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Avdagic, Elbina. "Enhancing Treatment Engagement, Adherence and Outcomes in Generalised Anxiety Disorder (GAD)." Thesis, Griffith University, 2014. http://hdl.handle.net/10072/367878.
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Generalised anxiety disorder (GAD) is a chronic condition affecting around 5% of the population over the lifetime (Kessler, Berglund, Demler, Jin, & Walters, 2005). It is characterised by pervasive and uncontrollable worry and is associated with high rates of comorbidity and significant psychosocial impairment (Roemer & Orsillo, 2007). Although cognitive-behavioural therapy (CBT) has been found to be an efficacious treatment for GAD, the percentage of individuals with GAD who do not engage and adhere to CBT treatment protocols, disengage from therapy prematurely or continue to experience significant residual symptoms after treatment is larger than for other anxiety disorders (Wittchen, 2002; Westra, Arkowitz, & Dozois, 2009). Thus, addressing factors related to motivating individuals with GAD to start therapy, adhere to treatment protocols and improve their treatment response is an important task for researchers (Hoyer & Gloster, 2009). The current research investigated three factors identified in the literature as having a significant impact on engagement in therapy, adherence and therapy response. These factors include illness representations, motivational style and acceptance strategies. The research comprised of a series of three studies that aimed to contribute to the research literature and provide further clarification regarding some limited or inconsistent findings identified in previous research in relation to treatment engagement and treatment response rates of individuals with GAD.Thesis (PhD Doctorate)
Doctor of Philosophy in Clinical Psychology (PhD ClinPsych)
School of Applied Psychology
Griffith Health
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Martinez-Cengotitabengoa, Maria-Teresa. "Mindfulness, metacognition and the treatment of generalised anxiety disorder - single case studies." Thesis, University of East Anglia, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368282.
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Coelho, Helen. "Generalised social phobia and generalised anxiety disorder (GAD) : a phenomenological and family study of a non-clinical sample." Thesis, University of Reading, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.413892.
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Linardatos, Eftihia. "Qualitative and quantitative differences of worry among individuals with and without generalized anxiety disorder." [Kent, Ohio] : Kent State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=kent1216644679.
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Gelaye, Bizu, Alan M. Zaslavsky, Jesse R. Fann, Marta B. Rondón, Sixto E. Sánchez, Michelle A. Williams, and Qiu-Yue Zhong. "Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women." PLoS ONE, 2015. http://hdl.handle.net/10757/552241.
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OBJECTIVE: Generalized anxiety disorder (GAD) during pregnancy is associated with several adverse maternal and perinatal outcomes. A reliable and valid screening tool for GAD should lead to earlier detection and treatment. Among pregnant Peruvian women, a brief screening tool, the GAD-7, has not been validated. This study aims to evaluate the reliability and validity of the GAD-7. METHODS: Of 2,978 women who attended their first perinatal care visit and had the GAD-7 screening, 946 had a Composite International Diagnostic Interview (CIDI). The Cronbach's alpha was calculated to examine the reliability. We assessed the criterion validity by calculating operating characteristics. The construct validity was evaluated using factor analysis and association with health status on the CIDI. The cross-cultural validity was explored using the Rasch Rating Scale Model (RSM). RESULTS: The reliability of the GAD-7 was good (Cronbach's alpha = 0.89). A cutoff score of 7 or higher, maximizing the Youden Index, yielded a sensitivity of 73.3% and a specificity of 67.3%. One-factor structure of the GAD-7 was confirmed by exploratory and confirmatory factor analysis. Concurrent validity was supported by the evidence that higher GAD-7 scores were associated with poor self-rated physical and mental health. The Rasch RSM further confirmed the cross-cultural validity of the GAD-7. CONCLUSION: The results suggest that the Spanish-language version of the GAD-7 may be used as a screening tool for pregnant Peruvian women. The GAD-7 has good reliability, factorial validity, and concurrent validity. The optimal cutoff score obtained by maximizing the Youden Index should be considered cautiously; women who screened positive may require further investigation to confirm GAD diagnosis.: This research was supported by an award from the Eunice Kennedy Shriver Institute of Child Health and Human Development (R01-HD-059835) at the National Institutes of Health (NIH). The NIH had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication
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Holmes, Monique Colette. "No Worries - It's Just Not That Easy!: Investigation and Treatment of Worry and Generalised Anxiety Disorder in Children." Thesis, Griffith University, 2014. http://hdl.handle.net/10072/367586.
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Generalised Anxiety Disorder (GAD) is a highly prevalent, chronic and costly mental disorder in children, that is characterised by excessive and uncontrollable worry about numerous topics, that occurs more days than not for a period of at least six months (APA, 2013). Our knowledge and understanding of worry and GAD in children remains a neglected area of empirical enquiry. Given the dearth of research conducted with children in this area, much of what is currently known about childhood GAD is derived from empirical studies conducted with adults. Within the adult literature, research has demonstrated that cognitive factors such as intolerance of uncertainty (IU), positive and negative beliefs about worry (PBW and NBW), negative problem orientation (NPO) and cognitive avoidance (CA) are particularly important in the development and maintenance of pathological worry and GAD, and these variables therefore constitute the basis of treatment for adult GAD. Treatment programs for child GAD, unlike those for adults, are almost uniformly transdiagnostic in nature and do not specifically target the cognitive variables demonstrated to be involved in the aetiology and maintenance of the disorder.
This thesis investigated the cognitive variables of IU, NBW, PBW, NPO, and CA with respect to worry and GAD in children through a series of four studies, which have all been submitted for publication. The first study examined the cognitive variables of IU, NBW, PBW, NPO, and CA in a community sample of 114 children, aged 8 to 12 years. It was found that all child cognitive variables were significantly and positively related to child worry, and that parent worry, IU and CA were significantly and positively related to child worry. It was also found that the relationship between parent IU, NPO and CA and child worry was mediated by child IU, NPO and CA respectively.Thesis (PhD Doctorate)
Doctor of Philosophy in Clinical Psychology (PhD ClinPsych)
School of Applied Psychology
Griffith Health
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Woo, Samantha Suyon. "DO HOLISTIC PRACTICES AS AN ADJUNCT TO TRADITIONAL PSYCHOTHERAPY AFFECT GENERALIZED ANXIETY DISORDER-7 (GAD-7) SCORES?" CSUSB ScholarWorks, 2016. https://scholarworks.lib.csusb.edu/etd/311.
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ABSTRACT
This study examined the effect of holistic practices on anxiety. The study used a pre-experimental design and measured any differences in outcomes in Generalized Anxiety Disorder clients as measured by General Anxiety Disorder-7 (GAD-7) between the two following groups: 1) the experimental group who received holistic services in addition to traditional treatment such as psychotherapy and/or medication as compared to 2) the control group who received psychotherapy and/or medication alone. Pretest of GAD-7 at intake and post-tests at about 4 months into treatment were measured along with a holistic practice survey and analyzed post-hoc through SPSS data analysis. This study found that GAD-7 scores were improved, with majority of the participants involved in some sort of holistic supplemental practices. However there was no statistical correlation between the two phenomena in this small sample. More research is recommended with larger samples, as well as improved instrumentation that could vet out other possible effects on the GAD scores.
