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Broadening the Definition of Generalized Anxiety Disorder

Changes in Prevalance Rates if Changes are Made

From , former About.com Guide

Updated October 25, 2007

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The criteria for each mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are set by large committees of expert professionals after a close examination of theory and research. As the next revision of the DSM approaches in 2011, there are ongoing debates about changes that could be made to the manual. A research article brings this discussion to generalized anxiety disorder (GAD), exploring whether diagnostic criteria should be loosened.

The Current Study

The definition of GAD has shifted over the past three revisions of the manual. DSM-III required one month of anxiety along with a variety of other symptoms. DSM-III-R required six months with more of the possible symptoms needing to be present. For DSM-IV, the anxiety needed to be “excessive” and “uncontrollable.”

The study (Ruscio et al., 2007) used a nationally representative sample of people in the United States (5,692 subjects) who participated in face-to-face interviews. Information was gathered on mental health and a variety of other things, and the authors examined the data for GAD criteria. Results showed that if criteria for length of time symptoms would be experienced, excessiveness, and additional symptoms were relaxed, there was a 40% to 60% increase in those who could be diagnosed, depending on the degree of relaxation.

Additional Thoughts

Any time something like this is defined, there is risk of making one of two unavoidable errors. With a broader definition, the risk becomes having “false positives,” meaning that more people that don’t actually have GAD will actually be diagnosed with it. The alternative is having too strict a definition, leaving some people who actually have GAD to go undiagnosed. It is a neverending debate with significant implications on what is viewed as “healthy” and “unhealthy,” as well as what types of treatment may continue to be offered and developed.

Source:

Ruscio et al (2007). Broadening the definition of generalized anxiety disorder: Effects on prevalence and associations with other disorders in the National Comorbidity Survey Replication. Journal of Anxiety Disorders, 21, 662-676.

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