GAD Exam 1

Question 1

Generalized Anxiety Disorder (GAD) DSM-5 Diagnostic Criteria

Answer 1

Anxiety + Worry consistently for 6 months.
Difficult to control worry.
3 or more of the following symptoms for 6 months:
Restlessness, Fatigue, Difficulty Concentrating, Irritability, Muscle tension, sleeplessness
Symptoms cause significant distress/impairment
Not caused by substance or medical condition
Not better explained by another disorder

Question 2

GAD Assessment

Answer 2

Penn State Worry Questionnaire (self report)
GAD Questionnaire (self report)
SCID-5 - diagnostic measure

Question 3

GAD Theory for ACT

Answer 3

Excessive worry about future scenarios via catastrophizing and overestimation.
Worry is negatively reinforced since the feared outcome didn’t happen, worry becomes habit.
Worry distracts from deeper emotional experience.
React to internal experiences with distress; view the self as anxious person.
Leads to avoidance.
GAD lends itself to ACT approach.

Question 4

ACT Treatment for GAD (Acceptance and Commitment Therapy)

Answer 4

ACT Goal: Expand Awareness and Compassion towards experience. Accept internal experiences. Engage in value based behaviors.

Question 5

ACT for GAD Sessions 1-7 (First half)

Answer 5

Sessions 1-3:
Overview of treatment and rationale. 
Psychoeducation to explain and validate experience.
Introduce mindfulness breath
Progressive Muscle Relaxation (PMR)
Homework: Raisin Exercise

Session 4:
Mindfulness for awareness of physical sensations.
Remember experiences without altering emotions.
Emphasize values not goals.

Sessions 5-7:
Encourage willingness to experience instead of avoidance.
Use exercises to help client monitor reactions, thoughts, emotions, and physical sensations as transient events.
Identify values.

Question 6

ACT for GAD Sessions 8-16 (second half)

Answer 6

Sessions 8-12:
Personalize concepts in treatment to use in daily life.
Analyze and validate obstacles to willingness.
Have client monitor activities mindfully.

Sessions 13-16:
Treatment reflection and maintenance.
Client more directive in sessions.
Acknowledgement of lapses.
Review coping skills.