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Buhk, Alex H. "The Physiological Effects of Adaptive Emotion Regulation during Affect Induction in Generalized Anxiety Disorder." University of Toledo / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1532462233147242.
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Piedmont, Joanna I. "Examining Generalized Anxiety Disorder During Social Interactions: Cardiac Activity, and the Influence of Affect." University of Toledo / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1449839541.
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Aleson, Dan. "En effectiveness-studie av KBT-behandlingar för GAD på en specialistmottagning." Thesis, Stockholms universitet, Psykologiska institutionen, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-74005.
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En effectiveness-studie undersökte effekten av Dugas och Robichauds (2007) behandlingsmodell för GAD på en specialistmottagning för patienter med komplicerade ångest och eller depressionstillstånd. Utöver detta undersöktes vilka övriga KBT-behandlingar för GAD som förmedlats på mottagningen. Alla patienter behandlades som en del av klinikens ordinarie verksamhet. Huvudutfallsmått var Generalized Anxiety Disorder Scale-7 (GAD-7) som mättes före och efter behandling. Därutöver mättes även grad av depressiva besvär med PHQ-9 samt grad av klinisk remission efter behandling. Behandlingsmodellens resultat för de patienter som bidragit med eftermätning (completerdata) visade en stor inomgruppseffektstorlek för GAD-7 (Cohen’s d=1,76) och 65% bedömdes även efter behandling inte längre uppfylla kriterier för GAD enligt DSM-IV. Bortfallet av data från före- till eftermätning var dock stort, vilket försvårar tolkningen av huvudutfallsmåttet. Även moderatorer för effekt undersöktes, men inga signifikanta samband mellan behandlingsutfall och tidigare visade moderatorer för effekt såsom ålder, kön eller samtidig farmakologisk behandling kunde visas. Resultaten jämförs med tidigare studier och en diskussion förs kring studiens begränsningar.Objective: While the efficacy of Dugas and Robichauds (2007) CBT treatment model for GAD has been tested in clinical trials, it is still unclear how the treatment is received in a outpatient setting with clinically referred patients. The present effectiveness study aimed to examine the effect of Dugas and Robichauds (2007) CBT treatment on a large outpatient group (N=188) diagnosed with GAD. In addition other types of CBT treatments delivered to the outpatient group were examined, as well as potential moderators for treatment effect such as age, sex, initial GAD-7 scores and concurrent pharmacological treatment. The treatment for the outpatient group was delivered in a clinic (WeMind, www.wemind.se) specialized in treatments of depression and anxiety. Method: The study is an analysis of gathered data from CBT treatments of GAD during a 3 year span at the clinic. Patients (N=188) diagnosed with GAD were categorized according to type of CBT treatment received and if treatment was completed with intact data. 71 patients were treated with Dugas and Robichauds (2007) CBT treatment, but 22 of these patients also received other CBT interventions at the same time. 33 patients received other kinds of CBT treatment. A large group (N=84) had missing data or did not complete treatment. Measurements taken at the beginning and end of treatment were Generalized Anxiety Disorder scale-7 (GAD-7), Public Health Questionnaire-9 (PHQ-9) and Penn State Worry Questionnaire (PSWQ). Clinical remission was measured at the end of treatment with the help of the therapists. A completeranalysis design was used with no waitlist or control group. Results: A paired samples T-test for patients treated with Dugas and Robichauds (2007) CBT treatment and measured with GAD-7 and PHQ-9 gave significant results for GAD-7, t70=13,17 (p<0.001) and PHQ-9, t67=10,25 (P<0.001). 46 of the 71 patients (65%) was assessed with clinical remission (no clinical diagnoses after treatment). Effectsize calculated with Cohen's d were GAD-7=1.76, PHQ-9=1.46 and PSWQ=1.76. Moderators were examined by calculating GAD-7 change score (difference pre-post GAD-7) and correlating the change score with age, sex, initial GAD-7 score and pharmacological treatment. Age and sex gave no significant results. Whether concurrent pharmacological treatment had an moderator effect was examined by categorizing the patients into three groups: (1) no pharmacological treatment, (2) stable pharmacological treatment and (3) changed pharmacological treatment (increased dosage or new treatment). Again no significant effect was found. One positive significant correlation was found with initial GAD-7 scores and GAD-7 change score, GAD-7, r=.66, t69=7,36 (p<0.001). Higher initial GAD-7 measurement correlated with a greater change score. Conclusions:The results indicate a large treatment effect for Dugas and Robichauds (2007) CBT treatment model for GAD in an normal outpatient setting, with clinically referred patients and treatment administered by general CBT therapists. The effect was superior compared to the group that received general CBT treatment interventions for GAD. The effect of treatment measured with GAD-7 and PHQ-9 was also drastically improved if other CBT interventions was added to the treatment model, but these interventions did not have an effect on clinical remission. Serious limitations such as a high percentage of drop outs, a completeranalysis model, no control group and no follow up data restrict the possible interpretations of the results.
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Hoyer, Jürgen, and Hans-Ulrich Wittchen. "Generalisierte Angststörungen in der primärärztlichen Versorgung." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2012. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-99825.
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Der Beitrag untersucht auf der Grundlage neuer primärärztlicher Befunde die Versorgungsqualität bei der hinsichtlich Chronizität und Arbeitsausfall schwerwiegendsten Angsterkrankung, der Generalisierten Angststörung. Neben einer knappen Einführung in das Störungsbild werden die an über 20 000 Patienten in 558 Hausarztpraxen gewonnenen Kernbefunde der GAD-P-Studie (Generalisierte Angst und Depression in der Primärärztlichen Versorgung) zusammengefasst und Ansatzpunkte zur Verbesserung der Versorgungsqualität dieses selten adäquat behandelten Störungsbildes diskutiert. Insbesondere wird auf die zentrale Bedeutung einer sichereren diagnostischen Erkennung als Voraussetzung für therapeutische Verbesserungen hingewiesen. In Ergänzung zur Verbesserung bestehender Weiterbildungsangebote wird auf Arzt- und Patientenebene der breitere Einsatz bestehender Screeningverfahren, die Nutzung krankheitsspezifischer Patientenratgeber, sowie eine breitere Öffentlichkeitsarbeit zur Information über dieses bislang vernachlässigte, häufig chronisch verlaufende Krankheitsbild empfohlenBased on new empirical findings in a large-scale primary care study, the quality of care for the most chronic and debilitating anxiety problem, generalised anxiety disorder, is examined. Following a brief introduction of this disorder, the core findings of the GAD-P study (generalised anxiety and depression in primary care) with more than 20,000 patients of 558 family doctor practices are summarised and measures to improve the quality of care of patients with generalised anxiety disorder, a disorder which is rarely adequately treated, are discussed. This paper particularly emphasises the standard use of time-efficient diagnostic screening instruments, because improved recognition and diagnosis is the prerequisite for appropriate treatment. Further the role of the media to increase awareness of this disorder as well as patient education materials to improve compliance and to enhance treatment outcome effects are highlighted
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Free, Matthew Lee. "Testing the Cognitive Control Model of Pathological Worry Using Objective Measures of Cognitive Control and Autonomic Arousal." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1483459077464123.
