This article proposes a revision of the historical evolution of the concepts of generalized anxiety disorder (GAD). Currently, Darwin's evolutionary theory is the hegemonic paradigm for modern science and influences research on mental disorders. Throughout the 20th Century, the editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association) have changed the diagnostic criteria for GAD, reflecting the prevailing psychiatric understanding of this disorder. The prevalence and symptoms of major depression and GAD show the fragility of the categorical conception of these conditions. Differences in cultural views towards anxiety disorders also suggest that anxiety cannot have a uniform definition. This article provides contributions for reflecting future guidelines concerning the diagnostic criteria for GAD in DSM-V.

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This article reports the experience of treating low-income patients with a primary diagnosis of generalized anxiety disorder (GAD) in a public hospital in Rio de Janeiro, Brazil. At the start of the project for outpatient treatment, which included the application of a cognitive model for GAD treatment, we observed that the majority of patients presented low educational level, which made it hard for them to understand key aspects of the cognitive-behavioral based treatment offered. Therefore, important adaptations to the treatment protocol were made necessary, including the way techniques were presented and applied, the therapeutic approach used, and even the duration of sessions. Since variations of cognitive therapy are increasingly being applied in hospital outpatient clinics in countries worldwide, the objective of this article is to present the adaptations performed and promote a discussion on the possible solutions for the diffi culties faced in applying clinical psychology practice among patients with low educational and socioeconomic levels. This is a clinical study presenting an illustrative case, where adaptations to the treatment protocol were essential for the positive outcome of the case. It is concluded that, with the 1 Mailing address: Avenida Ataulfo de Paiva, 1079, sala 509,

Fear of vaginal birth is a very common phenomenon among women and may significantly impact maternal-infant health. The goal of this study is to investigate how Cognitive-@Behavioral Therapy (CBT) has been applied in cases of fear of childbirth and assess the efficacy of such interventions. A systematic review of these practices was made using the BVS Brazil, Scopus, and PubMed databases, from February to April 2019. After analyzing the inclusion and exclusion criteria, a total of six full studies were selected as the final sample for this research. Therapeutic techniques such as cognitive restructuring, exposure, and mindfulness have proven to be important means of developing a less catastrophic perception of childbirth along with greater self-confidence in the abilities to cope with labor.The review led to the conclusion that CBT does have the potential to treat fear of childbirth.

Sistema de avaliação: às cegas por pares (double blind review).