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62 Cards in this Set
- Front
- Back
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Criteria for Alcohol Intoxication
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A. Recent ingestion of alcohol
B. Clinically significant maladaptive behavioral or psychological changes (e.g. inappropriate sexual or aggressive behavior, mood lability, impaired judgment, impaired social or occupational functioning) that developed during, or shortly after, alcohol ingestion C. One (or more) of the following signs, developing during, or shortly after, alcohol use: (1) slurred speech (2) incoordination (3) unsteady gait (4) nystagmus (5) impairment in attention or memory (6) stupor or coma D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder |
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Criteria for Alcohol Withdrawal
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A. Cessation of (or reduction in) alcohol use that has been heavy and prolonged.
B. Two or more of the following, developing within several hours to a few days after criterion A (1) autonomic hyperactivity (i.e. sweating or pulse greater than 100) (2) increased hand tremor (3) insomnia (4) nausea or vomiting (5) transient visual, tactile, or auditory hallucinations or illusions (6) psychomotor agitation (7) anxiety (8) grand mal seizures C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder Specify if: with perceptual disturbances |
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Criteria for Amphetamine Intoxication
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A. Recent use of amphetamine or a related substance
B. Clinically significant maladaptive behavioral or psychological changes (e.g. euphoria, or affective blunting; changes in sociability; hypervigilance; interpersonal sensitivity, anxiety, tension or anger, impaired judgment, impaired social or occupational functioning) that developed during, or shortly after use of amphetamine or a related substance C. Two or more of the following, developing during, or shortly after, use of amphetamine or a related substance (1) tachycardia or bradycardia (2) pupillary dilation (3) elevated or lowered blood pressure (4) perspiration or chills (5) nausea or vomiting (6) evidence of weight loss (7) psychomotor retardation or agitation (8) muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias (9) confusion, seizures, dyskinesias, dystonias, or coma D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder specify if: with perceptual disturbances |
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Amphetamine Withdrawal
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A. Cessation of (or reduction in) amphetamine (or a related substnace) use that has been heavy and prolonged
B. Dysphoric mood and two or more of the following physiological changes, developing within a few hours to several days after A (1) fatigue (2) vivid, unpleasant dreams (3) insomnia or hypersomnia (4) increased appetite (5) psychomotor retardation or agitation C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder |
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Cannabis Intoxication
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A. Recent use of cannabis
B. Clinically significant maladaptive behavioral or psychological changes (e.g., impaired motor coordination, euphoria, anxiety, sensation of slowed time, impaired judgment, social withdrawal) that developed during, or shortly after cannabis use C. Two or ore of the following signs, developing within 2 hours of cannabis use (1) conjunctival injection (2) increased appetite (3) dry mouth (4) tachycardia D. The symptoms are not due to general medical condition and are not better accounted for by another mental disorder Specify if: with perceptual disturbances |
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Cocaine Intoxication
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A. Recent use of cocaine
B. Clinically significant maladaptive behavioral or psychological changes (e.g., euphoria, or affective blunting, changes in sociability, hypervigilance, interpersonal sensitivity, anxiety, tension, or anger; stereotyped behaviors, impaired judgment or impaired social or occupational functioning) that developed during or shortly after use of cocaine D. The symptoms are not due to a genreal medical condition and are not better accounted for by another mental disorder Specify if: with perceptual disturbances |
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Cocaine Withdrawal
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A. Cessation of (or reduction in) cocaine use that has been heavy and prolonged
B. Dysphoric mood and two or more of the following physiological changes, developing within a few hours to several days after criterion A (1) fatigue (2) vivid, unpleasant dreams (3) insomnia or hypersomnia (4) increased appetite (5) psychomotor agitation or retardation C. The symptoms in criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning D.The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder |
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Polysubstance Dependence
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behavior during the same 12 month period in which the person was repeatedly using at least 3 groups of substance (not including caffeine and nicotine) but no single substance predominated. Criteria for dependence is met for substance as a group but not for any specific substance
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Major Depressive Disorder
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characterized by one or more major depressive episodes (at least 2 weeks of depressed mood or loss of interest accompanied by at least 4 additional symptoms of depression)
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Dysthymic disorder
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characterized by at least 2 years of depressed mood for more days than not, accompanied by additional depressive symptoms that do not meet criteria for Major Depressive Episode
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Depressive Disorder NOS
