Generalised anxiety problems involve excessive worry about several lifestyle domains such as health, finances, relationships, and so on. Such worrying usually takes up most of the individual's time and becomes highly disabling, both for the individuals concerned and for their partners, friends, and families. This so-called pathological worry is associated with a number of physiological/somatic symptoms of fear or anxiety, although, for diagnostic purposes, it is not usually regarded as including among its domains of concern the sorts of stimuli that are associated with the other so-called anxiety disorders (for example, a specific aetiological trauma as in PTSD, the phobic object in phobias, etc.).
Such generalised worry has been labelled generalised anxiety disorder (GAD) in psychiatric classification systems such as the DSM-IV (APA, 1994). There are a variety of nosological issues involved in the conceptualisation of GAD. These concern: first, the relationship between GAD, a so-called clinical disorder, and subclinical levels of chronic anxiety as measured by concepts such as trait anxiety (e.g., Spiel-berger, Gorsuch, & Lushene, 1970); second, the relationship of GAD with depression and with mixed anxiety-depression disorders; and third, the relationship of the type of anxiety-related problems found in someone with GAD with the type of anxiety-related problems that epitomise panic disorder. An excellent overview of the debates can be found in Barlow's (2002) book Anxiety and its Disorders. For the purposes of the present chapter we confine ourselves to highlighting two points: first, that most individuals who meet the criteria for a diagnosis of GAD are also somewhat depressed and that this has implications for much of the research that we will discuss; second, there is clearly a relationship between subclinical chronic anxiety as measured by constructs such as trait anxiety and the clinical problem of GAD, and it does not seem unreasonable to suggest that high levels of trait anxiety represent a vulnerability factor for the onset of GAD (e.g., Eysenck, 1997). Rather than discuss either of these issues at length now, we will return to them at appropriate points in the chapter.
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