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Anxiety Disorders
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision. Washington , DC.
Anxiety is a natural response to threatening situations, a response to real danger, loss of self-esteem, or loss of control. Signs of anxiety include motor tension, increased activity in autonomic activities, worry about events that take place in the future, and taking caution. However if these signs of anxiety are continuous, cause overwhelming or almost overwhelming stress, there may be an Anxiety Disorder present. The more severe cases of Anxiety Disorder may include suicidal feelings, substance abuse, or self-destructing behaviors.
There are many types of Anxiety Disorders. They are Panic attacks, Agoraphobia, Panic Disorder without Agoraphobia (300.01), Panic Disorder with Agoraphobia (300.21), Agoraphobia without History of Panic Disorder (300.22), Specific Phobia (formerly Simple Phobia) (300.29), Social Phobia (Social Anxiety Disorder) (300.23), Obsessive Compulsive Disorder (300.3), Posttraumatic Stress Disorder (309.81), Acute Stress Disorder (308.3), Generalized Anxiety Disorder (includes Overanxious Disorder of Childhood) (300.02), Anxiety Disorder Due to a General Medical Condition (293.84), Substance-Induced Anxiety Disorder, and Anxiety Disorder Not Otherwise Specified (300.00). Although not classified under anxiety disorders in the DSM-IV one anxiety disorder more specific to children is Separation Anxiety Disorder (309.41)
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision. Washington , DC.
An individual could be diagnosed with Generalized Anxiety Disorder (includes Overanxious Disorder of Childhood) (300.02) if the following symptoms are seen.
1. Extreme anxiety and worry occurs most of the days in a 6 month period, for events or activities such as school or work. 2. The individual finds it difficult to control worry. 3. The anxiety and worry is seen by demonstration of at least one of the six symptoms in children or at least three of the six in an adult for most of the days within a six month period
4. The anxiety and worry is not justified another disorder. 5. The anxiety and worry causes distress or difficulties in social, work, or other important aspects of life. 6. The symptoms are not due to the use of a substance, a medical condition, or does not occur only during a mood disorder, a psychotic disorder, or a pervasive developmental disorder.
An individual could be diagnosed with Social Phobia (Social Anxiety Disorder) (300.23) if the following symptoms are seen.
1. Excessive and unreasonable fear that is persistent with social or performance situations that happen when in the presence of unfamiliar people or to possible scrutiny by others. The individual fears of acting in ways that will be embarrassing or humiliating. In children this fear must not be justified by age-appropriate behavior. 2. A social situation must cause anxiety, which may be seen as a Panic Attack. In children the anxiety may be seen as crying, tantrums, freezing, or clinging. 3. The person realizes that the fear is unreasonable however, children may not realize this. 4. Social situations are avoided or are dealt with, with stress and intense anxiety. 5. The stress and anxiety interferes with the person's normal life. 6. In individuals under 18 years old, this occurs for at least 6 months. 7. The anxiety disorder is not caused by the use of a substance. 8. The anxiety can not be justified by another mental disorder or medical condition.
An individual could be diagnosed with Specific Phobia (formerly Simple Phobia) (300.29) if the following symptoms are seen.
1. Excessive and unreasonable fear that is persistent and is caused by a specific situation or object such as flying, heights, animals, etc. 2. When exposed to the situation or object the individual has immediate anxiety or a Panic Attack. In children the anxiety may be seen as crying, tantrums, freezing, or clinging. 3. The person knows that this fear is excessive or unreasonable, however children may not realize this. 4. This fear and anxiety interferes with relationships, social behaviors, work, or other important activities. 5. In individuals under 18 years old, this occurs for at least 6 months. 6. The anxiety can not be justified by another mental disorder, medical condition, or substance use.
An individual could be diagnosed with Separation Anxiety Disorder (309.41) if the following symptoms are seen.
1. Excessive anxiety due to at least three of the following:
2. The symptoms last for four weeks or more. 3. The onset is before 18 years old. 4. The symptoms cause enough stress to interfere with social, school, or other aspects of life. 5. The symptoms can not be justified by a Pervasive Development Disorder, Schizophrenia, or another Psychotic Disorder and in adolescents and adults is not due to Panic Disorder with Agoraphobia. 6. Early onset is considered to be before the age of 6 years old.
An individual could be diagnosed with Panic Disorder without Agoraphobia (300.01) if the following symptoms are seen.
1. Both a and b:
2. There is no sign of Agoraphobia. 3. Panic attacks are not justified by a substance or medical condition. 4. Panic attacks are not justified by another mental disorder such as OCD or PTSD.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision. Washington , DC.
In individual is more likely to develop an Anxiety Disorder if family members also have an Anxiety Disorder. An Anxiety Disorder also may develop if an individual is repeatedly exposed to situations that cause anxiety.
Comorbidity Some common disorders associated with individuals that have an anxiety disorder are Major depression (28 to 69%), ADHD, and conduct disorder. Also, at least 1/3 of children meet the criteria for two or more anxiety disorders.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington , D.C.
The lifetime prevalence rate of generalized anxiety is 5%, social phobia is 3% to 13%, specific phobia is 10% to 11% and separation anxiety is 4%.
Listed below are either evidence-based practices or promising practices that have been successful at treating Anxiety Disorders.
Practice Guideline Clearing House
Fact Sheets from the American Academy of Child and Adolescent Psychiatry
Fact Sheets from the National Institute of Mental Health
Fact Sheets from the National Mental Health Association
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