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Anxiety Disorders
| Question | Answer |
|---|---|
| Anxiety based symptoms | Anticipation of future threat |
| Fear based symptoms | Emotional response to real or perceived imminent threat |
| Separation Anxiety Disorder | The essential feature of separation anxiety disorder is excessive fear or anxiety concerning separation from home or attachment figures. The anxiety exceeds what may be expected given the person’s developmental level. |
| Separation Anxiety Disorder (Criterion A: 1-2) | A) Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following: 1. Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures 2. Persistent and excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters, or death. |
| Separation Anxiety Disorder (Criterion A: 3-5) | 3. Persistent and excessive worry about experiencing an untoward event (e.g.,getting lost, being kidnapped, having an accident, becoming ill) that causes separation from a major attachment figure. 4. Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation. 5 Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings. |
| Separation Anxiety Disorder (Criterion A: 6-8) | 6. Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure. 7. Repeated nightmares involving the theme of separation. 8. Repeated complaints of physical symptoms(e.g.,headaches, stomach aches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated. |
| Separation Anxiety Disorder (Criterion B & C) | B) The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults. C) The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning. |
| Separation Anxiety Disorder (Criterion D) | D. The disturbance is not better explained by another mental disorder, such as refusing to leave home because of excessive resistance to change in autism spectrum disorder; delusions or hallucinations concerning separation in psychotic disorders; refusal to go outside without a trusted companion in agoraphobia; worries about ill health or other harm befalling significant others in generalized anxiety disorder; or concerns about having an illness in illness anxiety disorder. |
| Selective Mutism | When encountering other individuals in social interactions, children with selective mutism do not initiate speech or reciprocally respond when spoken to by others. Lack of speech occurs in social interactions with children or adults. Children with selective mutism will speak in their home in the presence of immediate family members but often not even in front of close friends or second-degree relatives |
| Selective Mutism (Criterion A,B, & C) | A. Consistent failure to speak in specific social situations in which there is an expectation for speaking (e.g., at school) despite speaking in other situations. B. The disturbance interferes with educational or occupational achievement or with social communication. C. The duration of the disturbance is at least 1 month (not limited to the first month of school). |
| Selective Mutism (Criterion D & E) | D. The failure to speak is not attributable to a lack of knowledge of, or comfort with, the spoken language required in the social situation. E. The disturbance is not better explained by a communication disorder (e.g., childhood- onset fluency disorder) and does not occur exclusively during the course of autism spectrum disorder, schizophrenia, or another psychotic disorder. |
| Specific Phobia | A key feature of this disorder is that the fear or anxiety is circumscribed to the presence of a particular situation or object (Criterion A), which may be termed the phobic stimulus. |
| Specific Phobia (Criterion A, B & C) | A. Marked fear or anxiety about a specific object or situation(e.g., flying, heights, animals, receiving an injection, seeing blood). Note: In children, the fear or anxiety 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 objector situation is actively avoided or endured with intense fear or anxiety. |
| Specific Phobia (Criterion D, E & F) | D. The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and 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. |
| Specific Phobia (Criterion G) | G. The disturbance is not better explained by the symptoms of another mental disorder, including fear, anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia); objects or situations related to obsessions; reminders of traumatic events (as in post-traumatic stress disorder); separation from home or attachment figures (as in separation anxiety disorder); or social situations (as in social anxiety disorder). |
| Specific Phobia (Criterion Specifiers) | Animal, Natural Environment, Blood-Injection- Injury (fear o f injections; fear of injury), Situational, Other |
| Social Anxiety Disorder (Social Phobia) | The essential feature of social anxiety disorder is a marked, or intense, fear or anxiety of social situations in which the individual may be scrutinized by others. |
| Social Anxiety Disorder (Social Phobia) (Criterion A & B) | A. Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Examples include social interactions, being observed (e.g., eating or drinking), and performing in front of others (e.g., giving a speech). Note: In children, the anxiety must occur in peer settings and 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. |
| Social Anxiety Disorder (Social Phobia) (Criterion C, D & E) | C. The social situations almost always provoke 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 and to the sociocultural context. |
| Social Anxiety Disorder (Social Phobia) (Criterion F, G & H) | 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. The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. |
| Social Anxiety Disorder (Social Phobia) (Criterion I & J) | I. The fear, anxiety, or avoidance is not better explained by the symptoms of another mental 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 or is excessive. Specify if: Performance only: If the fear is restricted to speaking or performing in public. |
| Panic Disorder | A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four or more of a list of 13 physical and cognitive symptoms occur. The term recurrent literally means more than one unexpected panic attack. The term unexpected refers to a panic attack for which there is no obvious cue or trigger at the time of occurrence—that is, the attack appears to occur from out of the blue, such as when the individual is relaxing or emerging from sleep |
| Panic Disorder (Criterion A: 1-3) | A. Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (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. |
| Panic Disorder (Criterion A: 4-9) | 4. Sensations of shortness of breath 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. |
| Panic Disorder (Criterion A: 10-13) | 10. Paresthesias (numbness or tingling sensations). 11. Derealization (feelings of unreality) or depersonalization (being detached from one-self). 12. Fear of losing control or “going crazy.” 13. Fear of dying. |
| Panic Disorder (Criterion B: 1-2) | B. At least one of the attacks has been followed by 1 month (or more) of one or both of the following: 1. Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, “going crazy”). 2. A significant maladaptive change in behavior related to the attacks (e.g.,behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations). |
| Panic Disorder (Criterion C & D) | C. The disturbance is not attributable to the physiological effects of a substance or another medical condition. D. The disturbance is not better explained by another mental disorder (e.g., the panic attacks do not occur only in response to feared social situations; in response to circumscribed phobic objects or situations; in response to obsessions; in response to reminders of traumatic events; or in response to separation from attachment figures). |
| Panic Attack Specifier | Symptoms are presented for the purpose of identifying a panic attack; however, panic attack is not a mental disorder and cannot be coded. Panic attacks can occur in the context of any anxiety disorder as well as other mental disorders and some medical conditions. When the presence of a panic attack is identified, it should be noted as a specifier. For panic disorder, the presence of panic attack is contained within the criteria for the disorder and panic attack is not used as a specifier. |
| Panic Attack Specifier (Criterion 1-6) | An abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (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 breath or smothering. 5. Feelings of choking. 6. Chest pain or discomfort. |
| Panic Attack Specifier (Criterion 7-13) | 7. Nausea or abdominal distress. 8. Feeling dizzy, unsteady, light-headed, or faint. 9. Chills or heat sensations. 10. Paresthesias (numbness or tingling sensations). 11. Derealization (feelings of unreality) or depersonalization (being detached from oneself). 12. Fear of losing control or “going crazy.” 13. Fear of dying. |
| Agoraphobia | The essential feature of agoraphobia is marked, or intense, fear or anxiety triggered by the real or anticipated exposure to a wide range of situations. When experiencing fear and anxiety cued by such situations, individuals typically experience thoughts that something terrible might happen (Criterion B). Individuals frequently believe that escape from such situations might be difficult or that help might be unavailable when panic-like symptoms or other incapacitating or embarrassing symptoms occur. |
| Agoraphobia (Criterion A) | A. Marked fear or anxiety about two (or more) of the following five situations: 1. Using public transportation (e.g., automobiles, buses, trains, ships, planes). 2. Being in open spaces(e.g.,parking lots, marketplaces, bridges). 3. Being in enclosed places(e.g.,shops, theaters, cinemas). 4. Standing in line or being in a crowd. 5. Being outside of the home alone. |
| Agoraphobia (Criterion B, C & D) | 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 toms or other incapacitating or embarrassing symptoms (e.g., fear of falling in the elderly; fear of incontinence). C. The agoraphobic situations almost always provoke fear or anxiety. D. The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety. |
| Agoraphobia (Criterion E, F, G & H) | E. The fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations and 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 is present, the fear, anxiety, or avoidance is clearly excessive. |
| Agoraphobia (Criterion I) | I. The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder—for example, the symptoms are not confined to specific phobia, situational type; do not involve only social situations; and are not related exclusively to obsessions, perceived defects or flaws in physical appearance, reminders of traumatic events, or fear of separation . |