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Hoyer, Jürgen, and Hans-Ulrich Wittchen. "Generalisierte Angststörungen in der primärärztlichen Versorgung." Verl. Versicherungswirtschaft, 2003. https://tud.qucosa.de/id/qucosa%3A26261.
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Der Beitrag untersucht auf der Grundlage neuer primärärztlicher Befunde die Versorgungsqualität bei der hinsichtlich Chronizität und Arbeitsausfall schwerwiegendsten Angsterkrankung, der Generalisierten Angststörung. Neben einer knappen Einführung in das Störungsbild werden die an über 20 000 Patienten in 558 Hausarztpraxen gewonnenen Kernbefunde der GAD-P-Studie (Generalisierte Angst und Depression in der Primärärztlichen Versorgung) zusammengefasst und Ansatzpunkte zur Verbesserung der Versorgungsqualität dieses selten adäquat behandelten Störungsbildes diskutiert. Insbesondere wird auf die zentrale Bedeutung einer sichereren diagnostischen Erkennung als Voraussetzung für therapeutische Verbesserungen hingewiesen.
In Ergänzung zur Verbesserung bestehender Weiterbildungsangebote wird auf Arzt- und Patientenebene der breitere Einsatz bestehender Screeningverfahren, die Nutzung krankheitsspezifischer Patientenratgeber, sowie eine breitere Öffentlichkeitsarbeit zur Information über dieses bislang vernachlässigte, häufig chronisch verlaufende Krankheitsbild empfohlen.Based on new empirical findings in a large-scale primary care study, the quality of care for the most chronic and debilitating anxiety problem, generalised anxiety disorder, is examined. Following a brief introduction of this disorder, the core findings of the GAD-P study (generalised anxiety and depression in primary care) with more than 20,000 patients of 558 family doctor practices are summarised and measures to improve the quality of care of patients with generalised anxiety disorder, a disorder which is rarely adequately treated, are discussed. This paper particularly emphasises the standard use of time-efficient diagnostic screening instruments, because improved recognition and diagnosis is the prerequisite for appropriate treatment. Further the role of the media to increase awareness of this disorder as well as patient education materials to improve compliance and to enhance treatment outcome effects are highlighted.
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Toh, Gim Y. "Why Does Effortful Control Moderate the Relationship between Worry and Subjective Reports of Physiological Hyperarousal?" The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1406042382.
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Sargeant, Elizabeth. "Attentional bias modification training for generalised anxiety disorder." Thesis, University of Southampton, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.617827.
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This thesis comprises a literature review and empirical study relating to Attentional Bias Modification Training (ABMT) and Generalised Anxiety Disorder (GAD). Following a general introduction of GAD, the literature review explores the cognitive models of GAD that place an emphasis on attentional bias. These models propose attentional bias as a key factor in developing and maintaining GAD. The dot probe and emotional stroop task have demonstrated empirical evidence of the relationship between attentional bias and GAD. ABMT represents a new paradigm for testing the relationship between attentional bias and GAD. ABMT uses contingency training to implicitly modify attentional bias to either increase vigilance to threat or avoid threat stimuli. ABMT represents a relatively novel treatment for GAD. Research that has explored the effectiveness of ABMT in treating GAD is discussed. Based on a critical evaluation of the current evidence base, there is emerging evidence to suggest that ABMT does represent a novel treatment for GAD and future research questions are suggested. The empirical paper investigates the effectiveness of ABMT in training an attentional bias from threat vigilance towards threat avoidance in a student population. Following training, symptoms of GAD were induced through the use of 7.5% CO2 challenge to evaluate the prophylactic effects of ABMT, compared to an active relaxation control group. The results of the study show that ABMT significantly changed attentional bias in the expected direction. The CO2 inhalation effectively induced anxiety across all participants. However, ABMT did not attenuate anxiety following the CO2 challenge. Correlations within the ABMT group demonstrated a relationship with attentional bias and anxiety as measured by physiological responses. The results of the study are discussed in relation to theoretical models and empirical research. Clinical implications of the study are considered and suggestions of future research as a result of the findings are also proposed.
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Young, Laura. "The lived experience of adults with generalised anxiety disorder." Thesis, City, University of London, 2019. http://openaccess.city.ac.uk/21343/.
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Despite the fact that generalised anxiety disorder (GAD) is the most frequent anxiety disorder and the second most frequent psychiatric disorder in clinical settings (Wittchen, Kessler, Beesdo, Krause, Höfler, & Hoyer, 2002), it is significantly under-detected and under-treated (Wittchen & Jacobi, 2005). There is also a lack of empirical literature on the lived experience of GAD. Considered together, this information highlights the need for a greater understanding of GAD. This study sought to address the gap in the literature, and thus contribute to this need, by exploring the lived experience of adults with GAD. Potential participants with a formal diagnosis of GAD were recruited via purposive sampling. Initial telephone screenings were conducted, during which they completed the Generalized Anxiety Disorder Questionnaire IV (GAD-Q-IV; Newman, Zuellig, Kachin, Constantino, Przeworski, Erickson, & Cashman-McGrath, 2002). A minimum total score of 7.67 was required to meet this questionnaire's GAD diagnostic criteria. Eight participants who met this requirement participated in one semi-structured interview. Data were analysed using interpretative phenomenological analysis (IPA) and four super-ordinate themes were developed. "Battling with uncertainty: What's going to happen next?" captured participants' difficulty tolerating uncertainty and consequent absence of perceived control over their life-worlds. "A struggle for autonomy: You either let it get a hold of you, or you get a hold of it" captured participants' continuous struggle for perceived control over their senses of self, as GAD takes over. "GAD and interpersonal relations: Worrying about what others think" explored the interactions between participants' experiences of GAD and their relationships with others. "The need to create meaning amid uncertainty and loss: GAD is an eye-opener" explored participants' attempts to locate meaning within their distress in order to tolerate the uncertainty, torment, and losses GAD has caused. The findings are discussed in relation to existing literature. Their implications for counselling psychology and the wider context are then considered as well as suggestions for future research.
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Palm, Marisha Emily. "The neurochemistry, neuropsychology and functional neuroanatomy of generalised anxiety disorder." Thesis, University of Manchester, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.492844.
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Generalised anxiety disorder (GAD) is a common mental illness characterised by excessive worry and anticipatory anxiety. The present study aims to elucidate the neuropsychology, neurochemistry, structural and functional neuroanatomy of female patients with GAD using dietary manipulation of 5-HT and magnetic resonance imaging (MRI).
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Wright, Tamsin. "The development and validation of the Generalised Anxiety Disorder Inventory." Thesis, University of Bristol, 2001. http://hdl.handle.net/1983/e65981df-1ee5-4a61-88b8-15604bfbefd5.
