Generalized Anxiety Disorder

Co-Principal Investigators

Richard E. Zinbarg, PhD
Patricia M. Nielsen Research Chair, The Family Institute
Associate Professor and Director of Clinical Training, Department of Psychology

Danielle Black, PhD
Assistant Director, Anxiety Research Program, Family Institute

Generalized Anxiety Disorder (GAD) is characterized by constant worry, leading to tension and irritability. Through this research we hope to learn more about the relationship between GAD and how couples function, with an ultimate goal of developing a more effective and longer lasting treatment for married adults with the disorder. The first phase of the study compared couples in which one person has GAD with couples in which neither partner has GAD or any other AXIS I (DSM IV-R) disorder. It then assessed the extent to which couple variables predict short and long term response to individual cognitive-behavior therapy, the current standard treatment for GAD. A principal goal was to identify interaction patterns in GAD couples that might become targets for a new intervention, which would be developed and tested in subsequent studies.

Dr. Zinbarg has completed pilot research demonstrating that GAD couples could be recruited in sufficient numbers to conduct the proposed research, and that these couples revealed interaction patterns in a laboratory setting that differed significantly from normal couples and distressed couples where neither member had GAD. He is currently completing an analysis of a second pilot project examining the relationship between the outcome of individual cognitive-behavior therapy for the GAD members in the first pilot study and their interaction patterns with their non-GAD partners.

The results of these pilot projects are the basis for two new grant submissions to the National Institute of Mental Health. The first application, submitted in February 2006, proposes evaluating the extent to which cognitive-behavior therapy plus worry imaginal exposure (WIE) improves regular cognitive-behavior therapy without WIE for adults with GAD. The treatment tested in the pilot research included WIE and had very positive effects. The second application — to be submitted as an addition to the WIE grant, if funded — would address the interpersonal predictors of suboptimal response to individual cognitive-behavior therapy plus WIE. The pilot data for this study have already identified some significant interpersonal predictors of suboptimal response in married patients with GAD.

Participation Opportunities

Publications

Brown, T., Moras, K., Zinbarg, R. & Barlow, D. H. (1993). Differentiating generalized anxiety disorder and obsessive
compulsive behavior. Behavior Therapy, 24, 227-240
Zinbarg, R. (1993). Information processing and classical conditioning: Implications for exposure therapy and the integration of
cognitive therapy and behavior therapy. Journal of Behavior Therapy and Experimental Psychiatry, 24, 129-139.

Zinbarg, R., Craske, M. & Barlow, D.H. (1994). Therapist's Guide for the Mastery of Your Anxiety and Worry Program. Albany,
NY: Graywing Publishing Co.
Zinbarg, R. & Barlow, D.H. (1996). The structure of anxiety and the DSM-III-R anxiety disorders: A hierarchical model. Journal of
Abnormal Psychology, 105, 181-193.
Street, L., Salman, E., Garfinkle, R., Silvestri, J., Carrasco, J., Cardenas, D., Zinbarg, R., Barlow, D. & Liebowitz, M. (1997).
Discriminating between generalized anxiety disorder and anxiety disorder not otherwise specified in a hispanic population:
Is it only a matter of worry? Depression and Anxiety, 5, 1 - 6.
Mohlman, J. & Zinbarg, R. (2000). What kind of attention is necessary for fear reduction? An empirical test of the Emotional
Processing Model. Behavior Therapy, 31, 113-133.
Zinbarg, R., Craske, M. & Barlow, D.H. (2006). Therapist's Guide for the Mastery of Your Anxiety and Worry Program. (2nd
Edition). New York, NY: Oxford University Press.
Yoon, L. & Zinbarg, R. (2007). Generalized anxiety disorder and entry into marriage or a marriage-like relationship. Journal of
Anxiety Disorders, 21, 955 - 965.
Zinbarg, R., Lee, J.E. & Yoon, L. (2007). Dyadic Predictors of Outcome in a Cognitive-Behavioral Program for Patients with
Generalized Anxiety Disorder in Committed Relationships: A ‘Spoonful of Sugar' and a Dose of Non-Hostile Criticism May
Help. Behaviour Research and Therapy, 45, 699 - 713.
Zinbarg, R., Uliaszek, A. & Adler, J. (2008). The role of personality in psychotherapy for anxiety and depression. Journal of
Personality, 76, 1649 - 1687.
Black, D., Uliaszek, A., Lewis, A. & Zinbarg, R. (In press). Generalized anxiety disorder and interpersonal relationships: The
case for a systemic intervention. To appear in F. Columbus (Ed.), Psychology of Relationships.
Fluckiger, C. Wusten, G., Zinbarg, R. & Wampold, B. (In press). Resource activation: Using clients' own strengths in
psychotherapy and counseling. Hogrefe

For more information about the Generalized Anxiety Disorder Project, contact the GAD Study at 847-733-4300 ext. 662 or by e-mail at GADstudy@family-institute.org.