Anxiety and Trauma Brief disorders of DSM

Anxirty and trauma disorders - DSM

1. 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
• Panic attacks or anxiety due to a
medical issue
• Not only during delirium
• Coding: include the name of the
medical condition
Other Specified Anxiety
Disorder
• 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


•
DSM-5 Anxiety





Disinhibited Social
Engagement Disorder
• child interacts with unfamiliar adults
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)
Reactive Attachment
Disorder
• Inhibited, emotionally withdrawn
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)

DSM-5 Trauma & Stressor PTSD
• Disturbance is ≥1 1 month
• Criterion A: Exposure to actual or
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)

Acute Stress Disorder
• Symptoms after trauma, persisting 3 days to 1
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 Stressor-
Related 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

Separation Anxiety
Disorder
• 4 weeks in kids, 6 months in adults
• developmentally inappropriate
anxiety concerning separation
evidenced by 3 symptoms
Selective Mutism
• 1 month (not the first month of
school)
• failure to speak in specific social
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
object/situation
o immediate fear, actively avoided
• Specifiers:
o Animal
o Natural environment
o Blood Injection
o Situational
o Other
Social Anxiety Disorder
• 6 months
• Anxiety/fear in social situations
with possible scrutiny
o fear of being negatively evaluated
o for kids, can't be with adults
• Specifiers:
o Performance Only

Panic Disorder
• 1 month of concern
• Recurrent unexpected panic attacks
with 4 symptoms

Panic Attack Specifier
• Same as panic attacks but it occurs
in context of another mental
disorder
Agoraphobia
• 6 months
• fear/anxiety about 2 or more public
situations
o fear is that escape is difficult
o place is avoided
• You can have agoraphobia and panic
disorder if criteria fits