User:Ongmianli/Portfolios/Generalized anxiety disorder

=DSM-IV Criteria: Generalized Anxiety Disorder= (Includes Overanxious Disorder of Childhood)


 * A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
 * B. The person finds it difficult to control the worry.
 * C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months).
 * Restlessness or feeling keyed up or on edge
 * Being easily fatigued
 * Difficulty concentrating or mind going blank
 * Irritability
 * Muscle tension
 * Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
 * (Note: Only one item is required in children.)


 * D. The focus of the anxiety and worry is not confined to features of an Axis I disorder, e.g., the anxiety or worry is not about having a Panic Attack (as in Panic Disorder), being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives(as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder.
 * E. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social,occupational, or other important areas of functioning.
 * F. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.

=Proposed DSM-5 Criteria: Generalized Anxiety and Worry Disorder=
 * A. Excessive anxiety and worry (apprehensive expectation) about two (or more) domains of activities or events (for example, domains like family, health, finances, and school/work difficulties)
 * B. The excessive anxiety and worry occur on more days than not for three months or more
 * C. The anxiety and worry are associated with one or both of the following symptoms:
 * a. Restlessness, feeling keyed up, or on edge
 * b. Muscle tension


 * D. The anxiety and worry are associated with one or more of the following behaviors:
 * a. Marked avoidance of situations in which a negative outcome could occur
 * b. Marked time and effort preparing for situations in which a negative outcome could occur
 * c. Marked procrastination in behavior or decision-making due to worries
 * d. Repeatedly seeking reassurance due to worries


 * E. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social,occupational, or other important areas of functioning.*
 * F. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.*
 * G. The anxiety and worry are not restricted to symptoms of another disorder, such as Panic Disorder (e.g.,anxiety about having a panic attack), Social Anxiety Disorder (e.g., being embarrassed in public), Obsessive-Compulsive Disorder (e.g, anxiety about being contaminated), Separation Anxiety Disorder (e.g., anxiety about being away from home or close relatives), Anorexia Nervosa (e.g., fear of gaining weight), Somatization Disorder(e.g., anxiety about multiple physical complaints), Body Dysmorphic Disorder (e.g., worried about perceived appearance flaws), Hypochondriasis (e.g,. belief about having a serious illness), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder.*

(*)An option that is still under discussion is the possibility of deleting criteria E, F, and G

Diagnostic Changes
There were no diagnostic changes in the DSM-5.

Demographic Information
This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of Generalized Anxiety Disorder that they are likely to see in their clinical practice.

Brief Screening Tools
The following are brief screening tools that typically take less than 5 minutes to administer to accurately diagnose Generalized Anxiety Disorder:


 * Penn State Worry Questionnaire
 * Penn State Worry Questionnaire- Child Version
 * Screen for Child Anxiety Related Emotional Disorders - Child Form
 * Screen for Child Anxiety Related Emotional Disorders - Parent Form

Clinically Significant Change Benchmarks with Common Instruments and Mood Rating Scales
Listed below are clinically significant change benchmarks of common screening instruments used for Generalized Anxiety Disorder.

{| class="wikitable sortable" border="1"
 * colspan="3" style="text-align:center;font-size:130%" width="300" |  Cut-scores
 * colspan="3" style="text-align:center;font-size:120%" |  Critical Change (unstandardized scores)
 * colspan="3" style="text-align:center;font-size:130%" width="300" |  Cut-scores
 * colspan="3" style="text-align:center;font-size:120%" |  Critical Change (unstandardized scores)

}
 * colspan="1" style="text-align:center;font-size:130%;" |  Measure
 * style="text-align:center;font-size:110%" |  A
 * style="text-align:center;font-size:110%" |  B
 * style="text-align:center;font-size:110%" |  C
 * style="text-align:center;font-size:110%" |  95%
 * style="text-align:center;font-size:110%" |  90%
 * style="text-align:center;font-size:110%" |  SEdifference
 * Penn State Worry Questionnaire (Chelminski & Zimmerman, 2002)
 * 51
 * 73
 * 59
 * 9
 * 8
 * 4.8
 * Penn State Worry Questionnaire- Past Week (Stober & Bittencourt, 1998)
 * 47
 * b
 * b
 * 9
 * 7
 * 4.4
 * Penn State Worry Questionnaire- Child Version (Chorpita et al., 1997)
 * 16
 * 18
 * 17
 * 8
 * 7
 * 4.0
 * Screen for Child Anxiety Related Emotional Disorders- Child Version (SCARED; Birmaher et al., 1997)
 * Anxiety vs. Other Disorders
 * Total
 * a
 * 41
 * 22
 * 12
 * 10
 * 5.9
 * Generalized Anxiety Scale
 * a
 * 16
 * 8
 * 9
 * 8
 * 4.7
 * GAD vs Other Anxiety Disorders
 * Generalized Anxiety Scale
 * 2
 * 17
 * 9
 * 9
 * 7
 * 4.5
 * GAD vs Other Anxiety Disorders
 * Generalized Anxiety Scale
 * 2
 * 17
 * 9
 * 9
 * 7
 * 4.5
 * 7
 * 4.5