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==Overview==
==Overview==
Anxiety as a symptom was recognized by [[Sigmund Freud]].
Generalized anxiety disorder was first recognized as a [[symptom]] by [[Sigmund Freud]]. In 1980, 'The American Psychiatric Association' introduced GAD as a diagnosis in the [[DSM-III]].


==Historical Perspective==
==Historical Perspective==
[[Sigmund Freud]] recognized anxiety as a "signal of danger" and a cause of "defensive behavior". He believed we acquire anxious feelings through classical conditioning and traumatic experiences.


We maintain anxiety through operant conditioning; when we see or encounter something associated with a previous traumatic experience, anxious feelings resurface. We feel temporarily relieved when we avoid situations which make us anxious, but this only increases anxious feelings the next time we are in the same position, and we will want to escape the situation again and therefore will not make any progress against the anxiety.
*In the late 19th century, [[Sigmund Freud]] recognized [[anxiety]] as:<ref name="pmid11225507">{{cite journal| author=Kessler RC, Keller MB, Wittchen HU| title=The epidemiology of generalized anxiety disorder. | journal=Psychiatr Clin North Am | year= 2001 | volume= 24 | issue= 1 | pages= 19-39 | pmid=11225507 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11225507  }} </ref>
**A "signal of danger"
**A cause of "defensive [[behavior]]"
*He believed we acquire [[anxious]] feelings through [[classical conditioning]] and [[trauma]]tic experiences.
 
*In the 19th century into the 20th century, the terms used to diagnose generalized anxiety included:<ref name="pmid28867935">{{cite journal| author=Crocq MA| title=The history of generalized anxiety disorder as a diagnostic category. | journal=Dialogues Clin Neurosci | year= 2017 | volume= 19 | issue= 2 | pages= 107-116 | pmid=28867935 | doi= | pmc=5573555 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28867935  }} </ref>
**“[[Pantophobia]]”
**“[[Anxiety neurosis]]”
***Such terms designated [[paroxysmal manifestations]] ([[panic attacks]]) as well as [[interparoxysmal phenomenology]] (the apprehensive mental state).
***Generalized anxiety was considered one of the numerous symptoms of [[neurasthenia]], a vaguely defined illness.
 
*In 1980, 'The American Psychiatric Association' introduced GAD as a diagnosis in the [[DSM-III]].
**[[Anxiety neurosis]] was split into:<ref name="pmid21285432">{{cite journal| author=Torpy JM, Burke AE, Golub RM| title=JAMA patient page. Generalized anxiety disorder. | journal=JAMA | year= 2011 | volume= 305 | issue= 5 | pages= 522 | pmid=21285432 | doi=10.1001/jama.305.5.522 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21285432  }} </ref>
***GAD
***[[Panic disorder]]
***We maintain [[anxiety]] through [[operant conditioning]];  
****When we see or encounter something associated with a previous [[trauma]]tic experience, anxious feelings resurface.  
***We feel temporarily relieved when we avoid situations which make us anxious.
****This only increases [[anxious]] feelings the next time we are in the same position, and we will want to escape the situation again and therefore will not make any progress against the [[anxiety]].
 
===Development of Diagnostic Criteria for Generalized Anxiety Disorder===
*In 1980, [[DSM-III]] portrayed GAD as:<ref name="pmid7666382">{{cite journal| author=Wittchen HU, Kessler RC, Zhao S, Abelson J| title=Reliability and clinical validity of UM-CIDI DSM-III-R generalized anxiety disorder. | journal=J Psychiatr Res | year= 1995 | volume= 29 | issue= 2 | pages= 95-110 | pmid=7666382 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7666382  }} </ref>
**Generalized, [[persistent anxiety]]
*In 1987, [[DMS-III-R]] portrayed GAD as:
**Unrealistic/excessive [[anxiety ]]and worry (apprehensive expectation) about 2 or more life circumstances
*In 1992, ICD-10 portrayed GAD as:
**Generalized and persistent anxiety, not restricted to or even predominating in any environmental circumstances (ie, “free-floating”)
*The ICD-11, beta draft, portrayed GAD as:
**Marked symptoms of anxiety accompanied by either general apprehension (ie, “free-floating anxiety”) or worry focused on multiple everyday events (family, health, finances, school, or work)
*In 1994, DSM-IV portrayed GAD as:
**[[Excessive anxiety]] and [[worry]] (apprehensive expectation) about a number of events or activities
**Difficult to control the worry
*In 2013, DSM-V portrayed GAD as:
**[[Excessive anxiety]] and [[worry]] (apprehensive expectation) about a number of events or activities
**Difficult to control the [[worry]]


==References==
==References==

Latest revision as of 17:46, 27 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Irfan Dotani

Overview

Generalized anxiety disorder was first recognized as a symptom by Sigmund Freud. In 1980, 'The American Psychiatric Association' introduced GAD as a diagnosis in the DSM-III.

Historical Perspective

  • In 1980, 'The American Psychiatric Association' introduced GAD as a diagnosis in the DSM-III.
    • Anxiety neurosis was split into:[3]
      • GAD
      • Panic disorder
      • We maintain anxiety through operant conditioning;
        • When we see or encounter something associated with a previous traumatic experience, anxious feelings resurface.
      • We feel temporarily relieved when we avoid situations which make us anxious.
        • This only increases anxious feelings the next time we are in the same position, and we will want to escape the situation again and therefore will not make any progress against the anxiety.

Development of Diagnostic Criteria for Generalized Anxiety Disorder

  • In 1980, DSM-III portrayed GAD as:[4]
  • In 1987, DMS-III-R portrayed GAD as:
    • Unrealistic/excessive anxiety and worry (apprehensive expectation) about 2 or more life circumstances
  • In 1992, ICD-10 portrayed GAD as:
    • Generalized and persistent anxiety, not restricted to or even predominating in any environmental circumstances (ie, “free-floating”)
  • The ICD-11, beta draft, portrayed GAD as:
    • Marked symptoms of anxiety accompanied by either general apprehension (ie, “free-floating anxiety”) or worry focused on multiple everyday events (family, health, finances, school, or work)
  • In 1994, DSM-IV portrayed GAD as:
    • Excessive anxiety and worry (apprehensive expectation) about a number of events or activities
    • Difficult to control the worry
  • In 2013, DSM-V portrayed GAD as:

References

  1. Kessler RC, Keller MB, Wittchen HU (2001). "The epidemiology of generalized anxiety disorder". Psychiatr Clin North Am. 24 (1): 19–39. PMID 11225507.
  2. Crocq MA (2017). "The history of generalized anxiety disorder as a diagnostic category". Dialogues Clin Neurosci. 19 (2): 107–116. PMC 5573555. PMID 28867935.
  3. Torpy JM, Burke AE, Golub RM (2011). "JAMA patient page. Generalized anxiety disorder". JAMA. 305 (5): 522. doi:10.1001/jama.305.5.522. PMID 21285432.
  4. Wittchen HU, Kessler RC, Zhao S, Abelson J (1995). "Reliability and clinical validity of UM-CIDI DSM-III-R generalized anxiety disorder". J Psychiatr Res. 29 (2): 95–110. PMID 7666382.