Worry and associated symptoms in younger versus middle-aged adults with DSM-IV Generalized Anxiety Disorder at pre- and post-treatment

Open Access
Gaines, Jeffrey Jay
Graduate Program:
Doctor of Philosophy
Document Type:
Date of Defense:
September 27, 2001
Committee Members:
  • Peter Andrew Arnett, Committee Member
  • Steven Howard Zarit, Committee Member
  • Thomas D Borkovec, Committee Chair
  • James Edward Martin, Committee Member
  • worry; associated symptoms; younger versus middle-
ABSTRACT This study investigated the relationship between worry, depression and associated symptoms (restlessness, difficulty concentrating, insomnia, fatigue, irritability and muscle tension) in young- to middle-aged adults (18-65 years) with and without DSM-IV GAD at pre-treatment, and with GAD from pre-to post-treatment. Data was drawn from a series of three treatment-outcome studies at the Pennsylvania State University investigating elements of Cognitive-Behavioral Therapy alone and in combination. Worry and associated symptom ratings were recorded via semi-structured interviews at pre-treatment, post-treatment, 6- and 12-month follow-ups using the Hamilton Anxiety Ratings Scale (Hamilton, 1959). Depression ratings were recorded with the BDI (Beck, 1978). Results showed that at pre-treatment in the total GAD client group (n=192), worry, depression and all associated symptoms were rated at clinical levels, with the exception of muscle tension. Worry in the total GAD client group was also associated with a specific “hyperaroused/hypervigilant” symptom constellation: restlessness, difficulty concentrating, insomnia, and fatigue. Depression was associated with a largely distinct symptom constellation: irritability and fatigue. Significant reductions in worry, depression and all 6 associated symptoms were found from pre- to post-treatment, and these reductions were maintained across 6- and 12-month follow-ups. Younger and middle-aged adults with GAD were equivalent on presentation and treatment response for worry, depression and associated symptoms, with two exceptions: younger adults with GAD (n=72) were slightly more irritable at pre-treatment, and middle-aged adults with GAD (n=24) showed slightly more difficulty concentrating at post-treatment.