Anxiety
Name three diagnosis within the Anxiety section of the DSM.
What is....
Separation Anxiety Disorder
Selective Mutism
Specific Phobia
Social Anxiety Disorder
Panic Disorder
Agoraphobia
Generalized Anxiety Disorder
Substance/Medication-Induced Anxiety Disorder
Anxiety Disorder Due to Another Medical Condition
Other Specified Anxiety Disorder
Unspecified Anxiety Disorder
(Panic Attack Specifier)
Most common _______ conditions are other anxiety disorders, most commonly social anxiety disorder, followed by separation anxiety disorder and specific phobia.
What are comorbid?
Specify if: Performance only: if the fear is restricted to speaking or performing in public.
What is Social Anxiety Disorder?
Layla is a 7 year old girl that only speaks when she is at home. She currently possesses all N's on her report card due to the teacher believing Layla is defiant and possibly on the spectrum without receiving care for the disorder. Layla's mother continuously tells the teacher that Layla speaks often while at home and has a bubbly personality.
What is Selective Mutism?
_____ is the emotional response to real or perceived imminent threat, whereas ___ is anticipation of future threat.
What is fear and anxiety?
The timeframe to for this diagnosis is..
What is 4 weeks in children and adolescents and 6 months or more in adults?
A marked fear or anxiety about two (or more) of the following five situations:
Using public transportation
Being in open spaces
Being in enclosed spaces (e.g., shops, theaters, cinemas)
Standing in line or being in a crowd
Being outside the home alone.
What is Agoraphobia?
Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed panic attack or panic-like symptoms. Fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train, or automobile.
What is Agoraphobia?
Sayeed is a 19 year old African American male currently repeating his junior year of high school. He is seeking treatment due to possessing difficulty separating from his father who recently quit working due to Sayeed's behaviors. Sayeed worries about his father often when they are apart, will not engage with his friends, and experiences nightmares often.
What is Separation Anxiety?
When client does not meet the full criteria and clinician does not desire to specify the criteria.
What is Unspecified Anxiety Disorder?
A discrete period of intense fear or discomfort, in which four or more of the following symptoms developed abruptly and reached a peak within 10 minutes
Palpitations, pounding heart, or accelerated heart rate
Sweating
Trembling or shaking
Sensations of shortness of breath or smothering
Feeling of choking
Chest pain or discomfort
Nausea or abdominal distress
Feeling dizzy, unsteady, lightheaded, or faint
Derealization (feelings of unreality) or depersonalization (being detached from oneself)
Fear of losing control or “going crazy”
Fear of dying
Paresthesias (numbness or tingling sensation)
Chills or hot flushes.
What is Panic Disorder?
1. Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).
2. The phobic object or situation almost always provokes immediate fear or anxiety.
3. The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.
4. The phobic object or situation is actively avoided or endured with intense fear or anxiety.
5. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
6. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
7. 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 (as in obsessive-compulsive disorder); reminders of traumatic events (as in posttraumatic stress disorder); separation from home or attachment figures (as in separation anxiety disorder); or social situations (as in social anxiety disorder).
What is Specific Phobia?
Essential features of GAD
What is excessive anxiety and worry about a number of events and activities?
_____ are not limited to anxiety disorders but rather can be seen in other mental disorders as well.
What are panic attacks?
Client possesses symptoms characteristic of an anxiety disorder that cause clinically significant distress or impairment in daily life but do not meet the full criteria for any disorders in the anxiety disorders diagnostic class. The clinician chooses to specify.
What is Other Specified Anxiety Disorder?
Criteria for Separation Anxiety Disorder
What is
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.
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.
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 (such as headaches, stomachaches, nausea, or vomiting) when separation from major attachment figures occurs or is anticipated
Criteria for Selective Mutism
Substance/Medication-Induced Anxiety Disorder
What is..
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.
Sarah is a 6 year old little girl. She is currently with her PCP due to experiencing stomachaches, headaches, and vomiting upon being dropped off at school. She cries often resulting in her parents having to pick her up from school. Sarah tells her PCP she's scared something will happen with her parents when she gets to school and noted it's difficult to control her emotions.
What is Separation Anxiety Disorder?
Criteria for Social Anxiety Disorder
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 (e.g., having a conversation, meeting unfamiliar people), 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.
The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated (i.e., will be humiliating or embarrassing; will lead to rejection or offend others).
B. The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context.
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.
G. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
F. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
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.
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.
Differential Diagnosis for Specific Phobia
Agoraphobia
Social Anxiety Disorder
Separation Anxiety Disorder
Panic Disorder
OCD
Trauma- and stressor-related disorders
Eating Disorders
Criteria for Generalized Anxiety Disorder
What is...
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 person finds it difficult to control the worry.
C. The anxiety and worry are associated with three or more of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months).
Restlessness or feeling keyed up or on edge
Being easily fatigued
Difficulty concentrating or mind going blank
Irritability
Muscle tension
Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep
D. The focus of the anxiety and worry is not confined to features of an Axis I disorder (e.g., the anxiety or worry is not about having a panic attack [as in panic disorder], being embarrassed in public [as in social phobia], being contaminated [as in obsessive-compulsive disorder] being away from home or close relatives [as in separation anxiety disorder], gaining weight [as in anorexia Nervosa], or having a serious illness [as in hypochondriasis]), and the anxiety and worry do not occur exclusively during posttraumatic stress disorder.
F. The disturbance is not better explained by another mental disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder).
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).
Cesar notes services are desired due to worrying often. He shares he is tired often and does not experience restorative sleep. It was identified he gets irritable often and feels restless.
What is Generalized Anxiety Disorder?