Should Uncontrollable Worry Be Removed From the Definition of GAD? A Test of Incremental Validity
Should Uncontrollable Worry Be Removed From the Definition of GAD? A Test of Incremental Validity
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DOI：
10.1037/a0031731
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发表时间：
2013-05-01
影响因子：
4.6
通讯作者：
Ruscio, Ayelet Meron
中科院分区：
文献类型：
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作者：
Hallion, Lauren S.;Ruscio, Ayelet Meron
在目前的DSM-IV中，广泛性焦虑症（GAD）的诊断需要过度和无法控制的担忧。有人建议将不可控性标准从DSM的未来版本中删除，主要是基于过度和不可控性之间的经验和概念重叠以及相对缺乏对不可控性的研究。然而，没有研究直接调查的增量有效性的不可控性标准，即在何种程度上不可控性预测重要的临床信息过度。这个问题是在一个社区样本126名成年人诊断为广泛性焦虑症。控制过度后，不可控性解释了一个显着比例的额外的方差在各种相关的临床措施，包括广泛性焦虑症的严重程度，临床医生评定的焦虑，共病疾病的数量和严重程度，以及精神药物和心理治疗的使用。即使控制了广泛性焦虑症的其他特征，结果仍具有统计学意义。相比之下，过度并没有显着预测任何临床措施以上的不可控性。这些研究结果表明，不可控性有助于广泛性焦虑症诊断的有效性，并应保留作为病理性担忧的核心特征。
In its current instantiation in DSM-IV, a diagnosis of generalized anxiety disorder (GAD) requires the presence of excessive and uncontrollable worry. It has been proposed that the uncontrollability criterion be removed from future editions of the DSM, primarily on the basis of empirical and conceptual overlap between excessiveness and uncontrollability and a relative lack of research on uncontrollability. However, no research has directly investigated the incremental validity of the uncontrollability criterion-that is, the extent to which uncontrollability predicts important clinical information over and above excessiveness. This question was examined in a community sample of 126 adults diagnosed with GAD. After controlling for excessiveness, uncontrollability explained a significant proportion of additional variance in a variety of relevant clinical measures, including GAD severity, clinician-rated anxiety, number and severity of comorbid disorders, and use of psychotropic medication and psychotherapy. The results remained statistically significant even when other features of GAD were controlled. By contrast, excessiveness did not significantly predict any clinical measure over and above uncontrollability. These findings suggest that uncontrollability contributes to the validity of the GAD diagnosis and should be retained as a core feature of pathological worry.