Generalized anxiety disorder historical perspective

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

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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.