The focus on avoidance in GAD has led to a plethora of research on what people with GAD are afraid will happen if they exit the safety of their current situation. But this research has not been able to answer the question of what is so frightening about potential negative events. While fear of being in pain and fear of death were rated as highly likely reasons for avoidance in GAD, these fears could only explain a part of the variance in avoidance behavior.
Symptoms of GAD
It is known that people with GAD are afraid of both social and nonsocial events, but it is not yet clear which specific fears contribute to the symptoms of GAD.
The current study investigated why people with Generalized Anxiety Disorder (GAD) avoid situations in which potential negative outcomes could occur. The researchers used questionnaire data from 57 adult patients diagnosed with GAD and found that fear of negative evaluation, social interaction anxiety, physical concerns (like pain), and fears of death were significantly associated with more avoidance.
GAD is characterized by excessive worry about many everyday life events in combination with the presence of at least three out of six additional symptoms for at least six months.
The six additional symptoms
- Difficulty concentrating or mind going blank,
- Muscle tension,
- Overly tired,
- Restlessness or difficulty sitting still, and sleep disturbance (difficulty falling/staying asleep). For children, this last symptom may be expressed by having difficulty staying seated or resisting going to bed or difficulties with morning awakenings.
A recent study that investigated the prevalence of GAD in a community sample found that 2% of the respondents were diagnosed with GAD and another 2% had symptoms substantially impairing their daily lives, but did not meet the full criteria for GAD.
In GAD, symptoms of anxiety are present more days than not for at least six months and the anxiety causes significant distress or impairs the person’s ability to function.
Although worry is always present in GAD, symptoms of anxiety may fluctuate over time.
Causes of GAD
The exact cause of GAD is not entirely understood. It has been suggested that biological, genetic, and environmental factors all play a role. Also, high levels of stress can trigger symptoms of GAD (stress-diathesis model).
Recent studies have shown that the brain structures involved in fear processing are also involved in worry. For example, patients with GAD showed increased brain activity in the anterior cingulate cortex (ACC) and insula, which are involved in fear processing, when they saw threat-related words.
GAD can also be caused by abuse or trauma occurring during childhood.
A high percentage of people diagnosed with GAD report a history of abuse as children which might cause the development of mental problems and disorders.
Risk factors of GAD
GAD is more common in women than men. Also, it has been reported that people with GAD have increased rates of the following disorders: Substance use disorder, depression, social phobia, specific phobia, panic disorder, and dysthymia.
Preventions of GAD
Generalized Anxiety Disorder can be treated effectively with medications and therapies. One type of therapy that has proven very effective is Cognitive Behavioral Therapy (CBT). CBT helps people to recognize their thought patterns and change them, which decreases symptoms of anxiety. Research shows that 90-95% of people benefited from CBT for GAD. Another treatment is mindfulness-based stress reduction (MBSR) which is a combination of meditation and yoga.
Generalized Anxiety Disorder can be managed with lifestyle changes as well, such as exercising regularly, practicing relaxation techniques, avoiding caffeine and alcohol, and getting enough sleep. Eating healthy food is also important because certain foods increase anxiety symptoms.
In addition to CBT and MBSR, there are other types of therapies that can help with GAD such as psychodynamic or supportive therapy.