
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Generalized anxiety disorder historical perspective
Introduction
Overview
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
Historical Perspective
- In the late 19th century, Sigmund Freud recognized anxiety as:[1]
- A “signal of danger”
- A cause of “defensive behavior“
- He believed we acquire anxious feelings through classical conditioning and traumatic experiences.
- In the 19th century into the 20th century, the terms used to diagnose generalized anxiety included:[2]
- “Pantophobia”
- “Anxiety neurosis”
- Such terms designated paroxysmal manifestations (panic attacks) as well as interparoxysmal phenomenology (the apprehensive mental state).
- Generalized anxiety was considered one of the numerous symptoms of neurasthenia, a vaguely defined illness.
- 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.
- Anxiety neurosis was split into:[3]
Development of Diagnostic Criteria for Generalized Anxiety Disorder
- In 1980, DSM-III portrayed GAD as:[4]
- Generalized, persistent anxiety
- 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:
- Excessive anxiety and worry (apprehensive expectation) about a number of events or activities
- Difficult to control the worry
References
References
- ↑ Kessler RC, Keller MB, Wittchen HU (2001). “The epidemiology of generalized anxiety disorder”. Psychiatr Clin North Am. 24 (1): 19–39. PMID 11225507.
- ↑ Crocq MA (2017). “The history of generalized anxiety disorder as a diagnostic category”. Dialogues Clin Neurosci. 19 (2): 107–116. PMC 5573555. PMID 28867935.
- ↑ 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.
- ↑ 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.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Irfan Dotani
