Cited by 19Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychology Research and BibliometricsChild and Adolescent Psychosocial and Emotional Development

The increase in interest in GAD: Commentary on Asmundson & Asmundson

Open access
Newman, Michelle G., Przeworski, Amy·2018·Journal of Anxiety Disorders

Abstract

Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders. It is associated with functional impairment and is unlikely to spontaneously remit. As identified by Asmundson and Asmundson (2018), published research studies on GAD have increased in number over the last decade. We propose that this is due to the high prevalence of the diagnosis and symptoms, interest in transdiagnostic processes, such as worry, increased interest in emotion dysregulation as a principle underlying diagnoses, and new methods of treating and disseminating treatment that may be particularly well suited to GAD. Despite the increase in research articles on GAD, GAD still remains one of the least studied anxiety disorders. We propose that this is due to the misconception that GAD does not lead to severe impairment, despite data showing otherwise. Future research should continue to examine the phenomenology, mechanisms, and treatment of GAD in order to better understand this common anxiety disorder. © 2018 Elsevier Ltd

Integrity signals

Registry

Crossref · 10.1016/j.janxdis.2018.04.006

Cites

22 of 22 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

9 of 30 cited sources checked · 6 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Later theories have highlighted emotion dysregulation as a central feature of GAD.

    “and subsequent theories have emphasized emotion dysregulation as a key feature of GAD (see Newman & Llera, 2011 for a complete review).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Newman & Llera, 2011 source
  • Premisecitation

    Larger studies show that GAD's functional impairment is equal to or greater than that of other diagnoses.

    “Although small studies have suggested that pure GAD is associated with less severe disability than other diagnoses, larger studies have demonstrated that the functional impairment associated with GAD is equivalent and sometimes greater than that of other diagnoses (see Newman et al., 2013 for a review).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Newman et al., 2013 source

      The “Health, Disability, and Cost” section (page unavailable) reports that pure GAD was associated with disability comparable to major depressive disorder and greater than several other diagnoses. It does not establish the citing sentence’s contrast between smaller and larger studies or identify study size as the reason for the differing findings. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Interpretationreasoning

    The persistence of GAD as one of the least studied anxiety disorders is attributed to the mistaken belief that GAD does not cause severe impairment, despite evidence to the contrary.

    “We propose that this is due to the misconception that GAD does not lead to severe impairment, despite data showing otherwise.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Some researchers and clinicians continue to view GAD as less severe or disabling than other anxiety diagnoses.
  • Premisereasoning

    Even with more GAD research articles, GAD is still among the least studied anxiety disorders.

    “Despite the increase in research articles on GAD, GAD still remains one of the least studied anxiety disorders.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Asmundson & Asmundson, 2018 source
  • Premisecitation

    From 2006 to 2016, GAD publication counts were lower than those for PTSD, social anxiety disorder, and OCD.

    “Nonetheless, despite being the most frequently experienced anxiety diagnosis, Asmundson and Asmundson (2018) highlight that between 2006 and 2016 publication numbers have lagged behind that of other anxiety diagnoses, including posttraumatic stress disorder, social anxiety disorder, and obsessive compulsive disorder.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Asmundson & Asmundson, 2018 source
  • May combine two claims. 11
  • Classified as probably not a substantial claim. 19
  • May combine two claims.

    Premisecitation

    Another study found 8% of students met GAD diagnostic criteria and 13.7% had subthreshold levels.

    “Another study found 8% met diagnostic criteria for GAD and another 13.7% met subthreshold levels (Kanuri, Taylor, Cohen, & Newman, 2015).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Kanuri, Taylor, Cohen, & Newman, 2015 source
  • May combine two claims.

    Premisecitation

    GAD's worry and anxiety are theorized to resemble trait anxiety, as both are persistent, high, diffuse states that can impair functioning and may be a common transdiagnostic experience in anxious people.

    “and to be similar in nature to trait anxiety, in that both are persistent, high, and diffuse anxiety states that can impair an individual’s functioning and that may serve as a common transdiagnostic experience in anxious individuals (Newman et al., 2013).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Newman et al., 2013 source

      In “Defining and Delineating the Boundaries of Generalized Anxiety Disorder” (page unavailable), the review describes worry as a possible transdiagnostic process. Its “Health, Disability, and Cost” section reports substantial impairment, and the Conclusion describes GAD’s long course. However, the copy does not compare GAD’s worry and anxiety with trait anxiety or describe both as high, diffuse states. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    GAD is linked to higher rates of health problems.

    “as well as increased rates of health problems (Newman et al., 2013).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Newman et al., 2013 source
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Contrast Avoidance Model of Worry proposes that people with GAD are uncomfortable when emotions shift from neutral or positive to negative, and that worrying sustains a negative state, which makes them more comfortable.

