DSM-IV Generalized Anxiety Disorder Research Articles

Specificity of generalized anxiety disorder symptoms and processes

This study's main goal is to test the broad specificity of generalized anxiety disorder (GAD) symptom and process variables. These variables were compared in four groups of participants: (1) 24 patients with primary GAD, (2) 24 patients with secondary GAD, (3) 38 other anxiety disorder patients, and (4) 20 nonclinical control subjects. Each participant received a structured diagnostic interview and a series of standardized questionnaires. The results show that DSM-IV GAD symptoms (worry, GAD physical symptoms, and interference due to worry and anxiety) distinguish GAD patients from those with other anxiety disorders. Two process variables, problem orientation and intolerance of uncertainty, also differentiated GAD patients from other anxiety disorder patients. Overall, these results support the DSM-IV definition of GAD and the broad specificity of problem orientation and intolerance of uncertainty as GAD process variables.

Empirical evaluation of DSM-IV geralized anxiety disorder criteria in children and adolescents

Evaluated the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) generalized anxiety disorder (GAD) criteria in children and adolescents. Clinic-referred children meeting criteria for DSM-IV GAD, those meeting criteria for another DSM-IV anxiety disorder, and normal children participated in a structured interview and completed self-report questionnaires. Groups were compared in terms of interview and self-report measures to examine convergent and discriminant validity. In addition, developmental differences, cross-informant symptom and syndrome agreement, and validity of parent and child report were determined. Finally, the symptoms comprising the GAD associated symptom criterion (Criterion C) were examined in terms of rate of endorsement and predictive power. Results showed that parameters of worry differentiated children with GAD from those with other anxiety disorders and controls. Developmental differences in the sample did not appear to necessitate a separate criteria set for the classification of generalized anxiety in children of this age. Symptoms from GAD Criterion C evidenced moderately high rates of endorsement and acceptable predictive power. Overall, the DSM-IV CAD criteria for children and adolescents are supported, but further evaluation is necessary before firm conclusions can be drawn.

Discriminant validity of the symptoms constituting the DSM-III-R and DSM-IV associated symptom criterion of generalized anxiety disorder

The associated (somatic) symptom criterion for DSM-IV generalized anxiety disorder (GAD) requires at least 3 of a list of 6 symptoms that previously resided in the Motor Tension (MT) and Vigilance and Scanning (VS) clusters of DSM-III-R. The decision to retain these six symptoms while eliminating all symptoms from the Autonomic Hyperactivity (AH) cluster, was made with limited data on discriminant validity and classification accuracy of the proposed DSM-IV associated symptom criterion. The present study examined this issue in a large sample ( N = 390) of patients with a DSM-III-R anxiety or mood disorder, all of whom were administered the GAD associated symptom ratings from the Anxiety Disorders Interview Schedule-Revised. Scores from the MT, VS, and DSM-IV symptom clusters correlated more strongly ( ps < .05) with measure of GAD (e.g., Penn State Worry Questionnaire) than did AH scores. Analyses that differentiated patients with GAD from other anxiety disorder groups produced the largest effect sizes using MT, VS, and DSM-IV cluster scores; GAD differed from mood disorders only on scores from the AH cluster. Whereas 98.6% of patients with GAD met the “3 of 6 symptoms” criterion proposed in DSM-IV, a large percentage of patients with other diagnoses met this criterion also (range = 35.3% to 92.9%). Raising the criterion to require four or more symptoms increased specificity without adversely affecting sensitivity. Implications for conceptual models of GAD are considered.