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Generalised anxiety disorder (GAD) is a chronic condition that has a significant impact on the lives of its sufferers. Although the validity of the diagnosis has been the subject of much controversy in psychiatric circles, the prevalence and economic impact of this syndrome warrants further study. Such research has hitherto been generally lacking. In the interests of furthering research, and of providing a tool to evaluate new progressions in the treatment of GAD, the present thesis embarks on the development of a new scale. The Generalised Anxiety Disorder Inventory (GADI) seeks to provide a simple self-completion measure of GAD, which can be used to track the severity of the condition over time. Four studies are reported which document the initial stages of the development and validation of the GADI. Study One describes the derivation of a 22-item scale from an initial pool of possible items. Studies Two and Three describes initial reliability and validity statistics in two non-psychiatric populations. Study Four reports the same reliability and validity analyses in a psychiatric outpatient sample. It is concluded that the GADI performs satisfactorily in the analyses performed in the course of this thesis. However, in order to realise the scale's full potential a number of additional, longitudinal studies are required. The thesis concludes with suggested methodologies for these, and the news of a planned multi-centre collaboration for their implementation.
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Hall, Josephine. "Cognitive behavioural therapy for older adults with generalised anxiety disorder." Thesis, University of Sheffield, 2016. http://etheses.whiterose.ac.uk/13859/.
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Cognitive behavioural therapy (CBT) and applied relaxation are the recommended talking treatments for generalised anxiety disorder (GAD) in adults. No specific recommendations are currently available for older adults with GAD due to paucity of evidence. In order to contribute to the GAD older adult evidence base (1) a meta-analysis of clinical trials has been performed and (2) a case series of providing group CBT has been conducted. The first part of the thesis reports a meta-analytic review of 14 randomized controlled trials of CBT for GAD in older adults. Results showed CBT to be an effective treatment, but did not provide conclusive evidence of superiority of CBT against other evidenced-based psychotherapies. Avenues for the continued methodological development of field are discussed. The second part of the thesis presents a case series study evaluating group delivery of an existing GAD treatment protocol with older adults. The focus of the study was on feasibility, acceptability and effectiveness. Mixed methods were used across the three main study phases (baseline, intervention and follow-up) with N=23 eligible participants. Participant dropout was low, homework compliance high, and large treatment effects on the primary outcome measure of worry were found. Merged findings suggested the group intervention was an acceptable, feasible, effective, and durable treatment option. The potential of group interventions for late life GAD are discussed. Taken together, the two studies suggest that group format does not reduce the acceptability and effectiveness of treatment, and provide an opportunity for delivery of cost-effective treatment for older adults with GAD.
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Hanson, Louise. "Portfolio of research : a psychological investigation of generalised anxiety disorder." Thesis, Queensland University of Technology, 2009.
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Webster, Rebecca. "Does resilience mediate the relationship between emotion dysregulation and Generalised Anxiety Disorder?" Thesis, University of East Anglia, 2016. https://ueaeprints.uea.ac.uk/63097/.
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The relationship between emotion dysregulation and Generalised Anxiety Disorder (GAD) has been demonstrated in research for the past ten years, with the positing of the Emotion Dysregulation Model of GAD (Mennin et al., 2005). The role of resilience in buffering against mood disorders has also been investigated and resilience training has been successfully utilised as an adjunct to therapy for GAD (Fava et al., 2004). This research considers whether resilience mediates between emotion dysregulation and GAD. One hundred and eighty seven participants were recruited from online social media platforms and self-help forums and completed online questionnaires. These questionnaires included a measure of resilience, two measures of emotion regulation, a measure of worry, a measure of GAD symptoms, a depression measure and brief demographic questions. Participants were split into high and low GAD symptoms groups dependent on their score on the Generalised Anxiety Disorder-7 item questionnaire using a cut-off of 10 (Spitzer, Kroenke, William & Lowe, 2006). The results showed that participants in the high GAD symptoms group had significantly higher emotion dysregulation scores, lower resilience scores and were less likely to engage in adaptive emotion regulation strategies. Emotion dysregulation was also found to be a significant predictor of GAD symptoms. Resilience was not found to be a mediator between emotion dysregulation and GAD, however the relationship between emotion dysregulation and worry was partially mediated by resilience. This highlights potentially different mechanisms behind the pervasive worry experienced by those with GAD and GAD symptoms in general. This has important implications for future research and clinical interventions for GAD.
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Kazer, J. F. "The hippocampus in memory and anxiety : an exploration within computational neuroscience and robotics." Thesis, University of Sheffield, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.339963.
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White, James David. "A controlled comparative investigation of large group therapy for generalised anxiety disorder - "stress control"." Thesis, University of Glasgow, 1989. http://theses.gla.ac.uk/3708/.
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One hundred and nine generalised anxiety disorder (GAD) patients, referred by their General Practitioners to a clinical psychology primary care service, were assigned to either Cognitive, Behavioural, Cognitive-behavioural, Placebo or Waiting List conditions. `Stress Control' large group therapy combined didactic therapy with a workshop model and emphasised the aim of turning patients into their own `therapists' in order to enable them to deal with present and future problems. Patients were thus encouraged to view Stress Control as an `evening class' rather than `group therapy'. Measures of treatment process and outcome were obtained mainly from self-report instruments. Follow-up data were collected at six months post-treatment. At post-therapy, all active therapy conditions and, against expectation, the Placebo condition had shown significant time within treatment group change. The active therapy conditions, and to a lesser extent, the Placebo condition, were significantly different to the Waiting List condition, which, overall showed no evidence of improvement. At follow-up the active therapy condition generally enhanced therapy gains while the placebo condition maintained therapy gains. Process measures did not, with the exception of self-statement change, differentiate between the groups. Noted variable response in the main analyses was somewhat explained by various sub-group analyses. There appeared to be little benefit in dividing patients into those who experienced panic and those who did not. There was some evidence that `matching' patients to therapy, i.e. cognitive responders to cognitive therapy was of value at post-therapy although differences generally disappeared at follow-up. Synchronous change was associated with enhanced performance. Finally, attempts to predict response to Stress Control by a comparison of responders and non-responders were attempted and the results assessed in terms of clinical as opposed to statistical significance. The results of the present study are discussed with reference to other treatment outcome studies and an attempt to produce a model to account for the similar effects found across treatment conditions. The implications of these findings and some suggestions for future research for GAD and other diagnostic categories are discussed.
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Brodrick, Paul Matthew. "Cognitive bias in generalised anxiety disorder and its relationship with the effect od SSRI treatment." Thesis, University of Southampton, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270352.
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Remes, Roxana-Olivia. "Risk factors and outcomes associated with generalised anxiety disorder : findings from a large population study." Thesis, University of Cambridge, 2019. https://www.repository.cam.ac.uk/handle/1810/287469.
