Part One of Anxiety Disorders

Part One of Anxiety Disorders

Part One of Anxiety Disorders details Generalized Anxiety Disorder and Separation Anxiety Disorder.  Anxiety Disorders is the fifth diagnostic class being covered in the Mental Health Diagnosis! blog series.  If you missed the introduction to the blog series click HERE to learn how the Diagnostic and Statistical Manual-5 works.  Click HERE to read the Introduction to Anxiety Disorders.

What are the specific characteristics of anxiety and worry?

The Diagnostic and Statistical Manual of Mental Disorders (2013) lists the following characteristics of anxiety and worry:

1. Restlessness or feeling keyed up or on edge
2. Being easily fatigued
3. Difficulty concentrating or mind going blank
4. Irritability
5. Muscle tension
6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).

Are there Any Similarities between Generalized Anxiety Disorder and Separation Anxiety Disorder?

Yes!  Both disorders are characterized by symptoms of anxiety and worry, however, they differ in the typical age of onset, the duration of symptoms, and the cause of the symptoms.

As with each disorder within the Diagnostic and Statistical Manuel of Mental Disorders 5, the symptoms and characteristics of the disorder must disrupt the individual’s typical functioning in school, at work, or in other important settings; and, the symptoms of the disorder are not due to the physiological effects of a substance, nor to an abuse of a drug, nor any other medical condition.

Generalized Anxiety Disorder

Generalized Anxiety Disorder is characterized by excessive worry and trouble controlling the worry.  Diagnosis requires that the individual experience at least three of the above characteristics of anxiety and worry for “more days than not for at least six months” (Diagnostic and Statistical Manual of Mental Disorders, 2013).  Topics or scenarios that cause some persons to experience excessive anxiety and worry include work, school, social activities, presentations, and so forth.

There are several disorders that must be ruled out prior to diagnosing an individual with Generalized Anxiety Disorder.  These disorders, which we will cover throughout the Mental Health Diagnosis! Blog series, cause the individual to worry and/or experience anxiety that is better explained by a more specific set of criteria.  Disorders that include excessive worry and anxiety include, but are not limited to, Social Anxiety Disorder, Obsessive-Compulsive Disorder, Separation Anxiety Disorder, Post-Traumatic Stress Disorder, Anorexia Nervosa, and Body Dysmorphic Disorder.

Separation Anxiety Disorder

Separation Anxiety Disorder is characterized by fear and anxiousness “about separation from attachment figures to a degree that is developmentally inappropriate” (Diagnostic and Statistical Manual of Mental Disorders, 2013).  It is developmentally appropriate for a toddler to physically cling to a parent or to cry when the parent exits the room; however, these behaviors would be considered developmentally inappropriate if the person were a teenager or an adult.

The onset of symptoms typically begins during an individual’s childhood, but they can continue into adulthood.  Diagnosis requires that the feelings of fear, anxiety, and/or avoidance are persistent:  lasting at least four weeks in children and adolescents and lasting approximately 6 months or more in adults (Diagnostic and Statistical Manual of Mental Disorders, 2013).

An individual can be diagnosed with Separation Anxiety Disorder when they experience three or more of the following developmentally inappropriate types of “excessive fear or anxiety concerning separation from those to whom [they are] attached:

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 (e.g., headaches, stomachaches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated adults” (Diagnostic and Statistical Manual of Mental Disorders, 2013).

Disorders that must be ruled out prior to diagnosing an individual with Separation Anxiety Disorder include, but are not limited to, “excessive resistance to change in autism spectrum disorder; delusions or hallucinations concerning separation in psychotic disorders; refusal to go outside without a trusted companion in agoraphobia; worries about ill health or other harm befalling significant others in generalized anxiety disorder; or concerns about having an illness in illness anxiety disorder (Diagnostic and Statistical Manual of Mental Disorders, 2013).

Up Next!

Part Two of Anxiety Disorders which describes Panic Disorder, Panic Attack Specifiers, and Selective Mutism.

References

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. Web. [access date: 6 June 2018]. dsm.psychiatryonline.org