One or more somatic symptoms that are distressing or result in significant disruption of daily life. B. Excessive thoughts, feelings or behaviors related to the somatic symptoms or associated health concerns as manifested by at least 1 of the following:1. Disproportionate and persistent thoughts about the seriousness of one’s symptoms. 2. Persistently high level of anxiety about health or symptoms. 3. Excessive time and energy devoted to these symptoms or health concerns. Even if one somatic symptom is not be continuously present, the state of being symptomatic is persistent (typically more than 6 months)
Somatic Symptom Disorder
Preoccupation with having or acquiring a serious illness. Somatic symptoms are not present, or, if present, are only mild in intensity. There is a high level of anxiety about health, person is easily alarmed about health status, and performs excessive health-related behaviors. Thorough investigation fails to identify a medical condition that accounts for the individual’s concerns. Anxiety is not alleviated by medical reassurance, negative tests, or benign course.
Illness Anxiety Disorder
One or more symptoms of altered voluntary motor or sensory function. Clinical findings provide evidence of incompatibility between the symptom and recognized neurological or medical conditions. Conflicts/stressors trigger it, most common symptoms are blindness, paralysis, mutism, or seizures. Bizarre Gait. Glove anesthesia - Numbness of hands stops at wrist. Symptoms are not produced on purpose. No intended benefit from the symptoms. Symptoms may be related to a stressful event or trauma. Medical conditions must all be ruled out. Disorder can mimic real physical health problems
Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present, the person's concern is markedly excessive
Body Dysmorphic Disorder
Men feel they are ‘puny’ and thus work out excessively. They’re never big enough
Muscle Dysmorphia (Bigorexia)
An inability to recall important personal information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetfulness
An inability to recall important personal information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetfulness that also includes wandering away from home/work for hours or even months
Dissociative Amnesia with Dissociative Fugue
The presence of persistent or recurrent experiences of depersonalization, derealization, or both. Reality testing remains intact. Persistent or repeatedly feeling that you're outside your body. Feeling that you are observing yourself as an outsider. Or possible duality of self as both observer and actor. Perceptual and cognitive alterations. Distorted sense of time. Emotional physical numbing. Difficulty in expressing feelings
The presence of persistent or recurrent experiences of depersonalization, derealization, or both. Reality testing remains intact. Experiences of unreality or detachment with respect to surroundings. A sense that things around you are not real (persons or objects are experienced as unreal, dreamlike, foggy or lifeless).
Falsifying medical or psychological signs and symptoms in oneself or others that are associated with the identified deception. Predominantly physical signs and symptoms. Patient fakes illness to gain attention/sympathy/etc from physicians. Clever and convincing medical problems. Exaggerating symptoms. Vague or inconsistent symptoms. Conditions don't respond to treatment as expected. Eagerness to have frequent testing or risky operations. Extensive knowledge of medical terms and diseases. Seeking treatment from many different doctors or hospitals. Contaminating medical samples
Falsifying medical or psychological signs and symptoms in oneself or others that are associated with the identified deception. Deliberately causing injury or illness to another person, usually a child, to gain attention
Munchausen by Proxy
Person acts out physical or mental illness. Patient has either caused physical symptoms themselves or made them up. Inner need to be seen as ill or injured. Attempt to obtain the sympathy and special attention. Often willing to undergo painful or risky tests and operation. Frequently associated with severe emotional difficulties. Characterized by nonsense answers to questions, or doing things incorrectly. Symptoms include confusion, stress, echolalia, echopraxia, ‘clouding’ of consciousness, hallucinations. May also have other dissociative symptoms (amnesia issues, fugue, conversion disorder type symptoms).
Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. Each identity has its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self. Recurring gaps in the recall of every day events, important personal information and/or traumatic events
Acute, intense attack of anxiety coupled with feelings of impending doom Rapid onset of symptoms within 10 min., overall episode 20-30 min. Attacks can range from several times a day to several times a year. Often associated with agoraphobia and other phobic anxiety disorders. Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur. 1. Palpitations, pounding heart, or accelerated heart rate. 2. Sweating. 3. Trembling or shaking. 4. Sensation of SOB or smothering. 5. Feeling of choking. 6. Chest pain or discomfort. 7. Nausea or abdominal distress. 8. Feeling dizzy or faint. 9. Chills or hot flushes. 10. Parasthesias. 11. Derealization or depersonalization. 12. Fear of losing control or going crazy. 13. Fear of dying. B. At least one of the attacks has been followed by 1 month (or more) of one or both of the following: 1. Persistent control or worry about additional panic attacks or their consequences. 2. A significant maladaptive change in behavior relating to the attacks.
Milder form of Panic disorder in which the patient exhibits 4 or less symptoms of the panic disorder criteria
Limited Symptoms Attack
Fear or anxiety associated with open or public spaces from which escape might be difficult. Almost always want to be accompanied by friend or family member when going anywhere. Extreme cases don’t leave home
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
A strong persistent fear of being judged by others, or embarrassed. Could be anything; not wanting to eat in front of someone, or use a public restroom
Social Anxiety Disorder
Marked fear or anxiety about one or more social situations in which the person is exposed to possible scrutiny by others. The person fears that they will act in a way or show anxiety symptoms that will be negatively evaluated. The social situations almost always provoke fear or anxiety.