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Scientific interest in the clinical implications, public health importance, and risk factors of anxiety disorders has grown substantially in the past two decades. Despite this, the evidence base on anxiety is insufficient to inform health care planning and policy-making. Further research on the outcomes and risk factors associated with anxiety disorders, and ways of mitigating these risks is needed. One of the aims of this thesis was to provide an overview of the existing literature on the prevalence of anxiety in adults living in countries across the globe, and to describe the prevalence in the context of various health states and life stages. Because generalised anxiety disorder is one of the most common psychiatric conditions in the population, the remainder of the thesis focused on this disorder and aimed to explore its links with health service use and mortality. Risk for this condition was also explored and area deprivation was studied as a possible determinant. Since depression is commonly studied alongside anxiety, the relationship between the residential environment and major depressive disorder was also assessed. Finally, to provide insight into the mitigation of risks of generalised anxiety disorder, a study of coping mechanisms was undertaken. Primary study findings from this thesis are based on the European Prospective Investigation of Cancer in Norfolk, a large, population study of British people over the age of 40. Results from the systematic review showed that anxiety is common in population sub-groups around the world, with women, younger people, and those suffering from chronic physical conditions, such as cancer and cardiovascular disease being particularly affected. Results from the primary studies of the thesis showed that generalised anxiety disorder is associated with increased risk for deaths, though it is not significantly associated with non-psychiatric hospital admissions. Results from the risk factor analyses showed that living in a deprived area is associated with generalised anxiety disorder in women and major depressive disorder in men. The risk mitigation analysis indicated that sense of coherence is an important coping mechanism that can protect against generalised anxiety disorder among women living in disadvantaged circumstances. My work has shown novel associations and attempted to provide a more complete picture of one of the most common psychiatric conditions in the population by focusing on several angles: health outcomes, risk factors, and ways of mitigating risks.
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Kiely, Brian Gerard. "Bibliotherapy for generalised anxiety disorder : a controlled trial comparison and exploration of factors related to outcome." Thesis, University of Leicester, 2002. http://hdl.handle.net/2381/31345.
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The pilot study served to develop and initially evaluate a cognitive behavioural bibliotherapy programme for use in treating Generalised Anxiety Disorder. Administered during 16 one hour appointments with a Psychologist, the programme was associated with significant improvements in anxiety, depression and problem severity. The finalized programme comprised two components - information about anxiety and cognitive behavioural anxiety management guidance. In the main study 46 patients with a primary diagnosis of Generalised Anxiety Disorder were randomly allocated to one of two treatment conditions - receipt of the full programme or only the information component - or a waiting list control condition. Psychologist administration of the programme took 10 minutes. Patients in receipt of the full programme experienced significantly greater gains than those in the waiting list condition in self assessed anxiety, depression, quality of life, and stress. There were no other between condition differences, but a trend in pre to post changes favouring the full programme. The presence of other co-morbid anxiety or depression conditions did not affect outcome. Clinical improvements in both treatment conditions were associated with improvements in anxiety related health attitudes including self-efficacy. Additionally, clinical improvements in patients in the full programme condition were associated with improvements in coping skills and compliance with the programme. The potential inter-relationship between clinical, attitudinal and coping skills change, and programme compliance were discussed.
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Koller, Anthony. "The newer anticonvulsants in the treatment of generalised anxiety disorder: a systematic review and meta-analysis." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/23047.
Full textAbstract:
Generalised anxiety disorder (GAD) is a common, chronic and debilitating mental disorder impairing quality of life and functioning. The 1st line treatments for GAD include the selective serotonergic reuptake inhibitors (SSRIs) and the selective serotonergic noradrenergic reuptake inhibitors (SNRIs). However, they have rates of non-response ranging from 25 to 40%. There is justification to search for new and more efficacious GAD medication. It has hypothesised anticonvulsants possess anxiolytic properties based on animal studies and epilepsy trials. There is inconsistent evidence that anticonvulsants are efficacious in GAD. It was considered useful and timely to investigate this further. The newer anticonvulsants (felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, tiagabine, topiramate and zonisamide) were investigated as they were considered to have a more benign side effect profile and fewer drug interactions than older anticonvulsants. This study is a systematic review and meta-analysis of the newer anticonvulsants in the treatment of GAD. The main objective was to use randomised controlled trial (RCT) data to estimate efficacy of the newer anticonvulsants in GAD. using A search strategy was designed and three separate searches conducted by the Cochrane Depression Anxiety and Neurosis Group of the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR) and clinicaltrials.gov (the last search in May 2013). An updated, independent, search was conducted in May 2016 with no additional citations retrieved. 287 citations were retrieved and screened in total. Two independent raters assessed citations using the abstracts and selected trials that satisfied the inclusion criteria. 12 RCTs were included with eight using pregabalin and four using tiagabine. A single rater collated data from RCTs assisted by Covidence Systematic Review Software. All statistical analyses were performed using Review Manager. A random effects meta-analysis was performed expressing summary statistics as effect estimates with 95% confidence intervals (CI). There were 4001 participants in total with 2516 in the anticonvulsant group and 1485 in the placebo. Primary outcomes were reduction in symptom severity using the Hamilton Anxiety Rating Scale (HAM-A) and treatment response using the Clinical Global Impressions Scale-Improvement item (CGI-I). Secondary outcome was medication acceptability. Reduction of symptom severity on the HAM-A for: the anticonvulsant group (pregabalin and tiagabine combined) was significantly favourable with a mean difference (MD) of -2.10 ([-2.83, -1.36] 95% CI); pregabalin was significantly favourable (MD -2.86 [-3.52, -2.21] 95% CI) tiagabine was statistically insignificant (MD - 0.58 [-1.41, 0.25] 95% CI). The risk ratio (RR) of treatment response using the CGI-I (RR >1 favours the anticonvulsant) for: the anticonvulsant group was significantly favourable (RR 1.23 [1.12, 1.35] 95% CI); pregabalin was significantly favourable (RR 1.35 [1.21, 1.50] 95% CI) tiagabine was statistically insignificant (RR 1.09 [0.98, 1.22] 95% CI). The RR of treatment acceptability (RR >1 favoured placebo) for: the anticonvulsant group was significantly unfavourable (RR 1.49 [1.18, 1.88] 95% CI); pregabalin was statistically insignificant (RR 1.23 [0.92, 1.65] 95% CI) tiagabine was significantly unfavourable (RR 1.95 [1.29, 2.93] 95% CI). In conclusion, this systematic review of the newer anticonvulsants included only RCTs of pregabalin and tiagabine. The main finding was that pregabalin showed significant efficacy in reducing symptom severity and improving treatment response in GAD. Tiagabine failed to show significant efficacy in primary outcomes. Further work is needed to better clarify the place of the newer anticonvulsants in the treatment armamentarium of GAD.
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Stapleton, Craig. "An investigation of the physiological concomitants of worry in a cognitive model of generalised anxiety disorder." Thesis, Federation University Australia, 2005. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/165027.
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Kentish, Diana. "A comparison of the cognitive processes of worry by persons diagnosed with generalised anxiety disorder, persons experiencing moderate levels of anxiety, and persons experiencing minimal levels of anxiety /." Title page, contents and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09AR.PS/09ar.psk371.pdf.
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Whittaker, Bork Natalie. "Predictors of worry and generalised anxiety disorder : the role of intolerance of uncertainty, negative metacognitive beliefs, and experiential avoidance." Thesis, University of Liverpool, 2013. http://livrepository.liverpool.ac.uk/13653/.