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included for coding disorders with depressive features that do not meet criteria for major depressive disorder, dysthymic disorder, adjustment disorder with depressed mood, adjustment disorder with mixed anxiety and depressed mood
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Bipolar I Disorder
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Characterized by one or more manic or mixed episodes usually accompanied by major depressive episodes
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Bipolar II Disorder
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Characterized by one or more major depressive episodes accompanied by at least one hypomanic episode
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Cyclothymic disorder
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characterized by at least 2 years of numerous periods of hypomanic symptoms that do not meet criteria for a manic episode and numerous periods of depressive symptoms that do not meed criteria for a major depressive episode
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Criteria for Major Depressive Episode
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A. Five or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning at least one of the symptoms is either depressed mood or loss of interest or pleasure
Note: do not include symptoms that are clearly due to a general medical condition or mood-incongruent delusions or hallucinations (1) depressed mood most of the day, nearly every day, as indicated by either subjective report (feels sad or empty) or observation made by others (e.g. appears tearful) Note: in children and adolescents, can be irritable mood (2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (3) significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day Note: in children, consider failure to make expected weight gains (4) insomnia or hypersomnia nearly every day (5) psychomotor agitation or retardation (6) fatigue or loss of energy nearly every day (7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (8) diminished ability to think or concentrate or indecisiveness nearly every day (9) recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide B. The symptoms do not meet criteria for a mixed episode C. The symptoms cause clinical significant distress or impairment in social, occupational or other important areas of functioning (axis IV) D. The symptoms are not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or a general medical condition (hypothyroidism) E. The symptoms are not better accounted for by Bereavement (i.e. after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation) |
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Criteria for Manic Episode
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A. A distinct period of abnormality and persistently elevated, expansive or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary)
B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree (1) inflated self-esteem or grandiosity (2) decreased need for sleep (feels rested after only 2 hours of sleep) (3) more talkative than usual or pressure to keep talking (4) flight of ideas or subjective experience that thoughts are racing (5) distractibility (i.e. attention too easily drawn to unimportant or irrelevant external stimuli) (6) increased in goal directed activity (either socially, at work or school, or sexually or psychomotor agitation) (7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments) C. The symptoms do not meet criteria for a mixed episode D. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent hard to self or others or there are psychotic features E. The symptoms are not due to the direct physiological effects of a substance, or a general medical condition Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder |
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Criteria for Mixed Episode
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A. The criteria are met both for a Manic Episode and for Major depressive Episode (except for duration) nearly every day during at least a 1 week period
B. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others or to necessitate hospitalization to prevent harm to self or others or there are psychotic features C. The symptoms are not due to the direct physiological effects of a substance or general medical condition Note: Mixed-like episodes that are clearly caused by somatic antidepressant treatment should not count toward a diagnosis of Bipolar I disorder |
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Criteria for Hypomanic Episode
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A. A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different form the usual nondepressed mood
B. During the period of mood disturbance, three or more of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree (1) inflated self-esteem or grandiosity (2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep) (3) more talkative than usual or pressure to keep talking (4) flight of ideas or subjective experience that thoughts are racing (5) distractibility (i.e. attention too easily drawn to unimportant or irrelevant external stimuli) (6) increase in goal directed activity (either socially, at work o school, or sexually, or psychomotor agitation) (7) excessive involvement in pleasurable activities that have a high potential for painful consequences C. The episode is associated with unequivocal change in functioning that is uncharacteristic of the person when not symptomatic D. The disturbance in mood and the change in functioning are observable by others E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization and there are not psychotic features F. The symptoms are not due to the direct physiological effects of a substance or general medical condition Note: hypomanic-like episodes that are clearly caused by somatic antidepressant treatment should not count toward diagnosis of Bipolar II Disorder |
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Criteria for Major Depressive Disorder, Single Episode
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A. Presence of a single Major Depressive Episode