Social Anxiety Disorder
Marked fear or anxiety about a specific object or situation. 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. The fear is persistent, typically lasting 6 months or more. Adults recognize the fear is irrational.
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). Individual finds it hard to control the worry. The anxiety and worry are associated with 3 (or more) of the following symptoms - Restlessness or feeling on edge, Being easily fatigued, Difficulty concentrating, Irritability, Muscle tension, Sleep disturbances
Generalized Anxiety Disorder
Presence of obsessions, compulsions, or both - Obsessions are defined by (1) and (2) - 1. Recurrent, intrusive, unwanted, and persistent thoughts, urges, or images that (mostly) cause anxiety or distress. 2. Attempts to ignore or suppress them with some other thought or action (i.e., by performing a compulsion). Compulsions are defined by (1) and (2) - 1. Repetitive behaviors or mental acts in response to an obsession, or “rule” that must be applied rigidly. 2. Behaviors or mental acts aimed at reducing anxiety, or preventing some dreaded event or situation, are not connected in a realistic way with desired aims. The obsessions or compulsions are time-consuming or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Persistent difficulty in discarding or parting with possessions, regardless of their actual value. This results in the accumulation of possession that congest and clutter active living areas. Treatment with 5-HT drugs is most effective along with Exposure and ritual prevention (ERP) therapy.
Recurring pulling out of one’s hair, resulting in hair loss. Repeated attempts to decrease or stop hair pulling. Treatment with 5-HT drugs is most effective along with exposure and ritual prevention (ERP)
Recurrent skin picking resulting in skin lesions. B. Repeated attempts to stop skin picking. Treatment with 5-HT drugs is most effective along with Exposure and ritual prevention (ERP)
Exposure to actual or threatened death, serious injury, or sexual violation in one or more of the following ways: 1. Directly experiencing the event. 2. Witnessing the events as they occur to others. 3. Learning the traumatic event has happened to friend or family member. B. Presence of one or more of the following intrusion symptoms associated with the traumatic events, beginning after the events occurred: 1. Recurrent, involuntary, and intrusive or distressing memories of the events. 2. Recurrent distressing dreams. 3. Dissociative reactions (i.e. flashbacks). 4/5. Intense or prolonged psychological or physiological distress at exposure to cues resembling the event. Symptoms last more than one month and significantly affects social, family, and other areas of life. Symptom onset typically within 3 months of event, but can be years before full symptom criteria are met.
The development of characteristic symptoms lasting from 3 days to one month following exposure to one or more traumatic events. Exposure to actual or threatened death, serious injury, or sexual violation in one or more of the following ways: 1. Directly experiencing the event. 2. Witnessing the events as they occur to others. 3. Learning the traumatic event has happened to friend or family member. The result of exposure results in symptoms in the following areas B. Symptoms are from the following categories: 1. Intrusion symptoms (recurring dreams, memories). 2. Negative mood. 3. Dissociative symptoms. 4. Avoidance symptoms. 5. Arousal symptoms (sleep problems, concentration issues).
Acute Stress Disorder
An emotional and behavioral reaction which develops within 3 months of a life stress, and lasts less than 6 months. The life stress is ‘serious’ i.e. divorce, moving, etc., but not life threatening. Symptoms include anxiety, depression, conduct problems
Children interact with strangers the same way they interact with parents or parental figures, i.e. they do not discriminate between parents and strangers. The disorder is caused by severe neglect at a young age, likely before the age of 2. A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following. 1.Reduced or absent reticence in approaching and interacting with unfamiliar adults. 2. Overly familiar verbal or physical behavior. 3. Diminished or absent ‘checking back' with adult caregiver after venturing away, even in unfamiliar conditions. 4. Willingness to go off with an unfamiliar adult with minimal or no hesitation. The child has experienced a pattern of extremes of insufficient care as evidenced by at least 1 of the following: 1. Social neglect or deprivation. 2. Repeated changes of primary caregivers. 3. Rearing in unusual settings that limit opportunities for attachments.
Disinhibited Social Engagement Disorder
Panic attacks or anxiety is predominant in the clinical picture. Evidence of both Criteria A symptoms developed during or soon after substance intoxication, or withdrawal, or after exposure to a medication. Substance/medication is capable of producing the symptoms. The disturbance is not better explained by another anxiety disorder. Evidence of an different anxiety disorder could include - Symptoms preceding the onset of the substance/medication use. Symptoms persist for a substantial period of time (e.g., >1mth) after the cessation of acute withdrawal or severe intoxication. Evidence suggesting the existence of an independent non-substance/medication-induced anxiety disorder. The disturbance does not occur exclusively during the course of a delirium. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning