Generalized anxiety disorders

David A. Spiegel and David H. Barlow

CNnicalJeatures

Classification

Diagnosis

PSM„criteria

I.CD-lo.cnteria

PifferenM.diaflnosis

Epidemiology

Comorbidity

Aetiology

Genetic„factors

Neu.robiologjca.!„mecha.n.is.ms The„noradrenergic, .neryous., system

The„hypothalamic-pituitary-adrena!.axis

Theamygdala.., and,, .the.., ,be,d„ nn..u,c!e.u,s„.of, the., stria.,terminalis

Theseptohippocampalsystem .lbe,hayio,u,ra! „inhibition ..system)

The,.Mbe,n,zodiazepine-g-amin,obutyric., ,ac,id,„,system

Other.neurotransmitter.sysiems

Psychosocial .mechanisms

Stressfu!, !ife„events

Parenting

Course „and„.prognosis Treatment Pharmacotherapy

Benzodiazepines

Azapirones

Antidepressants

Psychosocia! . treatment

Combined, pharmacotherapy .an.d„ps.ychotherap.y Effect.. of „comorbidity. on. treatment. outcome .and„vice „versa C!inica!„.management

Conclusions

Chapter., References

Anxious apprehension and over-concern are common to many anxiety and mood disorders. Prior to 1980 in the American DSM diagnostic system, and 1992 in the international ICD system, individuals who experienced those symptoms in the absence of a realistic focus of concern were classified as having an 'anxiety neurosis' (DSM-II) or 'anxiety state' (ICD-9). In DSM-III, panic disorder was split off from that classification, and the residual category was renamed generalized anxiety disorder (GAD). A similar nomenclature was adopted in ICD-10.

Since its inception, GAD as a nosological entity has been troubled by problems of poor reliability and high comorbidity. Those concerns have prompted several revisions of the DSM criteria and also have raised more basic questions regarding the validity of GAD as a disorder distinct from other anxiety and mood states. The question of what is GAD is still being debated. Unfortunately, most of the information we have about it, including the majority of the published treatment studies, is based on criteria that are now outdated.

Break Free From Passive Aggression

Break Free From Passive Aggression

This guide is meant to be of use for anyone who is keen on developing a better understanding of PAB, to help/support concerned people to discover various methods for helping others, also, to serve passive aggressive people as a tool for self-help.

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