Comparative Effectiveness Research and the Future Practice of Medicine
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Two previous U.S. studies found that although generalized anxiety disorder (GAD) without self-perceived excessive worry was milder than GAD with excessive worry, its persistence, impairment, and risk for subsequent onset of other mental disorders were still substantial. This study examined the implications of relaxing the "excessiveness" criterion on the prevalence and socio-demographic profile of GAD in a Chinese population sample by considering both self and others' perception of excessive worry.2,005 respondents aged 15-65 years participated in a structured telephone interview that covered socio-demographic profile, 12-month DSM-IV diagnosis of GAD, core depressive symptoms, longest duration of worry episode, number of domains of worry, impairment measured by the Sheehan Disability Scale, and treatment-seeking. Excessive worry was assessed from the perception of both respondents and others as reported by respondents.The 12-month prevalence of GAD increased from 3.4 to 4% when the excessiveness requirement was relaxed. Excessive GAD and nonexcessive GAD had similar socio-demographic, symptom, chronicity, impairment, depressive symptom, and treatment-seeking profiles.GAD without excessive worry was less common than GAD with excessive worry but was likely to be a valid nosological entity. Future iterations of the DSM-IV should clarify whether excessive worry should be retained and, if so, how individuals who only reported excessive worries perceived by others should be optimally assessed.
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Generalized anxiety disorder (GAD) involves excessive and uncontrollable worry as well as chronic somatic anxiety symptoms. The lifetime prevalence is estimated at 5.7%, suggesting that GAD is a pervasive problem in the United States. GAD disproportionately affects women compared to men. Worry typically involves verbal-linguistic thought instead of imagery and tends to be vague and abstract rather than concrete. Worry appears to suppress physiological activation and may interfere with emotional processing following exposure to stressful stimuli. GAD is characterized by autonomic inflexibility and chronic muscle tension rather than autonomic hyperactivity. Individuals with GAD tend to report worry about minor topics more often than nonanxious individuals. GAD may be maintained by meta-cognitive beliefs about the functions and consequences of worry. These topics along with differences between worry, obsessions, and depressive rumination are examined in the chapter.
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This chapter contains section titled: A Definition of Worry Generalized Anxiety Disorder A Metacognitive Model of Gad Implications for Treatment Eliciting Metacognitions Generating a Case Formulation Socialis Ation Modifying Type 2 Worry and Negative Beliefs Modifying Positive Beliefs Strategy Shifts (Developing New Plans) Relapse Prevention and Co-Morbidity Conclusions
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Background: There are widespread anxiety and fear related to contracting COVID-19 infection in the general public ever since the outbreak of COVID-19, which had now increased to a great extent due to the ever-rising number of positive cases and mortality rates associated with COVID-19. Aim: The present study aimed to evaluate the anxiety related to contracting COVID-19 infection in the public. Methodology: An online survey was conducted using the SurveyMonkey® platform-generated link in which a COVID-19 anxiety-specific questionnaire was used to assess anxiety and worry related to contracting COVID-19. A total of 462 responses were analyzed. About one-sixth (18.8%) of the responders reported anxiety in at least one domain and worry in at least one domain related to contracting COVID-19 infection. While 42.2% of the responders had anxiety in at least one domain, highest being in the domain of anxiety related to behaviors of others, about one-fourth of the responders (26.6%) expressed worry in at least one domain, more in the domain of worry related to family members going out to buy something or for work. Males and people of younger age group had significantly greater anxiety score, and those with a chronic physical illness had significantly greater worry score. Conclusion: The present study suggests that there is a heightened level of anxiety in the society due to COVID-19 and about 18.8% of the people may be having anxiety severe enough to require clinical attention. However, the survey findings should be interpreted well with regard to its limitations being circulated in few social media platforms and, therefore, may not be generalized to the entire country.
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Generalized anxiety
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Abstract Generalized anxiety disorder (GAD) is a relatively new concept. Worry is the main characteristic of GAD, which can be a highly debilitating illness, with profound effects on a person's career, relationships, and overall wellbeing. About 3% of people suffer from generalized anxiety disorder, and women are twice as likely to be affected as men. There are four main theories of worry: the metacognitive model; the cognitive avoidance theory; intolerance of uncertainty; and the mood-as-input theory.
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Chapter 1 explores the nature of generalised anxiety disorder (GAD). This includes the DSV-IV diagnostic criteria for GAB, its prevalence, GAD in the elderly. The differences between GAD and anxiety following a traumatic experience, and normal worry vs abnormal worry are also discussed. The chapter also presents an outline of the Mastery of Your Anxiety and Worry treatment program, the benefits, costs, and alternative treatments, to allow clients to make an informed decision about if the program is right for them.
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