NEW PERSPECTIVES ON GENERALIZED ANXIETY DISORDER

NEW PERSPECTIVES ON GENERALIZED ANXIETY DISORDER

Library of Congress Cataloging-in-Publication Data

Contents

Preface

What Does Generalized Anxiety Mean?

References

Contributors

Chapter 1: The History of the Concept of Anxiety and Nosography of Generalized Anxiety Disorder

Institute of Psychiatry and Clinical Psychology,

Catholic University Medical School of Rome, Italy

Abstract

Introduction

The Concept of Anxiety from 18th to 20th Century

Anxiety and Generalized Anxiety Disorder in the DSM Classification

GAD in DSM-IV-TR and ICD 10

Conclusion

References

Chapter 2: Epidemiology of Generalized Anxiety Disorder

1Department of Public Health, Section of Hygiene,

Catholic University Medical School of Rome, Italy

2Institute of Psychiatry and Clinical Psychology,

Catholic University Medical School of Rome, Italy

Abstract

Introduction

Distribution of the Disease

Risk Factors and Associated Conditions

Natural History of the Disease

and Issues of Personal Functioning

Conclusion

References

Chapter 3: The Neurobiology of Generalized Anxiety Disorder

Abstract

Introduction

Biological Models of GAD

GAD and Neurobiology

GABA/Benzodiazepine Sites

Noradrenergic System

Serotonergic System

Cholecystokinin (CCK)

Corticotropin-Releasing Factor (CRF)

Tachykinins

Neuropeptide Y (NPY)

Glutamate

Neurosteroids

Autonomic Functions

Structural and Functional Neuroanatomy

Behavioral Inhibition, Anxious Temperament and GAD

GAD and Cardiovascular Disease

Does the Neural Basis of GAD Change over Time?

Conclusion

References

Chapter 4: Neuroimaging in Generalized Anxiety Disorder (GAD)

Abstract

Introduction

Mental Defence System in Anxiety Disorders

Anticipation and Intolerance of Uncertainty

Emotion Dysregulation

Worry

Anxious Temperament and GAD

Conclusion

References

Chapter 5: Basic Pharmacology of Generalized Anxiety Disorder

Abstract

Introduction

Rodent Models and Tests

Molecular Targets

GABA–Benzodiazepine System

5-HT

Glutamate

Endocannabinoids

Neuropeptides

Conclusion

References

Chapter 6: Clinical Presentation

Abstract

Introduction

Clinical Picture

Course

Differential Diagnosis

Conclusion

References

Chapter 7: Comorbidity of Affective Disorders, Alcohol Use and Gambling

Institute of Psychiatry and Clinical Psychology,

Catholic University Medical School of Rome, Italy

Abstract

Introduction

GAD and Major Depressive Disorder

GAD and Dysthymia

GAD and Bipolar Disorder

GAD and Alcohol Dependence

GAD and Gambling

Conclusion

References

Chapter 8: Personality Features and Anxiety

Abstract

Introduction

Personality Disorders

Personality Traits

Conclusion

References

Chapter 9: Anxiety Disorders in the Elderly with an Emphasis on Generalized Anxiety Disorder

Abstract

Introduction

Semiology

Epidemiology

Etiological Considerations

Comorbidity and Differential Diagnosis

Clinical Evaluation

Therapeutic Approaches

Psychopharmacological Treatment

Psychotherapeutic Treatments

Cognitive and Behavioral Psychotherapy

Body-Mediated Treatments

Mindfulness-Based Interventions

Psychodynamic Psychotherapy

Prognosis

Conclusion

References

Chapter 10: Memory and Neuropsychological Dysfunctions in the Generalized Anxiety Disorder

Abstract

Introduction

Cognitive Theories of Anxiety Disorders

Cognitive Paradigms: Memory Bias

Explicit and Implicit Memory Biases in Anxiety Disorders: Research Status Until 2003

Explicit and Implicit Memory in GAD: From 2003 to 2013

Conclusion

References

Chapter 11: Separation Anxiety Disorder in Adulthood

Abstract

Introduction

History of Clinical Classification

Assessment Tools

Main Studies

General Population Studies

Clinical and Volunteer Samples

Adult Separation Anxiety in Family and Attachment Studies

Neurobiology

Nosological Implications

Separation Anxiety Disorder in the DSM-5

Clinical Implications

Symptoms

Clinical Vignette

Comorbidity

Anxiety Disorders

Mood Disorders

PTSD and Complicated Grief

Personality Disorders

Adult Separation Anxiety and Pregnancy

Impairment of Functioning

Therapeutical Implications for Adult Separation Anxiety Disorder

Conclusion

References

Chapter 12: Pharmacological Treatments for Generalized Anxiety Disorder

Abstract

Introduction

1. First Line Pharmacological Treatment

1.1. SSRIs

1.2. SNRIs

1.3. α2δ Calcium Channels Anticonvulsants

2. Second-Line Pharmacological Treatments

2.1. Benzodiazepines

2.2. Other Antidepressants

3. Off-Label Used Drugs

4. Clinical Guide-Lines

Conclusion

References

Chapter 13: Cognitive Behavioural Therapy for Generalized Anxiety Disorder

Abstract

Introduction

Prevalence and Comorbidity

Worry: The Pathognomonic Symptom of GAD

Treatment of GAD

Cognitive Behavioural Therapy for GAD

Psychoeducation

Self-monitoring

Cognitive Restructuring

Relaxation

Imaginative Relaxation

Worry Behaviour Control and Problem Solving

Identifying and Evoking Metacognitions

Sharing the Model

Disputing Type 2 Worry and Metacognitive Beliefs

Strategy Shifts

Relapse Prevention

References

Index