A large body of research indicates that worry, anxiety, and depression are present in the modern American psyche at increasingly high levels. Everyday worry can lead to further mental health issues, interpersonal problems, and reduced physical wellbeing and should be reduced when possible. Previous research has examined the benefits of church attendance with varied results; however, understanding the relationship between church attendance and everyday worry could be useful in reducing the effects of worry on this population. The purpose of this quantitative study was to measure self-reported levels and causes of everyday worry among church-goers from three congregations and to examine the relationship among peers when sorted by frequency of church attendance and demographic group. Participants completed demographic questions and the Penn State Worry Questionnaire online. The survey was distributed among 3 congregations in the Raleigh, North Carolina area. The 3 congregations represented a spectrum of churches from the Baptist tradition in an attempt to determine if there were significant differences among conservative, moderate, and liberal churches. Two hundred sixty-six usable surveys were returned, an 84% response rate. Results from the statistical analysis indicated that more frequent church attendance was associated with less worry. Women tended to worry more than men, and younger people tended to worry more than older people. There was no significant relationship between level of worry and church type (conservative, moderate, or liberal).

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Bakgrund: Generaliserat ångestsyndrom (GAD) är en vanlig diagnos med negativa konsekvenser såväl på individ- som samhällsnivå. För att som fysioterapeuter kunna fånga upp den här typen av patienter och då ha god kunskap om olika träningsformer som tillförlitlig behandling ansågs det fördelaktigt att undersöka det vetenskapliga underlaget för styrketräning som behandlingsmetod. Syfte: Syftet med denna litteraturstudie var att undersöka det vetenskapliga underlaget för effekten av styrketräning, i jämförelse med annan eller ingen intervention, som behandlingsmetod för att minska oros- och ångestsymtom hos vuxna mellan 18-64 år med GAD. Metod: En litteraturstudie av randomiserade kontrollerade studier där populationen var vuxna mellan 18-64 år med GAD. Sökningar genomfördes i databaserna PubMed, Cochrane, PEDro och Psycinfo. Fyra studier inkluderades och granskades sedan med PEDro. Den sammanvägda tillförlitligheten av resultatet av tre studier bedömdes med hjälp av GRADEstud. Resultat: Det vetenskapliga underlaget för styrketräning som behandling för personer med GAD är för begränsat för att kunna dra några starka slutsatser. Alla inkluderade studier visade dock på reducering av oros- och ångestsymtom, som båda är kännetecknande symtom för GAD. Konklusion: Det sammanvägda resultatet indikerar på att styrketräning skulle kunna vara en alternativ behandlingsmetod för denna patientgrupp. Mer forskning behövs dock för att kunna utvärdera effekten av styrketräning som behandling för personer med GAD. / Background: Generalized anxiety disorder (GAD) is a common diagnosis with negative consequences both on an individual and societal level. In order for physiotherapists to be able to catch these patients and then have good knowledge of different forms of exercise as reliable treatment, it was considered beneficial to investigate the scientific basis for resistance exercise training as a treatment method. Objective: The aim of this literature review was to investigate the scientific basis for the effect of resistance exercise training, in comparison with other or no intervention, as a treatment method to reduce worry and anxiety symptoms in adults aged 18-64 with GAD. Method: A literature review of randomized controlled trials where the population was adults between 18-64 years old with GAD. Searches were conducted in the databases PubMed, Cochrane, PEDro and Psycinfo. Four studies were included and reviewed with PEDro. The combined reliability of the results of three studies was assessed using GRADEstud. Results: The scientific basis for resistance exercise training as a treatment for people with GAD is too limited to be able to draw any strong conclusions. However, all included studies showed a reduction in worry and anxiety symptoms, both of which are characteristic symptoms of GAD. Conclusion: The combined results indicate that strength training could be an alternative treatment method for this patient group. However, more research is needed to be able to evaluate the effect of strength training as a treatment for people with GAD.

This study examined whether schemas formed during training (graduate coursework, clinical supervision, etc.) are responsible for the tendency of clinicians to experience higher rates of false recall for clinical case details when compared to novices. Participants in this study were recruited from a general psychology class to limit preexisting knowledge of psychological disorders. Half of the participants were trained to recognize features of Generalized Anxiety Disorder with the purpose of forming a schema for that disorder, whereas the other half were not. Participants’ memory for the diagnostic and non-diagnostic details within a hypothetical case vignette was tested using a free recall prompt followed by a yes/no recognition test. Trained participants falsely recognized the diagnostic detail ‘restlessness’ and falsely recalled the diagnostic detail ‘uncontrollable worry’ at a significantly higher rate than controls, suggesting that the training successfully formed a schema for GAD symptoms.

