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CBT of generalized anxiety disorder

Publication |
2004

Abstract

The characteristic features of generalized anxiety disorder (gad) are excessive worries and physical symptoms such as restlessness, muscle tension, fatigue, irritability, problems with concentration and insomnia. With regard to the origins of generalized anxiety, it has been proposed that insecure attachment relationships, ambivalence of caregivers towards children, parental overprotection and lack of emotional warmth may all contribute to later development of anxiety.

Three mechanisms are considered to be perpetuating for generalized anxiety disorder. First, worry is used as a strategy for avoiding intense negative affects.

Second, worry about unlikely and future threat can distract from more realistic and imminent threats and therefore limits the capacity for problem solving. Finally, subjects with GAD are engaged in magical thinking to a certain degree and believe that their worries help them to prepare for apprehended outcomes, thus leading to a negative reinforcement of process of worrying.

Cognitive theory speculates about relationship of symptomatology to either early cognitive schemas, derived from negative experiences, of the world as a dangerous place or to insecure, anxious early attachments to important caregivers. According to the reviews of the research cognitive behavioral therapy is superior to general nondirective or supportive therapy in the treatment of GAD.

The therapist and client work together to identify client's anxious view of situation and events, to evaluate the accuracy of those perceptions through logic and evidence and to create alternative perspectives. Clients are encouraged to keep records of their worries and prediction about what might occur.

Then according to the real actual outcomes, client is evaluating the accuracy of their predictions and of the alternative ways of predicting. Because of their chronically elevated muscle tension, the most common behavioral intervention for GAD is relaxation training and application