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Reliable diagnosis and assessment of disorder severity can guide the nature, frequency and duration of therapeutic interventions. Given its prevalence and associated impairment, the significant burden imposed on health care resources, accurate assessment of GAD and its severity by mental health and primary care clinicians is an increasingly important goal.
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Additionally, there must be evidence of clinically significant functional impairment. The focus of worry is not on a situation that could be more parsimoniously subsumed under another anxiety disorder (e.g., fear of embarrassment or humiliation in social situations, as in social anxiety disorder). The worrying is difficult to control, and the individual experiences three or more associated symptoms, including restlessness, fatigue, difficulty concentrating, irritability, muscle tension and sleep disturbance. Among the most consequential of these revisions has been the designation of uncontrollable worry (apprehensive expectation) as the hallmark feature of the disorder and the specification of six key associated symptoms, primarily centering on motor tension (e.g., muscle tension, aches or soreness, restlessness) and vigilance (e.g., feeling keyed up or on edge, difficulty concentrating).Īs currently defined in the DSM-IV-TR, a diagnosis of GAD involves excessive anxiety and worry about a number of events or activities, which occur more days than not for at least six months. A number of factors have contributed to these developments including elimination of GAD's status as a residual category in the DSM-III-R and several empirically based refinements in the diagnostic criteria for GAD. Although historically neglected relative to other anxiety disorders, recent years have witnessed increasing attention and interest in the nature and treatment of GAD. population during any given 12-month period (Grant et al., 2005 Kessler et al., 2005). Generalized anxiety disorder (GAD) is a chronic, impairing and highly comorbid psychiatric condition afflicting an estimated 2.1% to 3.1% of the U.S.