Major Depression (MD) and Generalized Anxiety Disorder (GAD) are psychiatric disorders that arise from dysfunction of the core human capacities for emotion. Sapience is inextricably bound up with the potential for feelings of regret, worry and concern. When these emotions lead to clinically significant impairment or distress, they may result in one or both of the disorders of MD and GAD. The occurrence of MD and GAD in the same person, known as comorbidity, is remarkably high; substantially higher than would be expected by chance. MD and GAD have been studied since the mid-20th century, resulting in a substantial body of literature. The personality trait of neuroticism is also known to correlate highly with these disorders. This project was designed to compare the etiological structure of MD and GAD using a range of psychosocial and genetic methods in three datasets, while also assessing the correlated trait of neuroticism. Results are used to inform theoretical formulation of an approximate model of comorbidity for the two disorders. Psychosocial findings suggest that MD and GAD have similar relationships with most risk factors, and that neuroticism displays results consistent with it composing a portion of the liability to MD and GAD. Efforts to detect specific genetic loci involved in the etiology of MD and GAD are modestly successful. Two genome-wide significant variants were found for MD (one already identified in the literature); two for GAD, and one for neuroticism. There were also a number of significant genomic regions for each outcome. The use of aggregate genetic methods to estimate heritability based on genotypes was less successful. Estimation was only successful in one sample of the three, and produced modest estimates of heritability (0.2-0.25) for MD and comorbid MD+GAD. Genetic correlation was estimated to be very high between neuroticism and MD. Models of comorbidity are evaluated in light of these results, and a model comprising multiple liability distributions, one shared entirely by MD and GAD, and two additional correlated ones for the two disorders, with reciprocal phenotypic causation, is deemed most consistent with observed evidence.

Despite the success of available medical and psychosocial treatments, a sizable subgroup of individuals with commonly co-occurring disorders, generalized anxiety disorder (GAD) and major depressive disorder (MDD), fail to make sufficient treatment gains thereby prolonging their deficits in life functioning and satisfaction. Clinically, these patients often display temperamental features reflecting heightened sensitivity to underlying motivational systems related to threat/safety and reward/loss (e.g., somatic anxiety) as well as inordinate negative self-referential processing (e.g., worry, rumination). This profile may reflect disruption in two important neural networks associated with emotional/motivational salience (e.g., salience network) and self-referentiality (e.g., default network, DN). Emotion Regulation Therapy (ERT) was developed to target this hypothesized profile and its neurobehavioral markers. In the present study, 22 GAD patients (with and without MDD) completed resting state MRI scans before receiving 16 sessions of ERT. To test study these hypotheses, we examined the associations between baseline patterns of intrinsic functional connectivity (iFC) of the insula and of hubs within the DN (anterior and dorsal medial prefrontal cortex [MPFC] and posterior cingulate cortex [PCC]) and treatment-related changes in worry, somatic anxiety symptoms and decentering. Results suggest that greater treatment linked reductions in worry were associated with iFC clusters in both the insular and parietal cortices. Greater treatment linked gains in decentering, a metacognitive process that involves the capacity to observe items that arise in the mind with healthy psychological distance that is targeted by ERT, was associated with iFC clusters in the anterior and posterior DN. The current study adds to the growing body of research implicating disruptions in the default and salience networks as promising targets of treatment for GAD with and without co-occurring MDD.

Background. The proposed revisions of the ICD and DSM diagnostic systems have led to increased interest in evaluation of diagnostic criteria. This report focuses on the DSM-IV requirement that episodes of generalized anxiety disorder (GAD) must persist for at least 6 months. Community epidemiological data are used to study the implications of changing this requirement in the range 1–12 months for estimates of prevalence, onset, course, impairment, co-morbidity, associations with parental GAD, and sociodemographic correlates. Method. Data come from the US National Comorbidity Survey Replication (NCS-R), a US household survey carried out during 2001–2003. Version 3.0 of the WHO Composite International Diagnostic Interview (WMH-CIDI) was used to assess DSM-IV anxiety disorders, mood disorders, substance disorders, and impulse-control disorders. Results. Lifetime, 12-month, and 30-day prevalence estimates of DSM-IV GAD changed from 6·1%, 2·9%, and 1·8% to 4·2–12·7%, 2·2–5·5%, and 1·6–2·6% when the duration requirement was changed from 6 months to 1–12 months. Cases with episodes of 1–5 months did not differ greatly from those with episodes of [gt-or-equal, slanted]6 months in onset, persistence, impairment, co-morbidity, parental GAD, or sociodemographic correlates. Conclusions. A large number of people suffer from a GAD-like syndrome with episodes of <6 months duration. Little basis for excluding these people from a diagnosis is found in the associations examined here.

