively correlated with heart rate and subjective anxiety, while connectivity between midcingulate cortex and left amygdala negatively correlated with anxiety during CO2 challenge. Conclusions Response to CO2 challenge correlated with task-evoked functional connectivity in the potential threat system. Further studies should assess whether this translates into clinical populations.

Chest Pain in Generalized Anxiety Disorder

1992 ◽  
Vol 22 (3) ◽  
pp. 291-298 ◽  
Author(s):  
Cameron S. Carter ◽  
Richard J. Maddock
Keyword(s):  
Chest Pain ◽  
Anxiety Disorder ◽  
Panic Disorder ◽  
Generalized Anxiety Disorder ◽  
Panic Attacks ◽  
Medical Utilization ◽  
Generalized Anxiety ◽  
Common Diagnosis ◽  
History Of ◽  
Pain Patients

Objectives: The objectives of the current study were to evaluate the prevalence of chest pain and related medical utilization in patients with generalized anxiety disorder and to investigate the possible relationship between the occurrence of chest pain in these patients and the episodes of excessive worry which characterize this disorder. Method: The presence of a history of chest pain in patients with generalized anxiety disorder was investigated in an outpatient psychiatric sample using a structured interview which also assessed related medical utilization and the relationship of chest pain to panic attacks and episodes of excessive worry. Results: Of fifty sequentially evaluated patients meeting DSM-IIIR criteria for G.A.D., twenty-four (48%) reported a history of chest pain. Seven of these patients also had a history of panic attacks, however, four of the seven reported that their pain occurred independently of their panic attacks. Sixteen patients with G.A.D. reported that their chest pain episodes were associated with episodes of excess worry. Eleven had sought medical evaluation for their pain. Patients with chest pain and normal coronary arteries are frequently found to have panic disorder. The pattern of utilization of medical care was comparable in this sample of patients with G.A.D. and a group of patients with panic disorder recruited in a similar manner. Conclusions: These results suggest that in addition to panic disorder, G.A.D. may also be a common diagnosis in chest pain patients with no demonstrable coronary disease. Future studies of coronary artery disease negative patients with chest pain should include assessments for the presence of G.A.D. Our results also suggest that chest pain may be a common symptom in G.A.D. The possibility that chest pain should be included in the diagnostic criteria for this disorder should be the subject of further investigation.

scholarly journals Environmental transmission of generalized anxiety disorder from parents to children: worries, experiential avoidance, and intolerance of uncertainty

2017 ◽  
Vol 19 (2) ◽  
pp. 137-147 ◽  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Experiential Avoidance ◽  
Cognitive Styles ◽  
Intolerance Of Uncertainty ◽  
Generalized Anxiety ◽  
Verbal Information ◽  
Child Transmission ◽  
Potential Threat ◽  
Theoretical Approaches

Generalized anxiety disorder (GAD) runs in families. Building on recent theoretical approaches, this review focuses on potential environmental pathways for parent-to-child transmission of GAD. First, we address child acquisition of a generalized pattern of fearful/anxious and avoidant responding to potential threat from parents via verbal information and via modeling. Next, we address how parenting behaviors may contribute to maintenance of fearful/anxious and avoidant reactions in children. Finally, we consider intergenerational transmission of worries as a way of coping with experiential avoidance of strong negative emotions and with intolerance of uncertainty. We conclude that parents with GAD may bias their children's processing of potential threats in the environment by conveying the message that the world is not safe, that uncertainty is intolerable, that strong emotions should be avoided, and that worry helps to cope with uncertainty, thereby transmitting cognitive styles that characterize GAD. Our review highlights the need for research on specific pathways for parent-to-child transmission of GAD.

scholarly journals When Anxiety Actually Hides an Overdose of Missing. The Therapeutic Approach of a Transgenerational Journey

2020 ◽  
Vol 11 (3sup1) ◽  
pp. 48-53
Author(s):  
Mioara Grigoraş ◽  
Keyword(s):  
Anxiety Disorder ◽  
General Population ◽  
Anxiety Disorders ◽  
Generalized Anxiety Disorder ◽  
Stressful Life Events ◽  
Early Adulthood ◽  
Panic Attacks ◽  
Generalized Anxiety ◽  
Cultural Aspects ◽  
Unrealistic Expectations

Many people suffer from anxiety and panic attacks, statistics showing that 1 in 3 people have their lives affected because of these worrying and annoying symptoms. One of the most common anxiety disorders observed in general medical practice and in the general population is the generalized anxiety disorder. In about 85% of cases, generalized anxiety does not appear alone, but is accompanied by other psychological problems, of which the most common are: depression, other anxiety disorders, substance abuse, digestive problems, etc. The patient diagnosed with Generalized Anxiety Disorder (GAD) usually has suffered from severe anxiety and worries about several different areas of their life for at least six months. It occurs in 5-9% of the population, and the incidence is twice as high in women as in men. Generalized anxiety usually begins in adolescence or early adulthood. GAG is caused by several factors: 30%-50% of it can be genetic in nature, but it also can be caused by experiences during childhood, recent stressful life events, unrealistic expectations about others and oneself, conflicts in relationships, alcohol consumption, coping skills and other factors (Ciubara et al., 2018). Studies show that the anxiety levels in the general population have risen over the past 50 years - probably due to declining social cohesion affecting communities, unrealistic expectations for quality of life, excessive focus on negative news, and other factors, social and cultural aspects.

scholarly journals The Neurobiological Mechanisms of Generalized Anxiety Disorder and Chronic Stress

2017 ◽  
Vol 1 ◽  
pp. 247054701770399 ◽  
Author(s):  
Michelle A. Patriquin ◽  
Sanjay J. Mathew
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Mental Health Research ◽  
Classification Systems ◽  
Psychiatric Research ◽  
Generalized Anxiety ◽  
Research Domain Criteria ◽  
Diagnostic And Statistical Manual ◽  
Units Of Analysis ◽  
Research Domain

Two classification systems are now at the forefront of clinical psychiatric research: (1) Diagnostic and Statistical Manual, Fifth Edition and (2) the National Institutes of Mental Health Research Domain Criteria. Herein, we propose that these two classification systems are complementary rather than mutually exclusive, and when combined provide important information for understanding aspects of the pathophysiology related to Generalized Anxiety Disorder (GAD). The neurobiological literature for GAD and one relevant research domain criteria component, sustained threat, are reviewed from multiple units of analysis (genetic, neuroimaging, neuroendocrine, and psychophysiological). It is hypothesized that generating a comprehensive, biologically based understanding of the relationship between GAD, sustained threat, and the measureable units of analysis will provide information critical to design the most effective treatments.

scholarly journals The diagnosis and therapy of comorbid anxiety and depression disorders in clinical practice

2021 ◽  
pp. 102-112
Author(s):  
N. N. Petrova ◽  
K. S. Savickaya
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Clinical Case ◽  
Depressive Disorders ◽  
Combined Therapy ◽  
Panic Attacks ◽  
Anxiety And Depression ◽  
Generalized Anxiety ◽  
Diagnostic Difficulties ◽  
Depression Disorders

Objective: to discuss problems of diagnostics and psychopharmacotherapy of associated depressive disorders and anxiety circle disorders.Material and methods. The article is an analysis of a clinical case with the use of clinical and catamnestic method.Results. Diagnostics of Generalized Anxiety Disorder, issues of its comorbidity with other mental disorders including anxiety and depressive disorders are discussed. The principles of panic disorder diagnosis are analyzed. Diagnostic criteria of associated anxiety and depression in ICD-10, DSM-5 and ICD-11 are considered. Modern approaches to the choice of therapeutic tactics in comorbidal anxiety and depression are given. The analysis of the patient’s treatment is carried out with the justification of the choice of drugs. The possibilities of combined therapy of associated anxiety and depression disorders using vortioxetine are demonstrated. Achievement of qualitative remission of mental disorder without residual symptomatology and full restoration of social functioning of the patient with associated depressive and anxious disorders is shown.Conclusion. The clinical case demonstrates a characteristic chronic fluctuating course of GTR both in combination with different depths of depression and with other anxiety disorders (panic attacks). Diagnostic difficulties and therapeutic possibilities of a patient with double diagnosis: Generalized Anxiety Disorder and Depressive Episode have been analyzed.

Panic Attacks in Generalized Anxiety Disorder

2013 ◽  
Vol 201 (1) ◽  
pp. 52-55 ◽  
Author(s):  
Michael Van Ameringen ◽  
William Simpson ◽  
Beth Patterson ◽  
Catherine Mancini
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Panic Attacks ◽  
Generalized Anxiety

scholarly journals Brain functional connectivity correlates of response in the 7.5% CO2 inhalational model of generalized anxiety disorder: a pilot study

2019 ◽  
Author(s):  
Nathan T.M. Huneke ◽  
M. John Broulidakis ◽  
Angela Darekar ◽  
David S. Baldwin ◽  
Matthew Garner
Keyword(s):  
Heart Rate ◽  
Anxiety Disorder ◽  
Pilot Study ◽  
Functional Connectivity ◽  
Healthy Volunteers ◽  
Generalized Anxiety Disorder ◽  
Regions Of Interest ◽  
Generalized Anxiety ◽  
Affective Valence ◽  
Potential Threat

AbstractThe 7.5% CO2 inhalational model (‘CO2 challenge’) can be used to explore potential treatments for generalized anxiety disorder. However, it remains unknown how inter-individual variability in the functional architecture of negative affective valence systems might relate to the anxiogenic response to CO2 challenge. In this pilot study, we explored how connectivity in systems associated with processing potential threat (“anxiety”) correlated with behavioural measures of anxiety following prolonged CO2 inhalation.The negative affective valence system was identified using a passive emotional face perception task. Spherical regions of interest were created from peak voxels of significant brain activation when 100 young adult participants viewed emotional faces compared with black and white concentric circles during a functional MRI scan. Using these regions of interest, generalized psychophysiological interaction (gPPI) analysis was undertaken to explore task-evoked functional connectivity in a separate group of 13 healthy volunteers. Within 7 days of the scan, these participants underwent CO2 challenge and results from the gPPI analysis were correlated with CO2 outcome measures.Exposure to CO2 challenge significantly increased subjective anxiety, negative affect, systolic blood pressure and heart rate. Functional connectivity between the ventromedial prefrontal cortex and right amygdala was positively correlated with heart rate. Increased connectivity between the vmPFC and the right amygdala, and decreased connectivity between the midcingulate cortex (MCC) and the left amygdala, correlated with subjective anxiety during CO2 challenge.Response to CO2 challenge was related to task-evoked functional connectivity between regions known to be important in processing potential threat. Further studies are required to assess whether this translates into clinical populations. Measures of functional connectivity within emotional processing networks could be potential biomarkers to enable stratification of healthy volunteers, and to examine correlates of response, in trials using experimental medicine models.

Sign in / Sign up

Export Citation Format

Share Document