B. The major depressive episode is not better accounted for by schizoaffective disorder and is not superimposed on schizophrenia, schizoprehniform disorder, delusional disorder or psychotic disorder NOS C. There has never been a manic episode, a mixed episode or a hypomaic episode Note: this exclusion does not apply if all of the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects of a general medical condition If the full criteria are currently met for a major depressive episode, specify its current clinical status and/or features Mild, moderate, severe without psychotic features/severe with psychotic features Chronic with catatonic features with melancholic features with atypical features with postpartum onset If the full criteria are not currently met for MDE: In partial remission, in full remission with catatonic features with melancholic features with atypical features with postpartum onset |
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Criteria for Major Depressive Disorder, Recurrent
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A. Presence of two or more major depressive episodes
Note: to be considered separate episodes there must be an interval of at least two consecutive months in which criteria are not met for a MDE B. The MDEs are not better accounted for by Schizoaffective disorder etc. C. There has never been a manic episode, a mixed episode or hypomanic episode Specify: longitudinal course specifiers (with and without interepisode recover) and with seasonal pattern |
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Criteria for dysthymic disorder
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A. Depressed mood for most of the day, for more days than not, as indicated either by subjective or observation by others, for at least 2 years Note: in children and adolescents, mood can be irritable and duration must be at least 1 year
B. Presence, while depressed, of two or more of the following (1) poor appetite or overeating (2) insomnia or hypersomnia (3) low energy or fatigue (4) low self-esteem (5) poor concentration or difficulty making decisions (6) feelings of hopelessness C. During the 2-year period (1 year for children and adolescents) of the disturbance, the person has never been without the symptoms in criteria A and B for more than 2 months at a time D. No major depressive episode has been present during the first 2 years of the disturbance i.e., the disturbance is not better accounted for by chronic MDD or MDD in partial remission E. There has never been a manic episode, a mixed episode or a hypomanic episode and criteria have never been met for cyclothymic disorder |
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Bipolar I Disorder, Single Manic Episode
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A. Presence of only one Manic Episode and no past MDEs
Note: Recurrence is defined as either a change in polarity from depression or an interval of at least 2 months without manic symptoms B. The manic episode is not better accounted for Schizo-disorders Specify if: Mixed: if symptoms meet criteria for a mixed episode If the full criteria are currently met for a manic, mixed or major depressive episode specify its current clinical status and/or features: mild, moderate, severe without psychotic features/severe with psychotic features with catatonic features with postpartum onset If criteria not met specify the current clinical status of the bipolar I disorder or features of the most recent episode: in partial remission, in full remission with catatonic features with postpartum onset |
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Bipolar I Disorder, Most Recent Episode Hypomanic
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A. Currently (or most recently) in a hypomanic episode
B. There has been previously at least one manic episode or mixed episode C. The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning D. The mood episodes in A and B are not been accounted for by schizo-disorders Specify: Longitudinal course specifiers (without and without interepisode recovery) With seasonal pattern With rapid cycling |
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Bipolar I Disorder, Most Recent Episode Manic
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A. Currently or most recently in a manic episode
B. There has previously been at least one MDE, Manic episode or Mixed episode |
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Bipolar I Disorder, Most Recent Episode Mixed
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A. Currently or most recently in a mixed episode
B. There have previously been at least one major depressive episode, manic episode, or mixed episode |
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Bipolar I Disorder, Most Recent Episode Depressed
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A. Currently or most recently in a major depressive episode
B. There has previously been at least one manic episode or mixed episode |
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Bipolar I Disorder, Most Recent Episode Unspecified
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A. Criteria except for duration are currently or most recently met for a manic episode, a hypomanic episode, or a MDE
B. There has previously been at least one Manic episode or mixed episode C. The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning |
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Bipolar II Disorder
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A. Presence or history of one or more major depressive episodes
B. Presence or history of at least one hypomanic episode C. There has never been a manic episode, or a mixed episode Specify current or most recent episode: Hypomanic: if currently (or most recently) in a hypomanic episode Depressed: if currently or most recently in a major depressive episode |
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Cyclothymic Disorder
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A. For at least 2 years, the presence of numerous periods with depressive symptoms that do not meet criteria for a major depressive episode