Full textAbstract:
The overarching aim of this thesis was to gain an increased understanding of the psychological processes related to generalised anxiety disorder (GAD) and how they contribute to the development and maintenance of the disorder. Changes in the diagnostic criteria of GAD over the years, have led to increased identification of specific psychological processes that may be responsible for the disorder, all of which offer a plausible explanation. However, limited empirical research exists exploring the relative merits, or have made direct comparisons of each. Therefore, this thesis attempts to answer the following questions: Which psychological factors contribute to the severity of worry? and do the identified psychological factors explain the development of GAD? Delineation of these psychological processes may hold the key to increased efficacy of treatments, as outcomes are currently poor, which lead to increased health care utilisation and high economic costs to the public health service. Improving treatments is clearly an important factor for GAD sufferers who often experience significant impairment in overall functioning and quality of life. Chapter 2 presents an overview of the relevant literature, which provides a point of orientation for the research section that follows. This will initially offer a historical context, followed by an overview of GAD, the role of negative life events, and finally considers the implications for psychopharmacological and psychological treatments. The evolution of the development of psychological models of anxiety is outlined, which provided the foundation for the development of some of the current leading psychological models of GAD within this field. These have led to the identification of key processes that offer a clear hypothesis and explanation of the phenomena seen in worry and GAD; the most recent models included within this review are the Intolerance of Uncertainty (IU) model (Dugas, Gagnon, Ladouceur, & Freeston, 1998), the Metacognitive model (Wells, 1995, 1999), and finally the Acceptance Based model (Roemer, Salters, Raffa, & Orsillo, 2005). This leads into the final section of Chapter 2, which is a systematic review of the key processes to be explored within this thesis, the processes of interest are IU, negative metacognitive beliefs about worry, and finally experiential avoidance. Chapter 3 leads into the empirical paper, which provides a detailed account of the research and the outcomes. This research attempted to address some of the gaps in the literature by being the first to explore all three of these constructs in one study. The aim of which was to understand more about what factors are related to the prediction of worry severity and GAD status in a non-clinical sample. Additionally, this study attempted to address some of the limitations of previous literature by using a prospective design, which allowed inferences on causality to be made. Students were recruited and completed the study via a web-based design, completing measures at two time points. The findings of this research are presented with an overall discussion of how this relates to previous research. These are discussed in the context of several limitations. In the final chapter, the implications of the research are outlined, with reference to the theoretical and clinical relevance. In addition, methodological considerations are highlighted, including the relative strengths and limitations of the research. As the dissemination of research findings is an important process for any research, the next section is an article prepared for those participants who took. The final section relates to how future studies can continue to bridge the gaps within the literature, this is outlined in the form of a research proposal. Further empirical research is required within this field, specifically; replication of the current study within clinical samples would further and extend the findings presented in Chapter 3. The thesis then closes with an overall conclusion.
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Berger, Ariel, Ellen Dukes, Hans-Ulrich Wittchen, Robert Morlock, John Edelsberg, and Gerry Oster. "Patterns of healthcare utilization in patients with generalized anxiety disorder in general practice in Germany." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2012. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-99860.
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Background and Objectives: To describe patterns of healthcare utilization among patients with generalized anxiety disorder (GAD) in general practitioner (GP) settings in Germany.
Methods: Using a large computerized database with information from GP practices across Germany, we identified all patients, aged > 18 years, with diagnoses of, or prescriptions for, GAD (ICD-10 diagnosis code F41.1) between October 1, 2003 and September 30, 2004 ("GAD patients"). We also constituted an age- and sex-matched comparison group, consisting of randomly selected patients without any GP encounters or prescriptions for anxiety or depression (a common comorbidity in GAD) during the same period. GAD patients were then compared to those in the matched comparison group over the one-year study period.
Results: The study sample consisted of 3340 GAD patients and an equal number of matched comparators. Mean age was 53.2 years; 66.3% were women. Over the 12-month study period, GAD patients were more likely than matched comparators to have encounters for various comorbidities, including sleep disorders (odds ratio [OR] = 6.75 [95% CI = 5.31, 8.57]), substance abuse disorders (3.91 [2.89, 5.28]), and digestive system disorders (2.62 [2.36, 2.91]) (all p < 0.01). GAD patients averaged 5.6 more GP encounters (10.5 [SD = 8.8] vs 4.9 [5.7] for comparison group) and 1.4 more specialist referrals (2.3 [2.9] vs 0.9 [1.7]) (both p < 0.01). Only 58.3% of GAD patients received some type of psychotropic medication (i.e., benzodiazepines, antidepressants, and/or sedatives/hypnotics).
Conclusions: Patients with GAD in GP practices in Germany have more clinically recognized comorbidities and higher levels of healthcare utilization than patients without anxiety or depression.
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Berger, Ariel, Ellen Dukes, Hans-Ulrich Wittchen, Robert Morlock, John Edelsberg, and Gerry Oster. "Patterns of healthcare utilization in patients with generalized anxiety disorder in general practice in Germany." Universidad de Zaragoza, 2009. https://tud.qucosa.de/id/qucosa%3A26263.
Full textAbstract:
Background and Objectives: To describe patterns of healthcare utilization among patients with generalized anxiety disorder (GAD) in general practitioner (GP) settings in Germany.
Methods: Using a large computerized database with information from GP practices across Germany, we identified all patients, aged > 18 years, with diagnoses of, or prescriptions for, GAD (ICD-10 diagnosis code F41.1) between October 1, 2003 and September 30, 2004 ("GAD patients"). We also constituted an age- and sex-matched comparison group, consisting of randomly selected patients without any GP encounters or prescriptions for anxiety or depression (a common comorbidity in GAD) during the same period. GAD patients were then compared to those in the matched comparison group over the one-year study period.
Results: The study sample consisted of 3340 GAD patients and an equal number of matched comparators. Mean age was 53.2 years; 66.3% were women. Over the 12-month study period, GAD patients were more likely than matched comparators to have encounters for various comorbidities, including sleep disorders (odds ratio [OR] = 6.75 [95% CI = 5.31, 8.57]), substance abuse disorders (3.91 [2.89, 5.28]), and digestive system disorders (2.62 [2.36, 2.91]) (all p < 0.01). GAD patients averaged 5.6 more GP encounters (10.5 [SD = 8.8] vs 4.9 [5.7] for comparison group) and 1.4 more specialist referrals (2.3 [2.9] vs 0.9 [1.7]) (both p < 0.01). Only 58.3% of GAD patients received some type of psychotropic medication (i.e., benzodiazepines, antidepressants, and/or sedatives/hypnotics).
Conclusions: Patients with GAD in GP practices in Germany have more clinically recognized comorbidities and higher levels of healthcare utilization than patients without anxiety or depression.
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Fisher, Peter Leonard. "Recovery from generalised anxiety disorder following psychologcal therapy: An investigation using jacobson methodology, analysis of its validity and a conceptural framework for outcome prediction." Thesis, University of Dundee, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.488581.
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Baldwin, David S., Ian M. Anderson, David J. Nutt, Borwin Bandelow, Alyson Bond, Jonathan R. T. Davidson, Boer Johan A. den, et al. "Evidence-based guidelines for pharmacological treatment of anxiety disorders." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-103753.
