CMN 552
CMN 552
Module 2
Module 2
Primary Study Guide
Primary
University of South Study
AlabamaGuide
University of South Alabama
, CMN\552
\ Module\2\Primary\Study\Guide\
Sadock,\Chapter\14\Anxiety\Disorders\P.\1720\PD
F\1810
Sec6on\14.1\Anxiety\Disorders:\\\ Introduc
6on\and\Overview\P.\1720\PDF\1810
DSM-5\ModificaCons\in\Anxiety\Disorders\P.\1721\PDF\1811
The\major\subtypes\of\anxiety\disorders\in\the\DSM-
5\include\panic\disorder\(with\ or\without\agoraphobia),\agoraphobia\(without\a
\history\of\panic\disorder),\ specific\phobia,\social\phobia,\and\generalized\anxi
ety\disorder\(GAD).\Revisions\ to\the\classifica6on\of\anxiety\disorders\in\the\D
SM-5\involve\removing\obsessive-
\ compulsive\disorder\and\posVrauma6c\disorder\have\been\subsumed\under
\ newly\created\“obsessive-compulsive\and\related\disorders”\and\“trauma-
\and\ stressor-
related\disorders”\categories,\respec6vely.\Therefore,\both\obsessive–
\ compulsive\disorder\and\posVrauma6c\stress\disorder\are\not\considered\in\t
his\ chapter.\Other\modifica6ons\to\the\proposed\DSM-
5\anxiety\disorders\category\include\the\addi6on\of\separa6on\anxiety\disorde
r\(contained\under\Disorders\ Usually\First\Diagnosed\in\Infancy,\Childhood,\or
\Adolescence\in\the\DSM-
IV),\the\ iden6fica6on\of\agoraphobia\as\a\dis6nct\and\codable\disorder\(diagn
osed\only\ with\reference\to\panic\disorder\in\the\DSM-
IV),\minor\revisions\to\criterion\ language\to\enhance\clarity,\objec6vity,\and\co
nsistency\across\the\anxiety\ disorders,\and\the\relabeling\of\social\phobia\as\s
ocial\anxiety\disorder\(SAD).\As\ such,\the\term\“social\phobia”\will\now\be\repl
aced\with\“social
anxiety\disorder.”
Sec6on\14.2\Clinical\Features\of\t
he\\Anxiety\Disorders
Agoraphobia:\Epidemiology\P.\1725\PDF\1815
1
,Similar\to\Panic\Disorder,\more\women\than\men\have\agoraphobia\and\the\ag
e\of\onset\peaks\in\the\late\teens\to\early\twen6es.\Agoraphobia\in\the\absence
\of
2
, Panic\Disorder\is\considered\to\be\rarer\than\agoraphobia\with\comorbid\Pani
c\ Disorder.\However,\there\is\some\variability\in\the\prevalence\data.\The\mea
sured\prevalence\of\agoraphobia\in\specific\clinical\se^ngs\may\evolve\as\the
\ DSM-
5’s\ recogni6on\of\agoraphobia\without\Panic\Disorder\will\spur\clinicians\to\sc
reen\ and\consider\the\disorder\more\frequently,\even\in\pa6ents\who\do\not\pr
esent\ with\panic\aVacks.\Other\anxiety\disorders\are\seen\alongside\agoraph
obia\in\ comorbidity\rates\that\oaen\exceed\50\percent.\Comorbid\depressive\
disorders\ are\seen\in\33\to\52\percent\of\cases,\with\some\sugges6on\that\the\
presence\of\ comorbid\panic\aVacks\increases\the\risk\of\comorbid\depressiv
e\episodes.