B. During the above 2-year period, the person has not been without the symptoms in criterion A for more than 2 months at a time C. No major depressive episode, manic episode, or mixed episode has been present during the first 2 years of disturbance |
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Criteria for severity/psychotic/remission specifiers for current (or most recent) major depressive episode
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Mild--few if any symptoms in excess of those required to make the diagnosis and symptoms result in only minor impairment in occupational functioning or in usual social activities or relationship with others
Moderate: symptoms or functional impairment between "mild" and "severe" Severe without psychotic features: several symptoms in excess of those required to make diagnosis and symptoms markedly interfere with occupational functioning or with usual social activities or relationships with others Severe with psychotic features: delusions or hallucinations. If possible, specify whether the psychotic features are mood-congruent or mood-incongruent Mood-congruent psychotic features: delusions or hallucinations whose content is entirely consistent with typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment mood-incongruent psychotic features: delusions or hallucinations whose content does not involve typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment. In partial remission: symptoms of a major depressive episode are present but full criteria are not met, or there is a period without any significant symptoms of a major depressive episode lasting less than 2 months following the end of the major depressive episode. In full remission: during the past 2 months, no significant signs or symptoms of the disturbance were present Unspecified |
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Severity/Psychotic/Remission Specifiers for current or most recent manic episode
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Mild: minimum symptom criteria are met for a manic episode
Moderate: extreme increase in activity or impairment in judgment Severe without psychotic features: almost continual supervision required to prevent physical harm to self or others Severe with Psychotic Features: delusions or hallucinations. if possible specify whether the psychotic features are mood-congruent or mood-incongruent mood-congruent psychotic features: delusions or hallucinations whose content is entirely consistent with the typical manic themes of inflated worth, poer, knowledge, identity, or special relationship to a deity or famous person mood-incongruent psychotic features: delusions or hallucinations whose content does not involve typical manic themes of inflated worth, power, knowledge, identity or special relationship to a deity or famous person. Persecutory delusions, thought insertions, and delusions of being controlled In partial remission: symptoms of a manic episode are present but full criteria are not met, or there is a period without any significant symptoms of manic episode last less than 2 months following the end of the manic episode In full remission: during the 2 months no significant signs or symptoms of the disturbance were present Unspecified |
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Criteria for severity/psychotic/remission specifiers for current or most recent mixed episode
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Mild: no more than minimum symptom criteria are met for both a manic episode and a major depressive episode
Moderate: symptoms or functional impairment between mild and severe Severe without psychotic features: almost continual supervision required to prevent physical harm to self or others Severe with psychotic features: delusions, or hallucinations. Mood-congruent psychotic features: delusions or hallucinations whose content is entirely consistent with the typical manic or depressive themes Mood-incongruent psychotic features: delusions or hallucinations whose content does not involve typical manic or depressive themes. Included are symptoms such as persecutory delusions, thought insertion, and delusions of being controlled. In partial remission: symptoms of a mixed episode are present but full criteria are not met, or there is a period without any significant symptoms of a mixed episode lasting less than 2 months following the end of the mixed episode In Full remission: during the past 2 months no significant signs or symptoms of the disturbance were present Unspecified |
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Chronic specifier for major depressive episode
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can be applied to the current or most recent major depressive episode in major depressive disorder and to a major depressive episode in bipolar I or II disorder only if it is the most recent type of mood episode)
Full criteria for a major depressive episode have been met continuously for at least the past 2 years |
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Catatonic Features Specifier
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Can be applied to the current or most recent major depressive episode, manic episode, or mixed episode in MDD, BPI and BPII)
Dominated by at least 2 of the following (1) motoric immobility as evidenced by catalepsy (including waxy flexibility or stupor) (2) excessive motor activity (that is apparently purposeless and not influenced by external stimuli) (3) extreme negativism (an apparently motiveless resistance to all instructions or maintenance of a rigid posture against attempts to be moved) or mutism (4) peculiarities of voluntary movement as evidenced by posturing (voluntary assumption of inappropriate or bizarre postures), stereotyped movments, prominent mannerisms, or prominent grimacing) (5) echolalia or echopraxia |
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Melancholic Features Specifier
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Can be applied to the current or most recent MDE in MDD and to a MDE in BPI or BPII only if it is the most recent type of mood episode
