What is General Anxiety Disorder (GAD)?
GAD is a psychological condition whose distinctive feature is, according to DSM-IV TR, excessive worry about a variety of topics such as health, finances, social relationships, safety and other minor matters. Individuals with GAD report to have frequent, intense and impossible to control worries. In addition, recent research has shown that GAD is accompanied by difficulty in concentrating, irritability, insomnia and body symptoms such as headaches, muscle tension and nausea. Some studies also suggest that GAD is more common in women than men mainly because of the less effective strategies used by women to manage worry1.
A recent study conducted using DSM-IV criteria has shown that General Anxiety Disorder co-occurs mostly with Panic Disorder(41%), Social Phobia(42%) and Major Depressive Disorder(29%)2. This, on the other hand, is an indicator of the degree of comorbidity of GAD.
Worry vs Rumination
One of the first distinctions to be made in order to better define the nature of worry, the main feature of GAD, is to differentiate it from rumination. Among the main variables between worry and rumination are included chronicity, unpleasantness, reality of problem and future orientation. In regard, worry has a longer duration, the content of worries is more future oriented, more disturbing , less realistic and worries are associated with greater feelings of insecurity19.
Behavior Patterns
Problem-Solving Ability
Worry is considered to be a manifestation of the attempts to predict or solve real life problems. In non-pathological cases worry is a constructive process, however, when associated with poor problem-solving ability or low problem-solving confidence it becomes pathological inasmuch as the apparent unsolvability of problems becomes a further worry.
A 1996 study by Graham C. L. Davey et al.3 suggests that problem solving confidence has an impact in catastrophizing personal worries; where catastrophizing means to perceive a situation as dimmer and more difficult to control than it really is(e.g.: John thinks his life will be valueless if his girlfriend leaves him). On the other hand, there have been studies suggesting there is no relation between GAD and deficiencies in problem-solving abilities4.
Thought control strategies are an important aspect of GAD as far as they appear to be distinctive of GAD individuals as compared to controls5. In a study6, the TCQ(Thought Control Questionnaire) was given to 42 individuals showing GAD and 55 healthy controls. From the answers it could be deduced that individuals in the GAD condition made resort to punishment strategies(hit one`s head against the table, bite one`s hand etc.) instead of distraction strategies(play basketball, go out with friends etc.) in order to cope with worry. As result, GAD is to be related with some sort of desperation stemming from the odd and impractical thought control strategies.
1)This refers to a study(Gender differences in worry and associated cognitive-behavioral variables Robichaud, Dugas, & Conway, 2003) conducted with a sample consisting of 217 female and 100 male university students who completed six questionnaires assessing worry. Women reported a more negative problem orientation and engaging in more thought suppression, a type of cognitive avoidance. Thought suppression and negative orientation were found to have a cause-effect relationship with excessive worry.
2) Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample; Brown, Campbell, Lehman, Grisham, & Mancill, 2001.
3) Catastrophic worrying as a function of changes in problem-solving confidence, Graham C.L. Davey, Michael Jubb and Catherine Cameron, 1996.
4) Worrying, social problem-solving abilities, and social problem-solving confidence, Graham C. L. Davey, 1994.
5) à Case-Control Method.
6) Thought Control Strategies in Generalized Anxiety Disorder, Meredith E. Coles and Richard G.Heimberg, 2005.
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