Anxiety
Since there is a high comorbidity of anxiety and depression, we are focusing on these two disorders together.
Anxiety disorders affect almost 30% of adults at some point during their life. As a result, research into the effective treatment of anxiety is crucial given that it affects such a large portion of the population (American Psychiatric Association, 2021).
Risk Factors
While the risk factors for anxiety vary depending on the type of anxiety disorder, it is believed that genetic and environmental factors contribute to the development of an anxiety disorder. Some risk factors include
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Personal or family history of anxiety
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Exposure to stressful or negative events or environments
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Nervousness or feelings of distress in new situations as a child
DSM-Classified Anxiety Disorders
The DSM classifies six types of anxiety disorders. The following list also indicates estimated percent of US adults who experience each disorder (American Psychiatric Association, 2021).
Question
Why is it important to apply a transdiagnostic perspective, especially in the diagnosis and treatment of anxiety?
As previously mentioned, one major reason is that anxiety often co-occurs with depression and other disorders. We will discuss this further in future sessions. Additionally, within the anxiety disorder category, anxiety disorders commonly coexist. Brown et al. (2001) identified in one study that:
Clients had more than one anxiety disorder
Clients, throughout their life, had met the criteria for more than one anxiety disorder (McManus et al., 2010)
For this interactive, drag the items into the boxes where they belong. You can also use tab and the keys on your keyboard. When you have finished, select check to see your score.
Screening and Monitoring Instruments
The GAD-7 is the most commonly used screening and monitoring instrument for anxiety in clinical practice, demonstrating utility and diagnostic accuracy. Similar to the PHQ-2 and PHQ-9, scores of 0 (“not at all”) to 3 (“nearly every day”) are used for diagnosis.
GAD-7
The GAD-7 asks seven questions based on the criteria for generalized anxiety disorder in the DSM-5.
In the GAD-7, scores are classified as follows with the highest score possible being 21.
| GAD-7 Score | Diagnosis |
|---|---|
| 5 | Mild anxiety |
| 10 | Moderate anxiety |
| 15 | Severe anxiety |
Learn More
For an example of the GAD-7 used by the Canadian Association for Mental Health to screen clients for generalized anxiety disorder, please download their questionnaire.
References
American Psychiatric Association (2021). What are anxiety disorders?
Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., & Mancill, R. B. (2001). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of abnormal psychology, 110(4), 585–599.
McManus, F., Shafran, R., & Cooper, Z. (2010). What does a transdiagnostic approach have to offer the treatment of anxiety disorders? British Journal of Clinical Psychology.