    “Additionally, a new theory—the Contrast Avoidance Model of Worry—suggests that individuals with GAD become uncomfortable when their emotions shift from a neutral or positive state to a negative state and that worrying maintains a negative state, thereby leading them to be more comfortable (Newman & Llera, 2011).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Newman & Llera, 2011 source
  • May combine two claims.

    Premisecitation

    GAD tends to persist and is not likely to resolve without intervention.

    “GAD is chronic and unlikely to spontaneously remit (Newman, Llera, Erickson, Przeworski, & Castonguay, 2013).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Newman et al., 2013 source
  • Classified as probably not a substantial claim.

    Premisecitation

    The worry and anxiety typical of GAD have been theorized to underlie all emotional diagnoses.

    “The worry and anxiety that characterizes GAD has been conceptualized to underlie all emotional diagnoses (Newman et al., 2013)”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Newman et al., 2013 source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    GAD is linked to impairments in interpersonal relationships and career achievement.

    “It is associated with functional impairments in interpersonal relationships and career attainment (Blazer, Hughes, & George, 1987; Przeworski et al., 2011) as well as increased rates of health problems (Newman et al., 2013).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Blazer et al., 1987 source
    • cites Przeworski et al., 2011 source

      The Abstract reports interpersonal problems among people with GAD, including marital conflict, few friends, and difficulty in relationships. It does not address career attainment; searches for career achievement and occupational functioning did not establish that part of the claim. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In adults, GAD is among the most common psychological diagnoses, with a lifetime prevalence around 6.2%.

    “Generalized anxiety disorder (GAD) is one of the most common psychological diagnoses in adults, with about 6.2% of the population suffering from it at some point during their lifetime (Somers, Goldner, Waraich, & Hsu, 2006).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Somers et al., 2006 source
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    New wave approaches such as ACT and mindfulness are especially suitable for GAD and may have increased therapy-focused publications on GAD.

    “These approaches are particularly well-suited to GAD and may have led to the increased number of therapy-oriented publications on GAD.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Interpretationreasoning

    A possible reason for the rise in GAD publications is growing interest in emotion dysregulation as a principle underlying diagnoses.

    “We propose that this is due to the high prevalence of the diagnosis and symptoms, interest in transdiagnostic processes, such as worry, increased interest in emotion dysregulation as a principle underlying diagnoses, and new methods of treating and disseminating treatment that may be particularly well suited to GAD.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Empirical evidence supports theories that emphasize emotion dysregulation and discomfort with emotional shifts as underlying GAD.
  • May combine two claims.

    Premisecitation

    In a large national survey of 63,000 students, nearly 61% reported overwhelming anxiety and 57.6% reported elevated stress.

    “Nearly 61% of 63,000 students in a large national survey reported experiencing overwhelming anxiety and 57.6% reported elevated stress (American College Health Association, 2017).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites American College Health Association, 2017

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    GAD measures that perform well psychometrically in younger and middle-aged adults often perform poorly and have low diagnostic accuracy in older adults.

    “studies indicating that measures of GAD that have solid psychometric properties when used in younger and middle adults often have poor psychometric properties and diagnostic accuracy in older populations (Byrne et al., 2010).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Byrne et al., 2010 source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Claims that GAD is not a real disorder may have led researchers to prioritize other disorders they consider more important.

    “At the same time, suggestions that GAD is not a real disorder, may also have led a lot of researchers to focus on other disorders that might be viewed by them as more important.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Some researchers and clinicians continue to view GAD as less severe or disabling than other anxiety diagnoses.
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    These anxiety and stress symptoms are linked to worse academic performance, interpersonal functioning, and physical health.

    “Such symptoms are associated with poorer school performance, interpersonal functioning, and physical health (American College Health Association, 2016).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites American College Health Association, 2016

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    GAD's lifetime prevalence exceeds that of every other anxiety diagnosis.

    “In fact, the lifetime prevalence of this diagnosis is higher than that of all other anxiety diagnoses (Somers et al., 2006).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Somers et al., 2006 source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Using a 6-month duration criterion lowered comorbidity rates.

    “Rates of comorbidity were reduced when using a 6-month duration criterion (Breslau & Davis, 1985) and some argued that the 6-month duration criterion was important in distinguishing between temporary increases in anxiety and worry in response to stress.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Breslau & Davis, 1985 source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    GAD is among the most common psychological disorders in older adults, with 7.3% experiencing symptoms.

    “GAD is one of the most common psychological disorders in elderly individuals, with 7.3% of older adults experiencing symptoms of the disorder (Bryant, Jackson, & Ames, 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bryant, Jackson, & Ames, 2008 source
  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Applying the 6-month duration criterion may prevent many distressed people from receiving a diagnosis or accessing treatment.