A. Either of the following, occurring during the most severe period of the current episode (1) loss of pleasure in all, or almost all, activities (2) lack of reactivity to usually pleasurable stimuli (does not feel much better even temporarily when something good happens) B. Three or more of the following (1) distinct quality of depressed mood (the depressed mood is experienced as distinctly different from the kind of feeling experienced after the deal of a loved one) (2) depression regularly worse in the morning (3) early morning awakening (at least 2 hours before usual time) (4) marked psychomotor retardation or agitation (5) significant anorexia or weight loss (6) excessive or inappropriate guilt |
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Atypical Features Specifier
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Can be applied when these features predominate during the most recent 2 weeks of a current MDE in MDD or BPI or BPII disorder when a current MDE is the most recent type of mood episode or when these features predominate during the most recent 2 years of dysthymic disorder; if the MDE is not current it applies if the feature predominates during any 2 week period
A. Mood reactivity (mood brightens in response to actual or potential positive events) B. Two or more of the following features (1) significant weight gain or increase in appetite (2) hypersomnia (3) leaden paralysis (heavy laden feelings in arms or legs) (4) long-standing pattern of interpersonal rejection sensitivity (not limited to episodes of mood disturbance) that results in significant social or occupational impairment C. Criteria are not met for with melancholic features or with catatonic features during the same episode |
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Panic Attack
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A discrete period in which there is the sudden onset of intense apprehension, fearfulness, or terror often associated with feelings of impending doom. During these attacks symptoms such as shortness of breath, palpitations, chest pain or discomfort, choking or smothering sensations, and fear of "going crazy" or losing control are present
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Agoraphobia
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Anxiety about or avoidance of places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having a panic attack or panic-like symptoms
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Panic Disorder without Agoraphobia
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Characterized by recurrent unexpected panic attacks about which there is persistent concern.
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Panic Disorder with Agoraphobia
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characterized by both recurrent unexpected panic attacks and agoraphobia
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Agoraphobia without history of panic disorder
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characterized by the presence of agoraphobia and panic-like symptoms without a history of unexpected panic attacks
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Specific Phobia
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characterized by clinically significant anxiety provoked by exposure to a specific feared object or situation, often leading to avoidance behavior
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Social Phobia
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characterized by clinically significant anxiety provoked by exposure to certain types of social or performance situations, often leading to avoidance behavior
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Obsessive-compulsive disorder
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characterized by obsessions (which cause marked anxiety or distress) and/or by compulsions (which serve to neutralize anxiety)
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Post-traumatic stress disorder
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characterized by reexperiencing of an extremely traumatic event accompanied by symptoms of increased arousal and by avoidance of stimuli associated with trauma
the severity, duration and proximity of an individual's exposure to the traumatic event are the most important factors affecting the likelihood of developing this disorder |
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Acute stress disorder
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characterized by symptoms similar to those of PTSD that occur immediately in the aftermath of an extremely traumatic
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Generalized anxiety disorder
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is characterized by at least 6 months of persistent and excessive anxiety and worry
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Anxiety disorder due to a general medical condition
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characterized by prominent symptoms of anxiety that are judged to be a direct physiological consequences of a general medical condition
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Substance-induced anxiety disorder
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characterized by prominent symptoms of anxiety that are judged to be a direct physiological consequence of a drug of abuse, a medication or toxin exposure
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Criteria for Panic Attack
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A discrete period of intense fear or discomfort in which 4 or more of the following symptoms developed abruptly and reached a peak within 10 minutes
(1) palpitations (2) sweating (3) trembling or shaking (4) sensations of shortness of breath or smothering (5) feeling of choking (6) chest pain or discomfort (7) nausea or abdominal distress (8) feeling dizzy, unsteady, lightheaded, or faint (9) derealization (feelings of unreality) or depersonalization (being detached from oneself) (10) fear of losing control or going crazy (11) fear of dying (12) paresthesias (numbness or tingling sensations) (13) chills or hot flushes |
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Criteria for agoraphobia
