Generalized worry disorder: a review of DSM-IV generalized anxiety disorder and options for DSM-V

Background: Generalized anxiety disorder (GAD) has undergone a series of substantial classificatory changes since its first inclusion in DSM‐III. The majority of these revisions have been in response to its poor inter‐rater reliability and concerns that it may lack diagnostic validity. This article provides options for the revision of the DSM‐IV GAD criteria for DSM‐V. Method: First, searches were conducted to identify the evidence that previous DSM Work Groups relied upon when revising the DSM‐III‐R GAD and the overanxious disorder classifications. Second, the literature pertaining to the DSM‐IV criteria for GAD was examined. Conclusions: The review presents a number of options to be considered for DSM‐V. One option is for GAD to be re‐labeled in DSM‐V as generalized worry disorder. This would reflect its hallmark feature. Proposed revisions would result in a disorder that is characterized by excessive anxiety and worry generalized to a number of events or activities for 3 months or more. Worry acts as a cognitive coping strategy that manifests in avoidant behaviors. The reliability and validity of the proposed changes could be investigated in DSM‐V validity tests and field trials. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.