    “Thus, it was argued that applying the 6 month duration criterion may lead to many distressed individuals not receiving a diagnosis or being able to pursue treatment.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Colleges and universities have reported a large rise in students with psychological disorders.

    “Universities and colleges have been reporting a dramatic increase in the number of students who are struggling with psychological disorders (Reilly, 2018).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Reilly, 2018

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The number of students seeking college counseling services for any psychological distress rose by 30% from 2009 to 2015.

    “The number of students who have sought services at a college counseling center for any type of psychological distress increased by 30% between 2009 and 2015 according to a report by the Center for Collegiate Mental Health (American College Health Association, 2016).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites American College Health Association, 2016

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    By 2000, relatively few studies had examined GAD mechanisms, and most of those focused on treatment.

    “Further, as of 2000, far fewer published studies have investigated mechanisms underlying GAD and most of these have examined treatment (Dugas, 2000).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Dugas, 2000 source
  • Classified as probably not a substantial claim.

    Premisecitation

    People with shorter GAD symptom episodes show impairment and comorbidity rates similar to those who meet the 6-month duration criterion.

    “and that those who experience shorter duration episodes of GAD symptoms do not differ in impairment or rates of comorbidity from those meeting the 6 month duration criterion (Ruscio et al., 2007).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ruscio et al., 2007 source
  • Classified as probably not a substantial claim. May combine two claims.

    Premisereasoning

    CBT for GAD is brief and skills-based, making it a good fit for primary care and technology-based delivery.

    “Cognitive-behavioral therapy (CBT) for GAD is skills-based and brief and, therefore, fits nicely with primary care and technology-based approaches.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    Many people have subthreshold symptoms that do not satisfy the 6-month duration criterion for DSM-5 GAD.

    “research suggesting that many individuals experience subthreshold symptoms that do not meet the 6-month duration criterion for DSM-5 GAD”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ruscio et al., 2007 source
  • Classified as probably not a substantial claim.

    Premisecitation

    The number of published GAD studies has risen since 2006.

    “Given its high prevalence and associated impairment, it is not surprising that Asmundson and Asmundson (2018) found that publications on GAD have been increasing since 2006.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Asmundson & Asmundson, 2018 source
25 of 25
  • The paper relies on this without support.

    Some researchers and clinicians continue to view GAD as less severe or disabling than other anxiety diagnoses.

    “Despite this, some researchers and clinicians continue to see GAD as a diagnosis that is less severe or disabling than other anxiety diagnoses.”
  • The paper relies on this without support.

    In elderly individuals, GAD symptoms such as fatigue, sleeping difficulties, difficulty concentrating, and muscle aches are often present in those who do not have GAD.

    “Additionally, GAD is often not identified because its symptoms, such as fatigue, sleeping difficulties, difficulty concentrating, and muscle aches, are often present in elderly individuals who do not have GAD.”
  • The paper relies on this without support.

    Many people with anxiety diagnoses do not receive treatment.

    “Dissemination of evidence-based interventions has also become a major focus in the field, as many people with anxiety diagnoses do not receive treatment.”
  • The paper relies on this without support.

    There has been an increase in articles on GAD assessment instruments generally and greater emphasis on translating measures with good psychometric properties into other languages.

    “Similarly, there have been an increase in articles on assessment instruments in GAD in general and a greater emphasis on translation of measures with good psychometric properties into other languages.”
  • The paper relies on this without support.

    Empirical evidence supports theories that emphasize emotion dysregulation and discomfort with emotional shifts as underlying GAD.

    “Empirical evidence supports theories emphasizing emotion dysregulation and discomfort with the experience of emotional shifts as underlying GAD.”
5 of 5

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Authors
Newman, M. G., & Przeworski, A.
Affiliations
  • Pennsylvania State University (US)
  • Case Western Reserve University (US)
Corresponding author
Newman, Michelle G.
Venue
Journal of Anxiety Disorders
Publisher
Elsevier BV
Published
2018-05
Volume
56
Pages
11-13
ISSN
0887-6185 (ISSN-L)
OpenAlex
W2806801782
Cited by
19
References
25
Citations by year
2026: 2 · 2025: 3 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 2 · 2019: 3 · 2018: 3
FWCI
2.62
Type
journal article
Language
en
Open access
Locations
  • Journal of Anxiety Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • ScholarSphere (Penn State Libraries) (submittedVersion, cc-by)
Funders
National Institute of Mental Health (R01MH115128)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Psychology Research and Bibliometrics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
generalized anxiety disorder, research trends, prevalence, transdiagnostic mechanisms, worry, emotional dysregulation, functional disability, treatment dissemination, phenomenology
MeSH terms
Anxiety, Anxiety Disorders, Emotions, Humans

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