Anxiety, Obsessive-Compulsive, and Related Disorders

Separation Anxiety Disorder

. Developmentally inappropriate, excessive fear or anxiety concerning separation from caregiver, by evidenced by 3 of the following (at least 4 wks children; 6 or more months adults):

1. Recurrent excessive distress when anticipating/experiencing separation from home or major attachment figures 2. Persistent and excessive worry about losing major attachment figures or possible harm to them 3. Persistent and excessive worry about experiencing an untoward event that causes separation 4. Persistent reluctance or refusal to go out, away from home, to school, to work or elsewhere because of fear of separation 5. Persistent fear or reluctance about being alone or without major attachment figures at home or in other settings 6. Persistent fear or reluctance to sleep away from home or to go to sleep without being near a major attachment figure 7. Repeated nightmares involving a theme of separation 8. Repeated complaints of physical symptoms when separated from major attachment figures is anticipated

SELECTIVE MUTISM

A. Consistent failure to speak in specific social situations in which there is an expectation of speaking despite speaking in other situations

B. Interferes with educational or occupation achievement or social communication

C. Duration of disturbance is at least 1 month

D. Failure to speak is not attributable to lack of knowledge or discomfort with spoken language

E. Disturbance is not better explained by a communication disorder

SPECIFIC PHOBIA

Marked fear or anxiety about a specific object or situation B. Phobic object/situation almost always provokes immediate fear or anxiety C. Phobic object/situation is avoided or endured with intense fear or anxiety D. Fear or anxiety is out of proportion to the danger of the situation E. Persistent – typically lasting 6 months or more F. Causes clinically significant distress/impairment G. Not better explained by symptoms of another mental disorder

Panic disorder

Recurrent unexpected panic attacks B. At least one of the attacks has been followed by 1 month or more of concern for additional attacks and/or significant change in behavior C. Not due to physiological effects of medications, drugs, or medical conditions D. Not accounted for by another disorder

SOCIAL ANXIETY DISORDER

Marked fear or anxiety about one more more social situations where individual is exposed to possible scrutiny by others. B. The individual fears he/she will act in a way or show anxiety SX that will be negatively evaluated C. The social situations almost always provoke fear or anxiety D. The social situations are avoided or endured with intense fear/anxiety E. The fear/anxiety is out of proportion to the actual threat, and persists for 6 months or more F. Causes clinically significant distress or impairment G. Not due to effects of substance or medical condition H. Not due to SX of another mental disorder

AGORAPHOBIA

A. Marked fear or anxiety about 2 or more of the following situations: 1. Using public transportation 2. Being in open spaces 3. Being in enclosed spaces 4. Standing in line or being in a crowd 5. Being outside of the home alone
Individual fears of avoids these situations because of thoughts that escape might be difficult or help not available in event of developing panic like symptoms

GENERALIZED ANXIETY DISORDER

A. Excessive anxiety or worry occurring more days than not for at least 6 months about a number of events or activities

B. Difficulty controlling worry

C. Associated with 3 of these 6 symptoms (at least some are present for more days than not): restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance

D. Causes clinically significant distress/impairment E. Not due to the effects of a substance F. Not better explained by another mental disorder

OBSESSIVE-COMPULSIVE DISORDER

A. Presence of obsessions, compulsions, or both

O1. Recurrent persist thoughts, urges, & images that are intrusive and unwanted and cause anxiety

O2. Individual attempts to ignore or suppress thoughts, urges, or images

C1. Repetitive behave or mental acts that individual feels driven to perform

C2. Mental acts aimed at prevent/reduce anxiety or distress; usually not connected in realistic way with what they should neutralize

B. Obsessions & Compulsions are time consuming (+1 hour)

C. Not a substance  D. Not better explained by something else

BODY DYSMORPHIC DISORDER

 A. Preoccupation with 1+ defect or flaw that are not observable or only slight

B. At some point during the course of disorder, individual has repetitive behaviors or mental acts in response to appearance concerns

C. Preoccupation causes clinically significant distress or impairment

D. Appearance preoccupation is not better explained by eating disorder/weight

HOARDING DISORDER

A. Persistent difficulty discarding or parting with possessions, regardless of their actual value

B. Difficulty due to perceived need to save items and distress associated with discarding them

C. Difficulty discarding possessions result in congest and clutter active living areas (3rd party intervention may remove this one)

D. Hoarding causes clinically significant distress or impairment in functioning  E. Not attributable to other medical condition

F. Not better explained by other disorder

TRICHOTILLOMANIA

A. Recurrent pulling out of one’s hair, resulting in hair loss  B. Repeated attempts to decrease or stop hair pulling  C. The hair pulling causes clinically significant distress or impairment  D. Not a medical condition  E. Not better explained by another disorder

EXCORIATION DISORDER

A. Recurrent skin picking resulting in skin lesions  B. Repeated attempts to decrease or stop skin picking  C. Skin picking causes clinically significant distress or impairment  D. Skin picking is not due to substance or other medical condition  E. Not better explained by another disorder