Phenomenology of Generalized Anxiety Disorder

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.