1. Nor Firdous Mohamed Psychology and Counseling Department FPPM, UPSI

2. WHAT IS GENERALIZED ANXIETY DISORDER (GAD)? They can’t necessarily say why Feel anxious for much of the time Sleep disturbance Muscle tension General restlessness Feeling of being easily fatigued Their symptoms span a range of physical and psychological experiences

3. Financial problems Interpersonal relationship Death Family Friendship problems Health issues Work difficulties

4. A.Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). B.The person finds it difficult to control the worry. (continued) Diagnostic Criteria for 300.02 Generalized Anxiety Disorder

5. C. The anxiety and worry are associated with three (or more) of the following six symptoms ( with at least some symptoms present for more days than not for the past 6 months). Note: Only one item is required in children. (1)Restlessness or feeling keyed up or on edge (2)Being easily fatigued (3)Difficulty concentrating or mind going blank (4)Irritability (5)Muscle tension (6)Sleep disturbance (difficulty falling or staying asleep, restless unsatisfying sleep) (continued)

6. D. The focus of the anxiety and worry is not confined to features of an Axis I disorder, e.g., the anxiety or worry is not about having a Panic Attack (as in Panic Disorder), being embarrassed in public (as in Social Phobia), being contaminate (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Postraumatic Stress Disorder. (continued)

7. E. The anxiety, worry or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. F. The disturbances is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition( e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.

8. Causes of general anxiety disorder Biological perspectives Psychological perspectives Genetic Brain chemistry Environmental factor

9. Genetics Family history Overlap in genetic vulnerability with the personality trait of neuroticism.

10. Brain chemistry Abnormal levels of certain neurotransmitters. Disturbance in GABA, serotonergic and noradrenergic systems.

11. Environmental factor Trauma and stressful events such as, abusive, the death of loved and divorce. During period of stress The use of and withdrawal from addictive substances including, caffeine, alcohol, drug and nicotine.

12. Age onset development and duration Most patient s reported are early adulthood Smaller proportion cases emerged in middle adulthood More common in women than men Occurring more days, at least 6 month

13. PREVENTION

14. Get help earlyKeep a journal Prioritize your life Avoid unhealthy substance use

15. TREATMENT

16.  Cognitive-behavioral therapy (CBT) Physical control MonitoringEducation Behavioral Cognitive control

17. REFERENCES Diagnostic and Statistical Manual of Mental Disorder, 4 th edition(1994). Washington, DC: American Psychiatric Association. Whitbourne, S.K. & Halgin, R.P. (2013). Abnormal Psychology: clinical perspectives on psychological disorders, 7 th editon. United States: McGraw-Hill. Smith, M, M.A. & Segal, J. (July 2013). Generalized anxiety disorder(GAD). Retrieved by 24 September 2013 from http://www.helpguide.org/mental/generalized_anxiety_dis order.htm