Week 7 DSM-5 Criteria for Anxiety Disorders CF Flashcards
to Provide full details of the DSM-5 Diagnostic Criteria for Anxiety Disorders
There is a lot of overlap in the way various anxiety disorders are defined. What are the characteristics common to all?
All share excessively high or frequent anxiety.
With the exception of Generalised Anxiety Disorder (GAD) the anxiety disorders also involve tendencies to experience intense fear
There is a lot of overlap in the way various anxiety disorders are defined. What are the DSM criteria common to all, and, essential for diagnosis?
- Symptoms must interfere with important areas of functioning or cause marked distress
- Symptoms are not caused by a drug or a medical condition
- The fears and anxieties are distinct from the symptoms of another anxiety disorder
What is the DSM-5 Criteria for “Specific Phobia”?
A. Marked fear or anxiety about a specific object or situation (e.g. flying, heights). Note: in children, the fear may be expressed by crying, tantrums, freezing or clinging
B. The phobic object or situation almost always provokes immediate fear or anxiety
C. The phobic object or situation is actively avoided or endured with intense fear or anxiety
D. The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation & to the sociocultural context
E. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more
F. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
G. The disturbance is not better explained by the symptoms of another mental disorder, including fear, anxiety, & avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (i.e. agoraphobia); objects or situations related to obsessions (i.e. OCD); reminders of traumatic events (i.e. PTSD); separation from home or attachment figures (i.e. separation anxiety disorder); or social situations (i.e. social anxiety disorder)
What is the DSM-5 Criteria for “Social Anxiety Disorder”?
A. Marked fear or anxiety about one or more social situation in which the individual is exposed to possible scrutiny by others. Examples include social interactions, being observed, & performing in front of others. Note: In children, the anxiety must occur in peer settings & not just during interactions with adults
B. The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated (e.g. embarrassed, humiliated, rejection or offend others)
C. The social situation almost always provokes fear or anxiety. Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situations
D. The social situations are avoided or endured with intense fear or anxiety
E. The fear or anxiety is out of proportion to the actual threat posed by the social situation & to the sociocultural context
F. The fear, anxiety, or avoidance is persistent, lasting for 6 months or more.
G. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
H. The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g. drug, medication) or another medical condition
I. The fear, anxiety, or avoidance is not better explained by the symptoms of another medical disorder, such as panic disorder, body dysmorphic disorder, or autism spectrum disorder
J. If another medical condition (e.g. Parkinson’s disease, obesity, disfigurement from burns or injury) is present, the fear, anxiety, or avoidance is clearly unrelated.
Specify if: Performance only: If the fear is restricted to speaking or performing in public.
What is the DSM-5 Criteria for “Panic Disorder”?
A. Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, & during which time 4 (or more) of the following symptoms occur:
Note: the abrupt surge can occur from a calm state or an anxious state
1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breathe or smothering
5. Feelings of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, light-headed, or faint
9. Chills or heat sensations
10. Numbness or tingling sensations (paresthesias)
11. Derealisation (feelings of unreality) or depersonalisation (being detached from oneself)
12. Fear of losing control or “going crazy”
13. Fear of dying
Note: culture-specific symptoms (e.g. tinnitus, neck soreness, headache, uncontrollable screaming or crying) may be seen. Should symptoms should not count as 1 of the 4 required
B. At least 1 of the attacks has been followed by 1 month (or more) of both of the following:
1. Persistent concern or worry about additional panic attacks or their consequences (e.g. losing control, ‘going crazy’, have a heart attack)
2. A significant maladaptive change in behaviour related to the attacks (e.g. behaviours designed to avoid having panic attacks, i.e. avoiding exercise or unfamiliar situations)
C. The disturbance is not attributable to the physiological effects of a substance or another medical condition (e.g. hyperthyroidism, cardiopulmonary disease).
D. The disturbance is not better diagnosed by another medical disorder (e.g. the panic attack does not occur only in response to feared social situations, or circumscribed phobic, in response to obsessions or trauma, or separation from an attachment figure
What is the DSM-5 Criteria for “Agoraphobia”?
A. Marked fear or anxiety about 2 (or more) of the following 5 situations:
1. Use of public transportation
2. Being in open spaces (e.g. bridges, car parks)
3. Being in enclosed spaces (e.g. shops)
4. Standing in line or being in a crowd
5. Being outside or home alone
B. The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms (fear of falling or of incontinence)
C. The agoraphobic situation almost always provokes fear or anxiety
D. The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety
E. The fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations & to the sociocultural context
F. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more
G. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
H. If another medical condition (e.g. inflammatory bowel disease, Parkinson’s disease) is present, the fear, anxiety or avoidance, is clearly excessive.
I. The fear, anxiety, or avoidance disturbance is not better explained by the symptoms of another mental disorder, including fear, anxiety, & avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (i.e. agoraphobia); objects or situations related to obsessions (i.e. OCD); reminders of traumatic events (i.e. PTSD); separation from home or attachment figures (i.e. separation anxiety disorder); or social situations (i.e. social anxiety disorder)
Note: Agoraphobia is diagnosed irrespective of the presence of panic disorder. If an individual’s presentation meets criteria for panic disorder & agoraphobia, both diagnoses should be assigned.
What is the DSM-5 Criteria for “Generalised Anxiety Disorder”?
A. Excessive anxiety & worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number if events or activities (such as work or school performance)
B. The individual finds it difficult to control worry
C. The anxiety & worry are associated with 3 (or more) of the following 6 symptoms (with at least some symptoms having been present for more days than not for the past 6 months):
Note: Only 1 item is required in children
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 anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
E. The disturbance is not attributable to the physiological effects of a substance, or another medical condition (e.g. hyperthyroidism)
F. The disturbance is not better explained by another mental disorder (e.g. anxiety about having panic attacks or panic disorder, social anxiety disorder, OCD, PTSD, eating disorder, BDD, schizophrenia or delusional disorder)