Full textAbstract:
These British Association for Psychopharmacology guidelines cover the range and aims of treatment for anxiety disorders. They are based explicitly on the available evidence and are presented as recommendations to aid clinical decision making in primary and secondary medical care. They may also serve as a source of information for patients and their carers. The recommendations are presented together with a more detailed review of the available evidence. A consensus meeting involving experts in anxiety disorders reviewed the main subject areas and considered the strength of evidence and its clinical implications. The guidelines were constructed after extensive feedback from participants and interested parties. The strength of supporting evidence for recommendations was rated. The guidelines cover the diagnosis of anxiety disorders and key steps in clinical management, including acute treatment, relapse prevention and approaches for patients who do not respond to first-line treatments.
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James, Kirsty Michelle. "Mindfulness-Based Cognitive Therapy versus self-help for students with clinical perfectionism: a pilot randomised study ; Psycho-social risk factors for Generalised Anxiety Disorder: an exploratory literature review of current knowledge." Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.633159.
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Abstracts Mindfulness-Based Cognitive Therapy versus self-help for students with clinical perfectionism: A pilot randomised study Objective: This pilot study compared a mindfulness-based cognitive therapy (MBCT) intervention with a self-help guide based on a cognitive behaviour therapy (CBT) approach for students with clinical perfectionism. Method: Participants were randomised to either MBCT or self-help. Questionnaires were completed at baseline, eight weeks later (the primary outcome point, corresponding to the end of MBCT) and at ten-week follow-up. Results: Post-intervention intention-to-treat (ITT) analyses identified that MBCT participants (n = 28) had significantly lower levels of unhealthy perfectionism and stress than self-help participants (n = 32). There was also significant MBCT superiority for changes in unhelpful beliefs about emotions, rumination, mindfulness, self-compassion and decentering. At ten-week follow-up, effects were maintained in the MBCT group and both ITT and completer (per-protocol) analyses showed superior MBCT outcomes for unhealthy perfectionism and daily impairment caused by perfectionism. Mediational analysis showed that pre-post changes in self-compassion mediated the group differences in pre-post changes in clinical perfectionism. Conclusions: MBCT is a promising intervention for students with clinical perfectionism, which may result in larger improvements than self-help. The findings require replication with a larger sample. Session-by-session outcome monitoring in CAMHS: Clinicians beliefs The CYP-IAPT programme emphasises the meaningful contribution session-by-session routine outcome monitoring (ROM) can make to clinical practice and its importance in highlighting services’ effectiveness. Two studies on issues related to the implementation of ROM in children’s services were conducted. Study one was qualitative; twelve CAMHS professionals participated in focus groups. Themes identified included the idea that ROM could provide objectivity, could be collaborative and empowering. Concerns included how measures may adversely influence therapeutic sessions and how the information may be used by the service. These themes were used to develop a questionnaire about professional’s experience of and views on session-by-session ROM. In study two, 59 professionals from four CAMHS teams completed the questionnaire. It was found that only 6.8% reported “almost always” utilising session-by-session ROM. Detailed analysis of questionnaire responses suggested two factors reflecting the perceived negative and positive impact of session-by-session ROM. It was found that clinicians who currently use session-by-session ROM hold stronger positive and negative beliefs than clinicians who do not. This study suggests that session-by-session ROM is not currently routine practice within CAMHS and highlights the importance of considering how this practice can be best implemented within this setting with reference to clinician attitudes. Psycho-social risk factors for Generalised Anxiety Disorder: An exploratory literature review of current knowledge Research around worry and its central role within Generalised Anxiety Disorder (GAD) has primarily focused on characteristics and treatment, with little investigation into factors involved in its development. The current paper reviews literature to explore our existing understanding of risk factors involved in the aetiology of worry and GAD and briefly reviews how well current cognitive models account for identified aetiological factors. Collectively, current cognitive models vary in their focus on, and explanation of, aetiological factors of worry and GAD and require further theoretical development. Further research within this field focused on the role of parenting and insecure attachment styles, life events and the course of symptoms across gender and the lifespan will be beneficial.
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Baldwin, David S., Ian M. Anderson, David J. Nutt, Borwin Bandelow, Alyson Bond, Jonathan R. T. Davidson, Boer Johan A. den, et al. "Evidence-based guidelines for pharmacological treatment of anxiety disorders: Recommendations from the British Association for Psychopharmacology." SAGE Publications Ltd, 2005. https://tud.qucosa.de/id/qucosa%3A26469.
Full textAbstract:
These British Association for Psychopharmacology guidelines cover the range and aims of treatment for anxiety disorders. They are based explicitly on the available evidence and are presented as recommendations to aid clinical decision making in primary and secondary medical care. They may also serve as a source of information for patients and their carers. The recommendations are presented together with a more detailed review of the available evidence. A consensus meeting involving experts in anxiety disorders reviewed the main subject areas and considered the strength of evidence and its clinical implications. The guidelines were constructed after extensive feedback from participants and interested parties. The strength of supporting evidence for recommendations was rated. The guidelines cover the diagnosis of anxiety disorders and key steps in clinical management, including acute treatment, relapse prevention and approaches for patients who do not respond to first-line treatments.
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Baldwin, David S., Ian M. Anderson, David J. Nutt, Christer Allgulander, Borwin Bandelow, Boer Johan A. den, David M. Christmas, et al. "Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: A revision of the 2005 guidelines from the British Association for Psychopharmacology." Sage, 2014. https://tud.qucosa.de/id/qucosa%3A35384.
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This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treatment, and further approaches for patients who have not responded to first-line interventions. A consensus meeting involving international experts in anxiety disorders reviewed the main subject areas and considered the strength of supporting evidence and its clinical implications. The guidelines are based on available evidence, were constructed after extensive feedback from participants, and are presented as recommendations to aid clinical decision-making in primary, secondary and tertiary medical care. They may also serve as a source of information for patients, their carers, and medicines management and formulary committees.
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Hoyer, Jürgen, and Sabrina Heidrich. "Wann sind Sorgen pathologisch?" Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-132784.
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Pathologische Sorgen sind ungenau definiert. Für die Behandlungsplanung bleiben wichtige Fragen offen: Welche Merkmale sind für die Unterscheidung zwischen behandlungsbedürftigen und nicht behandlungsbedürftigen Sorgen relevant? Welche Art von Sorgen muss wie behandelt werden? Und: Welche Art von Sorgen gilt es eher zu akzeptieren? Wir machen praxisnahe Vorschläge dafür, wie Sorgen mittels einer einfachen Heuristik auch vom Patienten selbst als «pathologisch» identifiziert werden können. Im Sinne eines therapeutischen Arbeitsmodells ergeben sich differentielle Bearbeitungsstrategien, je nachdem, ob es sich um wichtige oder weniger wichtige, auf lösbare oder unlösbare Probleme bezogene sowie angemessene oder überzogene Sorgen handelt. Das vorgestellte Arbeitsblatt zu den Sorgen soll vor allem die wahrgenommene Kontrolle des Patienten stärken und die Psychoedukation zur Generalisierten Angststörung erleichternPathological worries have not yet been clearly defined. As a consequence, practically relevant questions remain open: Which characteristics distinguish worries relevant for treatment from those which are not? What kind of worries has to be treated in which way? And: What kind of worries is rather to be accepted? We propose a simple rationale which helps the therapist and the patient to identify pathological worries. According to this working model, different treatment strategies result depending on whether worries are central or not, whether they relate to a problem which can be solved or not, and whether they seem proportionate or exaggerated. The presented worksheet is meant to strengthen the perceived control of the patient and to help facilitate psychoeducation for generalised anxiety disorder
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
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Hoyer, Jürgen, and Sabrina Heidrich. "Wann sind Sorgen pathologisch?" Karger, 2009. https://tud.qucosa.de/id/qucosa%3A27469.
