Roemer, L., & Orsillo, S. M. (2005). An acceptance based behavior therapy for generalized anxiety disorder. In S. M. Orsillo & L. Roemer (Eds.), Acceptance and mindfulness-based approaches to anxiety: Conceptualization and treatment (p. 213-240). New York: Springer.
Generalized anxiety disorder (GAD) is a disorder characterized by chronic, pervasive, uncontrollable worry (as well as associated somatic complaints; American Psychiatric Association, 1994) for which we have yet to develop sufficiently successful interventions. The National Comorbidity Study yielded a lifetime prevalence estimate of 5.1% for GAD, and revealed, contrary to the common assumption that it is a mild disorder, that GAD is associated with significant psychosocial impairment (Wittchen et al., 1994). GAD is unlikely to remit on its own (Yonkers, Warshaw, Massion, & Keller, 1996) and remains more chronic than panic disorder after pharmacotherapy (Woodman, Noyes, Black, Schlosser, & Yagia, 1999). In addition, GAD is associated with high rates of comorbidity (most commonly other anxiety or mood disorders), and this comorbidity is associated with increased functional impairment (Wittchen et al., 1994) and health care utilization/cost (Soutre et al., 1994). Further, GAD has been associated with impaired well-being and life satisfaction beyond its association with major depression in a community study of 15 – 64 year olds (Stein & Heimberg, 2004), as well as with impaired quality of life, beyond that accounted for by comorbid diagnoses, among older adults (Wetherall et al., 2004). Recent studies in primary care settings have consistently found that “pure” (noncomorbid) GAD is associated with impairment in multiple domains (see Kessler, Walters, & Wittchen, 2004, for a review)....