Social\Anxiety\Disorder:\DifferenCal\Diagnosis,\ECology,\Course,\Treat
ment\P.\ 1725\PDF\1815
As\men6oned\above,\Avoidant\Personality\Disorder\(described\in\more\detail
\ elsewhere\in\this\book)\has\been\the\subject\of\debate\over\whether\it\is\dis6
nct\ from\Social\Anxiety\Disorder,\with\the\DSM-
5\separa6ng\the\two.\Social\Anxiety\Disorder\has\a\high\comorbidity\with\othe
r\anxiety\and\affec6ve\disorders,\as\ well.\The\use\of\illicit\anxioly6cs\and\seda
6ves\leads\to\the\rela6vely\high\rate\of\ comorbid\substance\use\disorders.\Th
e\comorbidity\between\Social\Anxiety\ Disorder\and\Selec6ve\Mu6sm\is\discu
ssed\elsewhere\in\this\chapter.\Social\Anxiety\Disorder\is\a\common\comorbi
dity\in\children\with\an\Au6sm\Spectrum\ diagnosis\and\also\appears\at\rates\
above\popula6on\baseline\in\pa6ents\with\ Schizophrenia.
Risk\factors\for\Social\Anxiety\Disorder\include\female\gender,\family\history,\
and\childhood\signs\of\behavioral\inhibi6on.\There\is\insufficient\data\on\speci
fic\ gene6c\factors\media6ng\the\increased\familial\risk,\but\paren6ng\styles\
may\also\ contribute\to\this\familiality.\The\Mini-Social\Phobia\Inventory\(Mini-
SPIN)\is\an\ appropriate\screening\tool\for\adults.
One\could\see\how\agoraphobia\could\be\confused\with\Social\Anxiety\Disord
er\or\ PTSD,\though\the\context-
dependent\fears\in\the\same\situa6on\would\be\ different.\For\example,\a\pa6e
nt\with\Social\Anxiety\Disorder\might\dislike\a\ crowded\party\because\they\feel\
that\everybody\is\looking\at\them\and\judging\ them.\A\pa6ent\with\agoraphobi
a\might\avoid\the\same\crowded\party\out\of\ concern\that,\were\they\to\develop
\anxiety,\it\would\be\difficult\to\sprint\for\the
3
CMN 552
Module 2
Module 2
Primary Study Guide
Primary
University of South Study
AlabamaGuide
University of South Alabama
, CMN\552
\ Module\2\Primary\Study\Guide\
Sadock,\Chapter\14\Anxiety\Disorders\P.\1720\PD
F\1810
Sec6on\14.1\Anxiety\Disorders:\\\ Introduc
6on\and\Overview\P.\1720\PDF\1810
DSM-5\ModificaCons\in\Anxiety\Disorders\P.\1721\PDF\1811
The\major\subtypes\of\anxiety\disorders\in\the\DSM-
5\include\panic\disorder\(with\ or\without\agoraphobia),\agoraphobia\(without\a
\history\of\panic\disorder),\ specific\phobia,\social\phobia,\and\generalized\anxi
ety\disorder\(GAD).\Revisions\ to\the\classifica6on\of\anxiety\disorders\in\the\D
SM-5\involve\removing\obsessive-
\ compulsive\disorder\and\posVrauma6c\disorder\have\been\subsumed\under
\ newly\created\“obsessive-compulsive\and\related\disorders”\and\“trauma-
\and\ stressor-
related\disorders”\categories,\respec6vely.\Therefore,\both\obsessive–
\ compulsive\disorder\and\posVrauma6c\stress\disorder\are\not\considered\in\t
his\ chapter.\Other\modifica6ons\to\the\proposed\DSM-
5\anxiety\disorders\category\include\the\addi6on\of\separa6on\anxiety\disorde
r\(contained\under\Disorders\ Usually\First\Diagnosed\in\Infancy,\Childhood,\or
\Adolescence\in\the\DSM-
IV),\the\ iden6fica6on\of\agoraphobia\as\a\dis6nct\and\codable\disorder\(diagn
osed\only\ with\reference\to\panic\disorder\in\the\DSM-
IV),\minor\revisions\to\criterion\ language\to\enhance\clarity,\objec6vity,\and\co
nsistency\across\the\anxiety\ disorders,\and\the\relabeling\of\social\phobia\as\s
ocial\anxiety\disorder\(SAD).\As\ such,\the\term\“social\phobia”\will\now\be\repl
aced\with\“social
anxiety\disorder.”