Theoretischer Hintergrund: Die diagnostischen Kriterien der Generalisierten Angststörung (GAS) und ihr Status als eigenständige psychische Störung waren lange umstritten. Inzwischen liegen neuere epidemiologische Daten vor, die ein präziseres Bild dieser Störung und ihrer Besonderheiten ermöglichen. Methode: Es wird ein systematischer Überblick zu Prävalenz, Verlauf und Komorbidität, zur Beeinträchtigung und zum Inanspruchnahmeverhalten sowie zur Spezifität des Kernsymptoms (Sorgen) erstellt. Ergebnisse: GAS ist eine häufige Störung, die im jungen Erwachsenenalter einsetzt, jedoch auch – anders als andere Angststörungen – hohe Inzidenzraten im mittleren Lebensalter aufweist. Der Verlauf ist eher chronisch. Trotz hoher Komorbidität lässt sich die Störung valide abgrenzen. Klinisch relevante Sorgen erweisen sich als störungsspezifisch. Die Beeinträchtigungen sind auch bei GAS-Patienten ohne Komorbidität beträchtlich. Schlussfolgerung: Der Forschungsstand spricht für die Bedeutung und Eigenständigkeit der Diagnose sowie für die stärkere Beachtung offener Forschungsfragen. / Background: The diagnostic criteria for generalized anxiety disorder (GAD) and its status as an independent mental disorder have been controversial. More recent epidemiological data provide a more precise picture of this disorder and its specific features. Methods: A systematic overview is given in regard to prevalence, course and comorbidity, impairment, and help-seeking behavior as well as to specificity of the core symptom (worries). Results: GAD is a frequent disorder with high incidence rates in middle-age groups, which are not seen in other anxiety disorders. Despite the high comorbidity GAD can be validly distinguished. Clinically relevant worries have been proven as specific for the disorder. The impairments are also considerable for patients without comorbid disorders. Conclusions: Research supports the independent status of GAD and the importance of this diagnosis. Unsolved questions are to be analyzed in future research.

BACKGROUND: There are many studies that have documented the increasing impact of stress and anxiety on an individual’s health and well-being. Everyone handles stress and anxiety differently with these conditions having varying physiological effects. To better recognize whether or not a person may need help in tackling these conditions, scholars have developed reliable validated instruments. Two prominent instruments that effectively assess stress and anxiety levels are the Perceived Stress (PSS) and Generalized Anxiety Disorder (GAD-7) scales. Furthermore, the literature has shed light onto the importance of the carotid intima-media thickness (c-IMT) measurement as a tool in evaluating the risk of cardiovascular disease. After all, heart disease has been reported as being the number one killer of Americans in recent years. The specific aims of this study were to determine if there was an association between perceived stress / generalized anxiety and c-IMT (static association), and also if higher levels of perceived stress / generalized anxiety result in a significant increase in c-IMT (changes over time). METHODS: Data was collected on about 700 participants comprised of employees from Emory University in Atlanta, Georgia. At baseline, six, twelve, and twenty-four months, the largest number of participants had completed and calculated their scores on the PSS and GAD-7 scales. At these same time points, participants had their IMT measured and recorded for the left and right common carotid arteries by a trained sonographer of the Emory Predictive Health Institute. Due to incomplete measurements and scores, only 228 participants were included for statistical analyses. This was still considered a suitable sample size given that this study only involved four measurement time points. Various statistical models were fitted for the data. All variables in the models were treated as categorical except for time which was continuous. Four separate models were built that included the variables perceived stress, age group, gender and time. In a similar manner, four models were built that included the variables generalized anxiety, age group, gender and time. AIC values, -2 log-likelihoods, partial correlations, p-values, and other relevant information were reported for these models. All statistical analyses were performed using the Statistical Analysis System (SAS), version 9.2. RESULTS: The mean c-IMT measurements for the Emory participants were higher than established normal ranges. A strong correlation existed between the PSS and GAD-7 two-year averages when treated as continuous variables (.7316, p <.0001). Likewise, a meaningful relationship existed when both scales were categorical (.4154, p < .0001). The analyses revealed that the left and right mean IMT measurements for the common carotid arteries modeled a linear trend with an unstructured covariance the best. The partial correlations for perceived stress and generalized anxiety revealed weak, but significant positive associations with the mean c-IMT measurement. Although the slope coefficients were not significant for perceived stress, an increase from below average to above average perceived stress level still resulted in an increase in mean c-IMT measurement. Conversely, mild generalized anxiety was found to be statistically significant in the regression model of the left mean c-IMT. This was after controlling for age group and gender. The p-value for mild generalized anxiety was 0.0258, and the slope coefficient was 0.04856. IMT measurements were consistently higher for males on both sides compared to females. They were also higher on the left side compared to the right. CONCLUSIONS: Failure to control anxiety could lead to c-IMT soaring to dangerous levels resulting in a myocardial infarction and/or cerebrovascular accident. Individuals should engage in healthy lifestyle practices that lower stress and anxiety levels to decrease the chances of cardiovascular disease. Based on this study’s findings, a person can certainly use their c-IMT readings, as well as their perceived stress and generalized anxiety scores, as indicators that lifestyle modifications may be needed.

Title from second page of PDF document. Includes bibliographical references (p. 103-109).