4.4 Anxiety Disorders and Fear-Related Disorders

2026 📋 Syllabus Objectives

By the end of this topic, you should be able to:

  1. Objective 1 — Describe the diagnostic criteria for generalised anxiety disorder (GAD), agoraphobia, and specific phobia; and explain the measures GAD-7 and BIPI
  2. Objective 2 — Explain anxiety disorders using biological (genetic) and psychological (classical conditioning, psychodynamic) approaches
  3. Objective 3 — Describe and evaluate treatments: systematic desensitisation, CBT, and applied tension (Chapman and DeLapp, 2013)

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OBJECTIVE 1: Diagnostic Criteria and Measures

What is an Anxiety Disorder?

An anxiety disorder is a mental health condition where a person experiences extreme, persistent fear or worry that is out of proportion to any real danger. This anxiety interferes with their everyday life — it affects their work, relationships, and ability to function normally. Anxiety disorders are among the most common mental health problems worldwide.

1A. Generalised Anxiety Disorder (GAD)

Generalised Anxiety Disorder, or GAD, is a condition where a person worries excessively and uncontrollably about a wide range of everyday things — not just one specific thing. The word "generalised" means the worry is spread across many different areas of life (money, health, family, school, the future, etc.).

Diagnostic Criteria for GAD

For a diagnosis of GAD, the following must be present:

  • Excessive, uncontrollable worry about multiple topics or events on most days
  • The worry has been present for at least 6 months
  • The person finds it very difficult to control the worrying
  • At least three of the following six symptoms are also present (only one is needed in children):
    • Restlessness — feeling on edge or keyed up, like you cannot sit still
    • Fatigue — becoming tired very easily
    • Difficulty concentrating — the mind going blank
    • Irritability — becoming easily frustrated or annoyed
    • Muscle tension — the body feels tight, stiff, or sore
    • Sleep disturbance — trouble falling asleep, staying asleep, or having restless, unsatisfying sleep
  • The anxiety causes significant distress or makes it hard to function in daily life (e.g., at school, work, or in relationships)
  • The symptoms are not caused by a physical illness or substance (e.g., drugs, medication)

Simple example: Imagine a student who constantly worries about exams, their health, whether their parents are safe, whether they said the wrong thing to a friend — all at once, every day, even when nothing is actually wrong. That pattern of uncontrollable, widespread worry is what GAD looks like.

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