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A. Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed panic attack or panic-like symptoms. Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train, or automobile
Note: consider the diagnosis of specific phobia if the avoidance is limited to one or only a few specific situations or social phobia if the avoidance is limited to social situations B. The situations are avoided (e.g. travel is restricted) or else are endured with marked distress or with anxiety about having a panic attack or panic-like symptoms or require the presence of a companion |
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Criteria for Panic Disorder without agoraphobia
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A. Both (1) and (2)
(1) recurrent unexpected panic attacks (2) at least one of the attacks has been followed by 1 month or more of one or more of the following (a) persistent concern about having additional attacks (b) worry about the implications of the attack or its consequences (e.g. losing control, having a heart attack, going crazy) (c) a significant change in behavior related to the attacks B. Absence of agoraphobia |
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Criteria for Panic Disorder with agoraphobia
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A. Both (1) and (2)
(1) recurrent unexpected panic attacks (2) at least one of the attacks has been followed by 1 month or more of one or more of the following (a) persistent concern about having additional attacks (b) worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy" (c) a significant change in behavior related to the attacks B. The presence of agoraphobia |
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Criteria for Agoraphobia without history of panic disorder
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A. The presence of agoraphobia related to fear of developing panic-like symptoms
B. Criteria have never been met for panic disorder (panic attacks) |
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Criteria for specific phobia
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A. Marked and persistent fear that is excessive or unreasonable cued by the presence or anticipation of a specific object or situation
B. Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed panic attack Note: in children the anxiety may be expressed by crying, tantrums, freezing, or clinging C. The person recognizes the fear is excessive or unreasonable Note: in children this feature may be absent D. The phobic situations is avoided or else is endured with intense anxiety or distress E. The avoidance, anxious anticipation, or distress in the feared situations interferes significantly with the person's normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia F. In individuals under age 18 years the duration is at least 6 months (developmentally appropriate) Specify type: Animal type, natural environment type, blood-injection-injury type, situational type (airplanes, elevators, enclosed placed), other type (e.g., fear of choking, vomiting, or contracting an illness; in children fear of loud sounds or costumed characters) |
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Criteria for social phobia
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A. A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way or show anxiety symptoms that will be humiliating or embarrassing. Note: in children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults
B. Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing or shrinking from social situations with unfamiliar people C. The person recognizes that the fear is excessive or unreasonable Note: in children, this feature may be absent D. The feared social or performance situations are avoided or else are endured with intense anxiety or distress E. The avoidance, anxious anticipation, or distress in the feared social or performance situations interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities and relationships or there is marked distress about having the phobia F. In individuals under age 18 years, the duration is at least 6 months H. If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it e.g., the fear is not of stuttering, trembling in Parkinson's disease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa Specify If: Generalized: if the fears include most social situations (also consider the additional diagnosis of avoidant personality disorder) |
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Criteria for Obsessive-Compulsive Disorder
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A. Either obsessions or compulsions
Obsessions are defined by (1) recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress (essence of obsession) (2) the thoughts, impulses, or images are not simply excessive worries about real life problems (3) the person attempts to ignore or suppress such thoughts, impulses or images or to neutralize them with some other thought or action (compulsion) (4) the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion) Compulsions as defined by (1) repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly (2) the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive B. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: this does not apply to children C. The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day) or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships D. If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it Specify if: With poor insight: if for most of the time during the current episode the person does not recognize that the obsessions and compulsions are excessive or unreasonable |
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Criteria for PTSD
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A. The person has been exposed to a traumatic event in which both of the following were present
