The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) provides criteria for various types of anxiety disorders. Each disorder has its own specific criteria, but they share common features such as excessive fear, anxiety, and related behavioral disturbances. Below are key criteria for some of the most common anxiety disorders:

1. Generalized Anxiety Disorder (GAD)

1. Excessive anxiety and worry: Occurring more days than not for at least 6 months, about a number of events or activities.
2. Difficulty controlling the worry.
3. Associated with 3 (or more) of the following symptoms (with at least some present for more days than not for the past 6 months):
   • Restlessness or feeling keyed up/on edge.
   • Being easily fatigued.
   • Difficulty concentrating or mind going blank.
   • Irritability.
   • Muscle tension.
   • Sleep disturbance (difficulty falling or staying asleep, or restless/unsatisfying sleep).
4. Causes significant distress or impairment in social, occupational, or other important areas of functioning.
5. Not attributable to the effects of a substance (e.g., drug abuse, medication) or another medical condition.
6. Not better explained by another mental disorder.

2. Panic Disorder

• Recurrent unexpected panic attacks: An abrupt surge of intense fear or discomfort that reaches a peak within minutes, during which time 4 (or more) of the following symptoms occur:

1. 1. Palpitations, pounding heart, or accelerated heart rate.
   2. Sweating.
   3. Trembling or shaking.
   4. Sensations of shortness of breath or smothering.
   5. Feelings of choking.
   6. Chest pain or discomfort.
   7. Nausea or abdominal distress.
   8. Feeling dizzy, unsteady, lightheaded, or faint.
   9. Chills or heat sensations.
   10. Paresthesias (numbness or tingling sensations).
   11. Derealization (feelings of unreality) or depersonalization (being detached from oneself).
   12. Fear of losing control or “going crazy.”
   13. Fear of dying.

• At least one attack has been followed by 1 month (or more) of one or both of the following:
  1. Persistent concern or worry about additional panic attacks or their consequences.
  2. A significant maladaptive change in behavior related to the attacks (e.g., avoiding situations where panic attacks might occur).
• Not attributable to the effects of a substance or medical condition.
• Not better explained by another mental disorder.

3. Social Anxiety Disorder (Social Phobia)

• Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.
  • Examples include social interactions, being observed, or performing in front of others.
• The individual fears that they will act in a way or show anxiety symptoms that will be negatively evaluated (i.e., lead to embarrassment, humiliation, rejection, or offend others).
• The social situations almost always provoke fear or anxiety.
• The social situations are avoided or endured with intense fear or anxiety.
• The fear or anxiety is out of proportion to the actual threat posed by the social situation.
• The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
• Causes significant distress or impairment in social, occupational, or other important areas of functioning.
• Not attributable to the effects of a substance or medical condition.
• Not better explained by another mental disorder.

4. Specific Phobia

• Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).
• The phobic object or situation almost always provokes immediate fear or anxiety.
• The phobic object or situation is actively avoided or endured with intense fear or anxiety.
• The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation.
• The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
• Causes significant distress or impairment in social, occupational, or other important areas of functioning.
• Not better explained by another mental disorder.

5. Agoraphobia

• Marked fear or anxiety about two (or more) of the following five 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.
• The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms.
• These situations almost always provoke fear or anxiety.
• The situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety.
• The fear or anxiety is out of proportion to the actual danger posed by the situations.
• The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
• Causes significant distress or impairment in social, occupational, or other important areas of functioning.
• If another medical condition is present (e.g., inflammatory bowel disease), the fear, anxiety, or avoidance is clearly excessive.
• Not better explained by another mental disorder.

6. Separation Anxiety Disorder

• Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least 3 of the following:
  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 possible harm to them.
  3. Persistent and excessive worry about experiencing an untoward event that causes separation from a major attachment figure (e.g., getting lost, being kidnapped, having an accident).
  4. Persistent reluctance or refusal to go out because of fear of separation.
  5. Persistent and excessive fear or reluctance about being alone.
  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 when separation from major attachment figures occurs or is anticipated.
• The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults.
• Causes significant distress or impairment in social, academic, occupational, or other important areas of functioning.
• Not better explained by another mental disorder.

Reference:

American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc.. https://doi.org/10.1176/appi.books.9780890425596

DSM Cover image source:

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