Generalized Anxiety Disorder is one of the mental disorders first diagnosed in the

DSM-III diagnostic book published and published in the 1980s. According to its definition in

the DSM-V used today, GAD is a very common disease characterized by uncontrollable

excessive worry and chronic tension (American Psychiatric Association, 2013). On the other

hand, the initial diagnostic criteria of GAD in DSM-III cannot fully define the diffuse part of

the disease. According to a study by Stein and Sareen (2015), this situation has been resolved

in the DSM-V criteria.

As of today, Generalized Anxiety Disorder has found a place between 1% and 5% of

the world population, and this rate is only 3% in the USA (Stein & Sareen, 2015). The onset

periods of GAD are highly variable; Some cases of generalized anxiety disorder begin in early

childhood, some in early adulthood, and may peak again in older adulthood, depending on the

severity of the disease. Likewise, according to most patient feedback, GAD is a lifelong and

recurrent disease (Mackenzie et al., 2011). However, patients can often present with

symptoms such as anxiety, headache, or gastrointestinal contraction and discomfort. In

addition to these symptoms, the symptoms in the DSM-V diagnostic criteria are as follows:

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

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).

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, or restless unsatisfying

sleep)

D. The disturbance is not better explained by another mental disorder (e.g., anxiety or

worry about having panic attacks in panic disorder, negative evaluation in social

anxiety disorder [social phobia], contamination or other obsessions in obsessive-

compulsive disorder, separation from attachment figures in separation anxiety

disorder, reminders of traumatic events in posttraumatic stress disorder, gaining

weight in anorexia nervosa, physical complaints in somatic symptom disorder,

perceived appearance flaws in body dysmorphic disorder, having a serious illness

in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or

delusional disorder).

E.  The disturbance is not attributable to the physiological effects of a substance (e.g.,

a drug of abuse, a medication) or another medical condition (e.g.,

hyperthyroidism) (American Psychiatric Association, 2013).

Among the risk factors that have an important place in the formation of Generalized

Anxiety Disorder; There may be economic weakness, drug use, and traumatic early childhood

experiences that cannot afford living expenses (Moreno-Peral et al., 2014). Physical violence

and abuse, especially in childhood, can cause GAD symptoms in adulthood.

Adverse Childhood Experiences

Generalized Anxiety Disorder may occur as a result of one or more factors and may

continue throughout life. However, one of the most important of these factors is the collection

of events experienced during childhood and which can affect the personality of the individual
in his later youth and adult life, and this is called "Early Childhood Experiences" in the

literature. These experiences can be negative and traumatic. As we mentioned in the previous

section, GAD; It is a psychopathology that children, young people and adults experience in a

certain period or all of their lives (Colonnesi et al., 2011). Completely negative experiences

such as abuse, loneliness, parental conflicts, peer bullying, and insecure attachment during

childhood can lead to an increasing course of GAD (Bernet & Stein, 1999; Goddard, 2021).

Other negative experiences in the literature that significantly changed the course of

psychopathology; chronic attachment disorders, interpersonal problems, inability to establish

healthy boundaries and risky behaviors (Kessler et al., 2010; Enoch, 2010).

Emotion regulation skills, which have an important place in other anxiety disorders

such as Generalized Anxiety Disorder, are in development since childhood and there may be

an increased risk of mood disorders in children who do not have effective emotion control

(Suveg et al., 2009). Considering the importance of early childhood experiences and parent-

child interactions in the development of children's emotion regulation abilities, the child who

cannot establish a secure attachment with their parents may be an important predictor of

emotion regulation difficulties and anxiety disorders. Bosquet and Egeland (2006) stated that

mood regulation skills are generally associated with increasing levels of negative affect and

that insecure attachment may act as a mediator in the development of childhood anxiety

disorders.
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