September 17, 2014

Anxiety Disorders in the DSM V

The following are the anxiety disorders that are defined in the new DSM V (Diagnostic and Statistical Manual of Mental Disorders 5) by the American Psychiatric Association. These major top-level anxiety diagnoses are the psychiatric labels that psychotherapists will use for categorizing the various psychopathologies falling under the banner of anxiety disorder.

Separation Anxiety Disorder

This disorder concerns a childhood onset anxiety disorder (18 years old or younger  in which the patient has strong life-disrupting anxiety stemming from actual or potential separation from their attachment figures. Attachment figures can be any major relationship, but is most typically a parent, a spouse, or romantic partner.

Panic Disorder

Panic disorder  is characterized by panic attacks that come on absent of a specific or reliable trigger. The attacks cannot be related to any substance use, such as caffeine. nor in response to a particular fear stimulus such as spiders or guns.

Agoraphobia

Agoraphobia an avoidance-driven phobic response to specific environments, and in particular public spaces. The agoraphobic may develop a fear of public areas such as shopping malls, airplanes, or a movie theatre. The situations are avoided or are tolerated only with great difficulty and usually with a regular companion. Agoraphobia is typically a ‘fear of fear’, in that the agoraphobic is afraid of having an anxiety attack in those spaces.

Specific Phobia

A specific phobia diagnosis is characterized by an intense out-of-proportion fear response to a specific stimulus. As is common with the anxiety disorders, avoidance of the stimulus is a key feature. There are a variety of specific phobia subtypes, including animal and blood-injection-injury.

Social Anxiety Disorder / Social Phobia

Social anxiety disorder (aka Social Phobia) is a persistent fear of social situations. The fear is particular and increases in intensity when the social phobic is likely to have attention placed on them by more than one person. For example, walking down a city street may not trigger the fear, but imagining eating in a public restaurant might. The prototypical scenario that induces a phobic response is public speaking or performance in which the attention of an entire group is on the phobic.

Generalized Anxiety Disorder

Generalized Anxiety Disorder, often abbreviated GAD, is a common anxiety disorder which includes excessive worry or concern about major life domains. Anxiety si often around family life, health issues (potential or current), or financial well being. GAD is particularly associated with chronic physical symptoms such as fatigue, irritability, muscle tension, and sleep disturbance. Behaviorally, the GAD diagnosis accompanies putting off decision making due to worry, avoidance of situations related to the anxiety domain (such as going to the doctor), and excessive time spent attempting to avoid negative outcomes.

Substance-Induced Anxiety Disorder

This diagnostic category accounts for anxiety behaviors (which could map on to any of the other anxiety diagnoses) which are directly linked to either the use of or withdrawal from drugs. The legal status of the drugs are immaterial, they could be recreational or therapeutic.

Anxiety Disorder Associated with Another Medical Condition

The anxiety disorder associated with another medical condition has a variety of etiologies. It is characterized by obsession, anxiety attacks, or a generalized anxiety which is common and prominent in the person. This is most commonly associated with a traumatic brain injury or other brain lesion, or the pathological function of a gland such as the thymus or adrenal gland.

Anxiety Disorder Not Elsewhere Classified

The anxiety disorder not elsewhere classified is used as a diagnosis when there is clear, present, and problematic anxiety presenting but without fitting entirely into one of the above listed diagnoses. Most typically, this is associated with subclinical or atypical symptoms. This catch-all diagnostic category is seen as containing a population of people with anxiety disorders that have yet not been well articulated by scientific research.