Full textAbstract:
Pathologische Sorgen sind ungenau definiert. Für die Behandlungsplanung bleiben wichtige Fragen offen: Welche Merkmale sind für die Unterscheidung zwischen behandlungsbedürftigen und nicht behandlungsbedürftigen Sorgen relevant? Welche Art von Sorgen muss wie behandelt werden? Und: Welche Art von Sorgen gilt es eher zu akzeptieren? Wir machen praxisnahe Vorschläge dafür, wie Sorgen mittels einer einfachen Heuristik auch vom Patienten selbst als «pathologisch» identifiziert werden können. Im Sinne eines therapeutischen Arbeitsmodells ergeben sich differentielle Bearbeitungsstrategien, je nachdem, ob es sich um wichtige oder weniger wichtige, auf lösbare oder unlösbare Probleme bezogene sowie angemessene oder überzogene Sorgen handelt. Das vorgestellte Arbeitsblatt zu den Sorgen soll vor allem die wahrgenommene Kontrolle des Patienten stärken und die Psychoedukation zur Generalisierten Angststörung erleichtern.Pathological worries have not yet been clearly defined. As a consequence, practically relevant questions remain open: Which characteristics distinguish worries relevant for treatment from those which are not? What kind of worries has to be treated in which way? And: What kind of worries is rather to be accepted? We propose a simple rationale which helps the therapist and the patient to identify pathological worries. According to this working model, different treatment strategies result depending on whether worries are central or not, whether they relate to a problem which can be solved or not, and whether they seem proportionate or exaggerated. The presented worksheet is meant to strengthen the perceived control of the patient and to help facilitate psychoeducation for generalised anxiety disorder.
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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Ogniewicz, Avital S. "An Evaluation of a Computerized Measure of Interpretation Bias in Generalized Anxiety Disorder (GAD)." Thesis, 2012. http://spectrum.library.concordia.ca/974633/4/Ogniewicz_MA_F2012.pdf.
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Theories suggest that individuals with generalized anxiety disorder (GAD) make threatening appraisals of ambiguous information related to health, finances, and relationships, among other domains. As a result, we have recently developed two parallel word-sentence association paradigm (WSAP) computer tasks designed to assess threat and benign interpretation biases relating to GAD worry. It was hypothesized that the GAD analogue group (i.e., individuals meeting diagnostic criteria by questionnaire) would endorse more threatening interpretations and fewer benign interpretations of ambiguous sentences relative to the non-GAD group (i.e., individuals not meeting diagnostic criteria by questionnaire) in WSAP Sets A and B. In the current study, 97 university students and community volunteers were randomly assigned to Set A (n = 49) or B (n = 48), and completed self-report measures of anxiety, worry, and related symptomatology. The results indicate that of those assigned to Set A, no differences were found between the GAD analogue (n = 19) and non-GAD group (n = 30) on tendency to endorse threat interpretations. Of those assigned to Set B, the GAD analogue group (n = 17) was significantly more likely to endorse an overall threat interpretation bias and specifically, to reject benign disambiguations than the non-GAD group (n = 31). No differences were found between the groups in either Set in the tendency to accept threatening disambiguations. More research is needed on the specific role of biases in the etiology and treatment of GAD, and why Set A did not distinguish between the groups. This study provides preliminary support for the use of word-sentence paradigms to assess, and possibly modify, threat interpretation biases in GAD.
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Haque, Maaria. "The Implications of an age of onset distinction for the presentation and treatment of late-life generalised anxiety disorder." Phd thesis, 2013. http://hdl.handle.net/1885/156019.
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This thesis is an investigation of the implications of an age of onset distinction for the presentation and treatment of late-life generalised anxiety disorder (GAD). The main aim was to provide empirical evidence of a bimodal distribution of age at onset of GAD and a method for determining an appropriate cut-off to distinguish these two subgroups (Study One). The subsequent investigations included in Study One aimed to investigate differences in the aetiology and phenomenology of early-onset (EO) and late-onset (LO) GAD. In addition, the relationship between the experience of negative life events and age at onset of GAD was examined. Finally, Study Two aimed to investigate the implications of an age at onset distinction for the treatment of late-life GAD Study One included 76 older adults aged 55-84 years meeting diagnostic criteria for a current DSM-IV anxiety disorder, of which GAD was the most commonly diagnosed (96%). The results confirmed a bimodal distribution for first lifetime onset of GAD and an age of 34.4 years was identified as the cut-off point to distinguish between participants classified as having EO (n= 24) or LO (n = 56) GAD. EO participants reported significantly greater benzodiazepine and health supplement use; a longer history of anxiety; a greater number of episodes of anxiety and/or depression; a greater family history of psychiatric illness; greater severity of the symptom 'restlessness and/or feeling keyed up;' greater time spent worrying; greater distress, and; greater interviewer-rated severity of GAD than LO participants. On the other hand, LO participants reported greater functional limitations, poorer perceptions of health, and greater frequency and severity of both health-related events and difficult financial circumstances preceding first onset of GAD than those with EO GAD. The results also showed that that LO GAD was associated with the experience and accumulation of greater levels of life stress than EO GAD. Forty-one treatment-seeking participants (EO = 18 and LO = 23) who took part in the initial clinical assessment (Study One) completed a 12-week cognitive-behavioural therapy (CBT) program for GAD (Study Two). Measures of anxiety, worry and depression were completed at five time-points: at pre-treatment(T0), following completion of relaxation training (T1), cognitive skills (T2) and behavioural skills (T3) modules of therapy, and six-months following treatment completion (T4). Participant-rated evaluations of symptom severity and treatment efficacy were completed from T1 through to T4. The results showed that treatment resulted in significant improvements on all outcome measures from pre- to post-treatment and that these gains were maintained at six-month follow-up. Age of onset was not found to have a significant effect on treatment outcome. With exception of the finding that LO participants reported significantly greater symptom severity than EO participants at T1, onset groups did not differ in patterns of change over the course of treatment. The theoretical and clinical implications of the results and the need for further development of the understanding of an onset distinction in the presentation and management of late-life GAD through future research are discussed.
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Werling, Verena Anne Christine. "Darstellung der Ziele und Probleme von Patienten mit Generalisierter Angststörung." Doctoral thesis, 2010. http://hdl.handle.net/11858/00-1735-0000-0006-B149-D.
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