People with generalized anxiety disorder (GAD) often worry about multiple facets of their lives — jobs, money, kids, health, and personal relationships. According to a new study, Anxiety tends to affect their social relationships in a variety of ways.

GAD affects almost 7 million Americans, and affects twice as many women as men. It can begin in childhood or later in life, and often coexists with other problems like depression or substance abuse.

In many cases, GAD is treated with cognitive behavior therapy (CBT), in which the patient learns different, more effective thought and behavior patterns than his or her current, problematic ones.

The researchers studied a group of people with GAD and discovered that they fell into one of four different groups of social interaction styles: intrusive, cold, nonassertive, or exploitable. The different styles of interaction were not linked to the severity of the person’s anxiety or Depression (major or clinical). This indicates that the level of a person’s anxiety does not dictate what social interaction style they tend towards, but that other factors, perhaps personality or coping style, may influence how one relates to other people.

"All individuals with these styles worried to the same extent and extreme, but manifested those worries in different ways," said lead author Amy Przeworski in the study’s press release. She gives the example of how two people might handle a situation in which a family member’s health is of concern. One person – falling into the "intrusive" category – may deal with this by calling the family member repeatedly, inquiring as to how he or she feels, and so on. Another person, favoring the "cold" category, might criticize or chastise the family member for what she sees as "careless" behavior.

"The worry may be similar, but the impact of the worry on their interpersonal relationships would be extremely different. This suggests that interpersonal problems and worry may be intertwined." Przeworski says that therapists should, in theory, treat both the underlying anxiety disorder and the social relationship problems in tandem. In many cases, GAD is treated with cognitive behavior therapy (CBT), in which the patient learns different, more effective thought and behavior patterns than his or her current, problematic ones. Pairing this with techniques to address social relationship issues might be a more effective method, and improve patients’ quality of life more than CBT alone.

The research was carried out at Case Western Reserve and Penn State Universities and published in the May 2011 issue of the Journal of Abnormal Psychology.