TABLE 91-4 - Diagnostic Criteria of the Most Common DSM-IV Anxiety Disorders

Diagnostic Criteria of the Most Common DSM-IV Anxiety Disorders

DSM-IV Criteria of Simple Phobia
Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).

Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed panic attack.

The person (adults only) recognizes that the feature is excessive or unreasonable.


The phobic situation is avoided or else is endured with intense anxiety or distress.


The avoidance, anxious anticipation, or distress in the feared situations interferes significantly with the person's normal routine, occupational (or academic) functioning, or social activities or relationships.


Or there is marked distress about having the phobia.


DSM-IV Diagnostic Criteria of Social Phobia

Marked fear of being focus of attention; avoidance of meeting unfamiliar people and close scrutiny by others.


Fear of behaving in embarassing or humiliating way.


Extreme anticipatory anxiety, which may manifest itself as a panic attack.


DSM-IV Diagnostic Criteria of Posttraumatic Stress Disorder

Experience of a traumatic event.


Reexperienced by intrusive and distressing recollection, dreams, flashbacks, distress in similar situations.


Persistent avoidance of stimuli associated with trauma.


Persistent symptoms of increased arousal.


Duration of disturbance of at least 1 month.


DSM-IV Diagnostic Criteria of Panic Disorder

Recurrent and unexpected panic attacks.


Plus one or more of the following:

• Persistent concern about having additional attacks (anticipatory anxiety) or
  
• Worry about the consequences of the attacks or
  
• A significant change in behavior related to the attacks (phobic avoidance)

Not due to a substance, medical condition, or mental illness.


At least 2 unexpected panic attacks for diagnosis.


Definition of Panic Attack

A period of intense fear or discomfort in which at least 4 of the following symptoms develop suddenly:

• Palpitations or increased heart rate
  
• Sweating
  
• Trembling or shaking
  
• Sensations of shortness of breath or smothering
  
• Feeling of choking
  
• Nausea or abdominal distress
  
• Chest pain or discomfort
  
• Dizziness, light-headedness, or faintness
  
• Derealization or depersonalization
  
• Fear of losing control or going crazy
  
• Chills or hot flashes
  
• Paresthesia (numbness or tingling)
  
• Fear of dying

DSM-IV Criteria of Generalized Anxiety Disorder

Excessive anxiety and worry for more days than not for past 6 months.


Difficulty controlling worry.


Functional impairment and/or distress.


Symptoms not attributable to other causes.


Physical symptoms

• Restlessness or feeling keyed up/on edge
  
• Fatigue
  
• Muscle tension

Psychological symptoms

Excessive anxiety or worry


Difficulty controlling worry


Irritability


Difficulty concentrating or mind going blank


Sleep disturbance