| Generalized Anxiety Disorder | The essential feature of generalized anxiety disorder is excessive anxiety and worry (apprehensive expectation) about a number of events or activities. The intensity, duration, or frequency of the anxiety and worry is out of proportion to the actual likelihood or impact of the anticipated event. The individual finds it difficult to control the worry and to keep worrisome thoughts from interfering with attention to tasks at hand. |
| Generalized Anxiety Disorder (Criterion A & B) | 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 individual finds it difficult to control the worry. |
| Generalized Anxiety Disorder (Criterion C) | C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months): Note: Only one 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). |
| Generalized Anxiety Disorder (Criterion D & E) | 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 (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). |
| Generalized Anxiety Disorder (Criterion F) | F. The disturbance is not better explained by another mental disorder (e.g., anxiety or worry about having panic attacks, negative evaluation in social anxiety disorder, contamination or other obsessions, separation from attachment figures, reminders of traumatic events in post-traumatic stress disorder, gaining weight, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness, or the content of delusional beliefs). |
| Substance/Medication-Induced Anxiety Disorder | The essential features of substance/medication-induced anxiety disorder are prominent symptoms of panic or anxiety that are judged to be due to the effects of a sub- stance (e.g., a drug of abuse, a medication, or a toxin exposure). The panic or anxiety symptoms must have developed during or soon after substance intoxication or withdrawal or after exposure to a medication, and the substances or medications must be capable of producing the symptoms. |
| Substance/Medication-Induced Anxiety Disorder (Criterion A & B) | A. Panic attacks or anxiety is predominant in the clinical picture. B. There is evidence from the history, physical examination, or laboratory findings of both (1) and (2): 1. The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication. 2. The involved substance/ medication is capable of producing the symptoms in Criterion A. |
| Substance/Medication-Induced Anxiety Disorder (Criterion C) | C. The disturbance is not better explained by an anxiety disorder that is not substance/ medication-induced. Such evidence of an independent anxiety disorder could include the following: The symptoms precede; the symptoms persist (e.g., about 1 month) after the cessation of acute withdrawal or severe intoxication; or there is other evidence suggesting the existence of an independent non-substance/medication-induced anxiety disorder (e.g., a history of recurrent non-substance/medication-related episodes). |
| Substance/Medication-Induced Anxiety Disorder (Criterion D & E) | D. The disturbance does not occur exclusively during the course of a delirium. E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
| Anxiety Disorder Due to Another Medical Condition | The essential feature of anxiety disorder due to another medical condition is clinically significant anxiety that is judged to be best explained as a physiological effect of another medical condition. |
| Anxiety Disorder Due to Another Medical Condition (Criterion A, B & C) | A. Panic attacks or anxiety is predominant in the clinical picture. B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition. C. The disturbance is not better explained by another mental disorder. |
| Anxiety Disorder Due to Another Medical Condition (Criterion D & E) | D. The disturbance does not occur exclusively during the course of a delirium. E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
| Other Specified Anxiety Disorder | This category applies to presentations in which symptoms characteristic of an anxiety disorder cause clinically significant distress or impairment in social, occupational, or other important areas of functioning do not meet the full criteria in the anxiety disorders diagnostic class. The other specified anxiety disorder category is used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific anxiety disorder. |
| Other Specified Anxiety Disorder (Other Specified Designation) | 1. Limited- symptom attacks. 2. Generalized anxiety not occurring more days than not. 3. Khyâl cap (wind attacks) 4. Ataque de nervios (attack of nerves) |
| Unspecified Anxiety Disorder | Applies to presentations in which cause clinically significant distress or impairment areas of functioning predominate but do not meet the full criteria for any of the disorders in the anxiety disorders diagnostic class. The unspecified anxiety disorder cate- gory is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for a specific anxiety disorder, and includes presentations in which there is insufficient information to make a more specific diagnosis |
| Depersonalization (Definition) | experiences of unreality or detachment from one’s mind, self, or body; out of body experience |
| Derealization (Defintion) | experiences of unreality or detachment from one’s surroundings |
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