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Anxiety Dx-list
- separation anxiety dx
- Selective Mutism
- specific phobia
- social anxiety disorder
- Panic Disorder
- Agoraphobia
- GAD
- Substance/medication induced anxiety dx
- anxiety dx due to another medical condition
- other specified anxiety dx
- unspecified anxiety dx
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fear
emotional response to real or perceived imminent threat
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anxiety
anticipation of future threat
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Separation Anxiety Dx
- A. Developmentally inappropriate and excessive fear/anxiety
concerning separation from those to whom the individual is attached,
evidenced by 3+ of the following:
- recurrent excessive distress when anticipating or experiencing separation from attachment figure
- persist worry about losing major attachment figures or about possible harm to them
- persistent worry about experiencing an untoward event that causes separation from a major attachment figure
- reluctance or refusal to go out, away from home, to school, work due to fear of separation
- excessive fear of or reluctance about being alone or w/out attachment figure
- reluctance or refusal to sleep away from home or attachment figure
- repeated nightmares involving separation
- complains of physical symptoms when separation from attachment figures
- B. fear, anxiety, or avoidance is persistence, lasting 4 wks in children and adolescents and typically 6 months or more in adults
- C. disturbance causes distress ir impairment in social/occupational/ other areas of functioning
- D. the disturbance is not better explained by another mental dx, such as asd, delusions, hallucinations, etc
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Selective Mutism
- A. consistent failure to speak in specific social situations in which there is an expectation for speaking despite speaking in other situations
- B. disturbance interferes with education or occupational achievement or with social communication
- C. the duration of the distruabcen is at least 1 month (and not limited to the first month of school)
- D. failure to speak is not attributable to a lack of knowledge of or comfort with the spoken language required in the social situation
- E. not better explained by a communication disorder and does not occur exclusively during the course of autism, schizophrenia, or other psychotic dx
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specific phobia
- A. marked fear/ anxiety about a specific object or situation
- B. phobic object or situation almost always provokes immediate fear or anxiety
- C. phobic object or situation is actively avoided or endured with intense fear or anxiety
- D. fear or anxiety is out of proportion to the actual danger
- E. fear/ anxiety/ avoidance is persistent, lasting for 6+ months
- F. fear/anxiety/avoidance causes clinically significant distress or impairment in areas of functioning
- G. not better explained by symptoms of another mental dx, not due to ocd, or separation from attachment figures
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specific phobia- specifiers
- code based on the phobic stimulus
- animal
- natural environment
- blood injection injury
- situational
- other
- if more than one phobic stimulus is present, code all that apply
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Social Anxiety Disorder
- A. marked fear/anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others
- B. individual fears that they will act in a way that shows anxiety symptoms 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 or anxiety
- E. fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context
- F. fear/anxiety/avoidance persistent for 6+ months
- G. fear/anxiety/avoidance causes clinically significant distress or impairment in areas
- H. dear/anxiety/avoidance is not attributable to substance use or other medical condition
- I. fear/anxiety/avoidance is not better explained by the symptoms of another mental dx, like panic dx or body dysmorphic dx
- J. if another medical condition is present, the fear/anxiety/avoidance is clearly unrelated or is excessive
- Specify if performance only
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Panic Disorder
- A. recurrent unexpected panic attacks- an abrupt surge of
intense fear or intense discomfort that reaches a peak within
minutes, during which time 4+ of the symptoms occur:
- palpitations, pounding heart
- sweating
- tumbling or shaking
- sensations of shortness of breath or smothering
- feelings of choking
- chest pain or discomfort
- nausea or abdominal distress
- feelings dizzy, unsteady, light headed
- chills or heat sensations
- paresthesia (numbness)
- derealization or depersonalization
- fear of losing control
- fear of dying
- B. at least one
of the attacks has been followed by 1 month or more one or both:
- persistent concern or worry about additional panic attacks
- significant maladaptive change in bx related to attacks
- C. disturbance is not due to substance use or other medical condition
- D. not better explained by another mental dx
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Panic Attack Specifier
- can occur in the context of any anxiety dx and other mental dx
- palpitations, pounding heart
- sweating
- tumbling or shaking
- sensations of shortness of breath or smothering
- feelings of choking
- chest pain or discomfort
- nausea or abdominal distress
- feelings dizzy, unsteady, light headed
- chills or heat sensations
- paresthesia (numbness)
- derealization or depersonalization
- fear of losing control
- fear of dying
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Agoraphobia
- A. marked fear or anxiety about 2+ of following:
- using public transportation
- being in open spaces
- being in enclosed placed
- standing in line or being in a crowd
- being outside of the home
- B. individual fears or avoids these situations bc of thoughts of escape might be difficulty or help might not be available in the event panic life symptoms start
- C. agoraphobic situations almost always produces fear or anxiety
- D. situation is actively avoided, requires the presence of a companion, or endured with lots of anxiety
- E. fear or anxiety out of proportion to actual posed danger
- F. fear/anxiety/avoidance lasting for 6 months or more
- G. causes significant distress or impairment
- H. if another med condition present, the avoidance is clearly excessive
- I. not better explained by symptoms of another mental dx
you can dx of both agoraphobia and panic dx
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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. individual finds it difficulty to control the worry
- C. anxiety and worry are associated with three or more of the
following symptoms:
- restlessness or feeling keyed up
- being easily fatigued
- difficulty concentrating or mind going blank
- irritability
- muscle tension
- sleep disturbance
- D. causes distress or impairment in social, occupational functioning
- E. disturbance not better attributable to effect of substance of other medical condition
- F. not better explained by another mental dx