(1) the person experienced, witnessed or was confronted with an event or events that involved actual or threatened death or serious injury or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror. Note: in children, this may be expressed instead by disorganized or agitated behavior B. The traumatic event is persistently reexperienced in one or more of the following ways (1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed (2) recurrent distressing dreams of the event Note: in children, there may be frightening dreams without recognizable content (3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur in awakening or when intoxicated Note: in young children, trauma specific reenactment may occur (4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event (5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma) as indicated by three (or more of the following) (1) efforts to avoid thoughts, feelings, or conversations associated with the trauma (2) efforts to avoid activities, places or people that arouse recollections of the trauma (3) inability to recall an important aspect of the trauma (4) markedly diminished interest or participation in significant activities (5) feeling of detachment or estrangement from others (6) restricted range of affect (e.g. unable to have loving feelings) (7) sense of a foreshortened future (e.g. does not expect to have a career, marriage, children or a normal life span) D. Persistent symptoms of increased arousal (not present before the trauma) as indicated by two or more of the following (1) difficulty falling or staying asleep (2) irritability or outbursts of anger (3) difficulty concentrating (4) hypervigilance (5) exaggerated startle response E. Duration of the disturbance is more than 1 month F. The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning Specify if: acute: if duration of symptoms is less than 3 months chronic: if duration of symptoms is 3 months or more Specify if: with delayed onset: if onset of symptoms is at least 6 months after the stressor |
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Criteria for Acute Stress Disorder
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A. The person has been exposed to a traumatic event in which both of the following were present
(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror B. Either while experiencing or after experiencing the distressing event, the individual has three or more of the following dissociative symptoms (1) a subjective sense of numbing, detachment, or absence of emotional responsiveness (2) a reduction in awareness of his or her surroundings (e.g. being in a daze) (3) derealization (4) depersonalization (5) dissociative amnesia (inability to recall an important aspect of the trauma) C. The traumatic event is persistently reexperienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes or a sense of reliving the experience; or distress on exposure to reminders of the traumatic event D. Marked avoidance of stimuli that arouse recollections of the trauma (e.g., thoughts, feelings, conversations, activities, places, people) E. Marked symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness) F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or impairs the individual's ability to pursue some necessary task, such as obtaining necessary assistance or mobilizing personal resources by telling family members about the traumatic experience G. The disturbance lasts for a minimum of 2 days and a maximum of 4 weeks and occurs within 4 weeks of the traumatic event |
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Criteria for Generalized Anxiety Disorder
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A. Excessive anxiety and worry (apprehensive expectation) occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance)
B. The person finds it difficult to control the worry C. The anxiety and worry are associated with three or more of the following six symptoms with at least some symptoms present for more days than not for the past 6 months Note: only one item is required in children (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 asleep or staying asleep, or restless unsatisfying sleep) D. The focus of the anxiety is not confied to features of an Axis I disorder, anxiety and worry do not occur exclusively during PTSD E. Anxiety, worry or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning |
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Anxiety disorder due to a general medical condition
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A. Prominent anxiety, panic attacks or obsessions or compulsions predominate in the clinical picture
B. There is evidence from the history, physical examination, or lab findings that the disturbance is a direct physiological consequence of a general medical condition C. The disturbance is not better accounted for by another mental disorder D. The disturbance does not occur exclusively during the course of a delirium E. The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning Specify if: with generalized anxiety: if excessive anxiety or worry about a number of events or activities predominates in the clinical presentation with panic attacks: if panic attacks predominate in the clinical presentation with obsessive-compulsive symptoms: if obsessions or compulsions predominate in the clinical presentation |
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Criteria for adjustment disorders
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A. The development of emotional or behavioral symptoms in response to an identifiable stressors occurring within 3 months of the onset of the stressors
B. These symptoms or behaviors are clinically significant as evidenced by either of the following (1) marked distress that is in excess of what would be expected from exposure to the stressor (2) significant impairment in social or occupational functioning C. The stress-related disturbance does not meet the criteria for another Axis I disorder and is not merely an exacerbation of a preexisiting Axis I or Axis II disorder D. The symptoms do not represent Bereavement E. Once the stressor (or its consequences) has terminated the symptoms do not persist for more than an additional 6 months Specify if: Acute: if the disturbance lasts less than 6 months Chronic: if the disturbance lasts for 6 months or longer Adjustment disorder with depressed mood with anxiety with mixed anxiety and depressed mood with disturbance of conduct with mixed disturbance of emotions and conduct unspecified |
