DSM-5 Anxiety Generalized Anxiety Disorder • 6 months of symptoms more days • • than not anxiety/worry about a number of events 3 of 6 symptoms of SITCOM (for kids only 1) o Sleep o Irritable o Tired o Concentrating o On edge o Muscle Tension Anxiety Disorder Due to Another Medical Condition Separation Anxiety Disorder • 4 weeks in kids, 6 months in adults • developmentally inappropriate anxiety concerning separation evidenced by 3 symptoms Selective Mutism school) situations where there is an expectation, not the result of lack of knowledge or issues with language Specific Phobia • 6 months • Anxiety/fear about a specific • Other Specified Anxiety Disorder Social Anxiety Disorder • 6 months • Anxiety/fear in social situations • Significant, has anxiety, doesn't meet criteria and you choose to communicate the reason it doesn't meet criteria, f.e.: Other Specified Anxiety Disorder, generalized anxiety not occurring more days than not Unspecified Anxiety Disorder • Significant, has anxiety, doesn't meet criteria and you choose not to specify the reason o includes when there's not enough info to make a more specific diagnosis Substance/Medication Induced Anxiety Disorder • Panic attacks or anxiety that occur • • soon after intoxication or withdrawal Not only during delirium Specifiers: o With onset during intoxication o With onset during withdrawal o With onset after medication use object/situation o immediate fear, actively avoided Specifiers: o Animal o Natural environment o Blood Injection o Situational o Other • with possible scrutiny o fear of being negatively evaluated o for kids, can't be with adults Specifiers: o Performance Only Panic Disorder • • • • • Panic Attack Specifier • in context of another mental disorder Agoraphobia • situations o fear is that escape is difficult o place is avoided You can have agoraphobia and panic disorder if criteria fits • Disturbance is ≥1 1 month • Criterion A: Exposure to actual or • Symptoms after trauma, persisting 3 days to 1 in ≥2 of the following o reduced reticence interacts with unfamiliar adults o overly familiar verbal/physical behavior o diminished checking back with adult caregiver o willingness to go off with unfamiliar adult without hesitation not limited to impulsivity (as in ADHD) extremes of insufficient care as evidenced by 1 of the following: o Social neglect and lack of basic emotional needs, repeated changes of primary caregivers, rearing in unusual settings Developmental age of at least 9 months Specify: Persistent (if >1 year) and/or Severe (all symptoms at high levels) • • • • Inhibited, emotionally withdrawn with 4 symptoms • 6 months • fear/anxiety about 2 or more public Acute Stress Disorder Reactive Attachment Disorder • 1 month of concern • Recurrent unexpected panic attacks • Same as panic attacks but it occurs PTSD • child interacts with unfamiliar adults • failure to speak in specific social medical issue medical condition Disinhibited Social Engagement Disorder • 1 month (not the first month of • Panic attacks or anxiety due to a • Not only during delirium • Coding: include the name of the DSM-5 Trauma & Stressor • • • behavior toward adult caregivers including both: child rarely seeks comfort AND doesn’t respond to comfort when distressed Persistent social/emotional disturbance including at least 2 of the following o Minimal social/emotional responsiveness, limited positive affect, or episodes of unexplained irritability/sadness/fearfulness even during non-threatening interactions with caregivers Pattern of extremes of insufficient care evidence by one of the following: o Social neglect and lack of basic emotional needs, repeated changes of primary caregivers, rearing in unusual settings Not autism Evidence before 5 years old, developmental age of at least 9 months Specify: Persistent (if >1 year) and/or Severe (all symptoms at high levels) • • • threatened death, injury, or sex violence in ≥1 of the following ways: o Directly experiencing o Witnessing o Learning a violent or accidental event occurred to a close family member/friend o Repeated exposure to aversive details of traumatic events Presence of ≥1 of the following: o Recurrent, involuntary/intrusive memories (in kids repetitive play) o Recurrent dreams o Dissociative reactions o Intense/prolonged distress at exposure to cues that symbolize or resemble the event o Physiological reactions to cues Persistent avoidance of stimuli associated evidenced by: avoidance of associations with the trauma AND/OR avoidance to avoid external reminds that arouse memories Negative alterations in cognition and mood as evidenced by 2 of the following: o Can’t remember important aspects of event o Persistent negative beliefs about oneself, others, or the world o Persistent distorted cognitions about event leading individual to blame themselves o Persistent negative emotional state o Decreased interest in activities o Feelings of detachment from others o Inability to experience positive emotions Alterations in arousal (2 of the following) o Anger outbursts with aggression towards people or objects o Self-destructive reckless behavior o Hypervigilance o Exaggerated startle response o Difficulty concentrating o Sleep disturbance Specify whether: with dissociative symptoms o depersonalization o derealization Specify if: with delayed expression (if ≥6 months after event) month • Criterion A of PTSD • Presence of ≥9 symptoms o Intrusion Symptoms ▪ Recurrent intrusive distressing memories (in kids repetitive play) ▪ Recurrent distressing dreams ▪ Dissociative reactions (flashbacks) ▪ Intense psychological distress with physiological responses to cues of event o Negative Mood ▪ Inability to experience positive emotions o Dissociative ▪ Altered sense of reality ▪ Inability to remember aspects of event o Avoidance ▪ Efforts to avoid distressing memories, thoughts, or feelings about event o Arousal ▪ Sleep disturbance ▪ Irritable behavior and angry outbursts ▪ Hypervigilance ▪ Problems with Concentration ▪ Exaggerated startle response Adjustment Disorder • Emotional/behavioral symptoms within 3 • • • months of onset of identifiable stressor, and once stressor stops symptoms don’t persistent >6 mo Distress out of proportion to severity of stressor OR significant impairment in function Doesn’t meet criteria for another mental disorder, and doesn’t represent normal bereavement Specifiers: o With depressed mood o With anxiety o With mixed anxiety and depressed mood o With disturbance of conduct o With mixed disturbance of emotions and conduct o Unspecified Unspecified Trauma and StressorRelated Disorder o Trauma / Stressor disorder causing significant distress and you don’t want to communicate the reason Other Specified Trauma and Stressor-Related Disorder o Trauma / Stressor disorder causing significant distress and you want to communicate the reason