Worry and generalized anxiety disorder: a review and theoretical synthesis of evidence on nature, etiology, mechanisms, and treatment.
Worry and generalized anxiety disorder: a review and theoretical synthesis of evidence on nature, etiology, mechanisms, and treatment.
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DOI：
10.1146/annurev-clinpsy-050212-185544
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发表时间：
2013
影响因子：
18.4
通讯作者：
Castonguay LG
中科院分区：
文献类型：
--
作者：
Newman MG;Llera SJ;Erickson TM;Przeworski A;Castonguay LG
广泛性焦虑症（GAD）与大量的个人和社会成本有关，但却是治疗最不成功的焦虑症。在这篇综述中，研究的临床特征，边界问题，和自然的过程中，以及风险因素和维持机制（认知，生物，神经，人际和发展），提出。综合这些数据，我们可以发现，情绪过度反应、对对比情绪的敏感性以及通过担忧科普强烈情绪变化的功能障碍都是一个核心因素。与对比回避模型相一致，有证据表明，担忧会唤起并维持负面情绪，从而阻止负面情绪的急剧增加。我们还回顾了目前的治疗模式，并建议如何对比回避模型可能有助于针对关键的恐惧和回避倾向，以维持病理广泛性焦虑症。
Generalized anxiety disorder (GAD) is associated with substantial personal and societal cost yet is the least successfully treated of the anxiety disorders. In this review, research on clinical features, boundary issues, and naturalistic course, as well as risk factors and maintaining mechanisms (cognitive, biological, neural, interpersonal, and developmental), are presented. A synthesis of these data points to a central role of emotional hyperreactivity, sensitivity to contrasting emotions, and dysfunctional attempts to cope with strong emotional shifts via worry. Consistent with the Contrast Avoidance model, evidence shows that worry evokes and sustains negative affect, thereby precluding sharp increases in negative emotion. We also review current treatment paradigms and suggest how the Contrast Avoidance model may help to target key fears and avoidance tendencies that serve to maintain pathology in GAD.