Sec6on\14.2\Clinical\Features\of\t
he\\Anxiety\Disorders
Agoraphobia:\Epidemiology\P.\1725\PDF\1815
1
,Similar\to\Panic\Disorder,\more\women\than\men\have\agoraphobia\and\the\ag
e\of\onset\peaks\in\the\late\teens\to\early\twen6es.\Agoraphobia\in\the\absence
\of
2
, Panic\Disorder\is\considered\to\be\rarer\than\agoraphobia\with\comorbid\Pani
c\ Disorder.\However,\there\is\some\variability\in\the\prevalence\data.\The\mea
sured\prevalence\of\agoraphobia\in\specific\clinical\se^ngs\may\evolve\as\the
\ DSM-
5’s\ recogni6on\of\agoraphobia\without\Panic\Disorder\will\spur\clinicians\to\sc
reen\ and\consider\the\disorder\more\frequently,\even\in\pa6ents\who\do\not\pr
esent\ with\panic\aVacks.\Other\anxiety\disorders\are\seen\alongside\agoraph
obia\in\ comorbidity\rates\that\oaen\exceed\50\percent.\Comorbid\depressive\
disorders\ are\seen\in\33\to\52\percent\of\cases,\with\some\sugges6on\that\the\
presence\of\ comorbid\panic\aVacks\increases\the\risk\of\comorbid\depressiv
e\episodes.
Social\Anxiety\Disorder:\DifferenCal\Diagnosis,\ECology,\Course,\Treat
ment\P.\ 1725\PDF\1815
As\men6oned\above,\Avoidant\Personality\Disorder\(described\in\more\detail
\ elsewhere\in\this\book)\has\been\the\subject\of\debate\over\whether\it\is\dis6
nct\ from\Social\Anxiety\Disorder,\with\the\DSM-
5\separa6ng\the\two.\Social\Anxiety\Disorder\has\a\high\comorbidity\with\othe
r\anxiety\and\affec6ve\disorders,\as\ well.\The\use\of\illicit\anxioly6cs\and\seda
6ves\leads\to\the\rela6vely\high\rate\of\ comorbid\substance\use\disorders.\Th
e\comorbidity\between\Social\Anxiety\ Disorder\and\Selec6ve\Mu6sm\is\discu
ssed\elsewhere\in\this\chapter.\Social\Anxiety\Disorder\is\a\common\comorbi
dity\in\children\with\an\Au6sm\Spectrum\ diagnosis\and\also\appears\at\rates\
above\popula6on\baseline\in\pa6ents\with\ Schizophrenia.
Risk\factors\for\Social\Anxiety\Disorder\include\female\gender,\family\history,\
and\childhood\signs\of\behavioral\inhibi6on.\There\is\insufficient\data\on\speci
fic\ gene6c\factors\media6ng\the\increased\familial\risk,\but\paren6ng\styles\
may\also\ contribute\to\this\familiality.\The\Mini-Social\Phobia\Inventory\(Mini-
SPIN)\is\an\ appropriate\screening\tool\for\adults.
One\could\see\how\agoraphobia\could\be\confused\with\Social\Anxiety\Disord
er\or\ PTSD,\though\the\context-
dependent\fears\in\the\same\situa6on\would\be\ different.\For\example,\a\pa6e
nt\with\Social\Anxiety\Disorder\might\dislike\a\ crowded\party\because\they\feel\
that\everybody\is\looking\at\them\and\judging\ them.\A\pa6ent\with\agoraphobi
a\might\avoid\the\same\crowded\party\out\of\ concern\that,\were\they\to\develop
\anxiety,\it\would\be\difficult\to\sprint\for\the
3
