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Review of DSM5 Mental Disorders for NCMHCE Study
1. Agoraphobia
2. Generalized Anxiety Disorder
3. Panic Disorder
4. Separation Anxiety Disorder
5. Social Anxiety Disorder (Social Phobia)
6. Specific Phobia
7. Substance/medication induced anxiety disorder
8. Anxiety due to medical condition
9. Other specified or unspecified anxiety disorder
Assessments
BAI Beck Anxiety Inventory
Penn State Worry Questionnaire
Anxiety Interview Schedule
SIAS Fear of Negative Evaluation
and Social Interaction Anxiety Scale
ASEBA Achebach System of
Empirically Based Assessment
RCMAS-2 Revised Children
Manifest Anxiety Scale
S4. Treatment
Medications
Anti depressants
Anti-anxiety
Benzodiazepine sedatives
Therapy
CBT, Cognitive Restructuring
Affective Therapy AWARE
ACT Acceptance Commitment
Therapy
PCT Panic Control Therapy
Exposure therapy
Mindfulness
Social skills training
Manage anxiety before it escalates
1. Mild anxiety
Can motivate one to positively
perform at a high level
Helps person to focus on the
situation at hand
2. Moderate anxiety
Narrowing of the perceptual field
Trouble attending to their
surroundings
Can follow commands/direction
3. Severe anxiety
Unable to attend to surroundings
except for maybe a detail.
Physical symptoms may develop
Anxiety relief is the goal.
4. Panic attack
Terror; only concern is to escape
Communication impossible at
this point
Diagnosis
Excessive anxiety and uncontrollable, unrealistic
worry about a number of topics
Occurs most days for at least 6 months
With the following symptoms:
 Restlessness
 Easily fatigued
 Difficulty concentrating
 Irritability
 Muscle tension
 Sleep disturbances
Comorbidity
Unipolar
disorder
S1. Find Out S2. Refer or Assess
BAI Beck Anxiety Inventory
Penn State Worry Questionnaire
Anxiety Interview Schedule
S4. Treatment
Medications
Anti depressants
Anti-anxiety
Benzodiazepine sedatives
Therapy
CBT, Cognitive Restructuring
Behavior thrapy
Affective Therapy AWARE
ACT Acceptance Commitment
Therapy
Expressive Therapy
Behavioral Relaxation training
Diagnosis
Overwhelming worry and self consciousness about
everyday social situations
 In children the anxiety must occur in peer
settings and not just during interactions with
adults
Fear is out of proportion to the actual threat
caused by social situation
Fear of being judged by others or behaving in a
way that would cause embarrassment or lead to
ridicule
Lasting for more 6 months or more
Specify if: performance only
Comorbid:
Major Depressive
Disorder
Substance Use
Disorders
Other anxiety disorders
S1. Find Out S2. Refer or Assess
SIAS Fear of Negative Evaluation and
Social Interaction Anxiety Scale
ASEBA Acheback System of
Empirically Based Assessment
RCMAS-2 Revised Children Manifest
Anxiety Scale
S4. Treatment
Medications
Antidepressants, SSRIs, SNRIs
Antihistamines
Beta blockers
Anti-anxiety
Therapy
CBT, Cognitive Restructuring
Exposure therapy
Mindfulness
Social skills training
S5. Monitoring S6. Termination
Diagnosis
1. Feelings of intense fear/discomfort that can
occur suddenly (from a calm state) or an
anxious state
Recurrent and unexpected
Sweating, chest pains and palpitations,
as if choking or having a heart attack
2. At least 1 attack has been followed by
1 month of:
Persistent concern or worry about additional
panic attacks or their consequences
Significant maladaptive change in behavior
related to the attacks
Comorbid:
Agoraphobia
Major Depression
Bipolar Disorders
Alcohol Use Disorder
S1. Find Out
Medical history
S2. Refer or Assess
ADVIS
Burns Anxiety Inventory
Medical evaluation
S4. Treatment
Medications
Anti anxiety, benzodiazapines
(acute panic attack)
Therapy
CBT-best
PCT Panic Control Therapy
ACT Acceptance Commitment
Therapy
EMDR
Diagnosis
1. Fear/anxiety about two or more of:
Using public transit; being in open space; being
in enclosed places; standing in line or being in a
crowd; being outside of the home alone
2. Avoidance of these situations because the
thoughts that escape may be difficult or help
might not be available if symptoms develop
Comorbidity
Panic Disorder
Social Anxiety Disorder
Major Depressive
Disorder
PTSD
Alcohol Use Disorder
S1. Find Out S2. Refer or Assess
Psychiatric evaluation
Tests
BAI Beck Anxiety Inventory
Mobility Inventory for
Agoraphobia
Agoraphobic Cognition
Questionnaire
S4. Treatment
Medications
Anti-anxiety
Therapy
PCT Panic Control Therapy
Diagnosis
1. Intense fear of specific object or situation
In children the fear/anxiety my be expressed by crying, tantrums,
freezing or clinging
2. Level of fear is inappropriate to the situation and may cause person
to avoid common every day situations
3. Specify feared stimulus
S1. Find Out S2. Refer or Assess
Psychiatric evaluation
Tests
Beck Anxiety Inventory
Burns Anxiety Inventory
S4. Treatment Therapy
Exposure Therapy--best
Relaxation Training
Breathing Retraining
Diagnosis
1. Excessive fear or anxiety around separation
from attachment figures
Recurrent, excessive distress when anticipating
or experiencing separation
Worry about losing or possible harm to
those figures
Fear of being alone, refusal to sleep away
from home or this attachment figure
Nightmares and physical symptoms with
anxiety
Reluctance or refusal to go out, away from
home, to school, to work for fear of separation
2. Lasting at least 4 weeks in children and
adolescents or 6 months or more in adults
Comorbidity
GAD
Phobias
PTSD
Agoraphobia
Social Anxiety Disorder
OCD
Personality Disorders
S1. Find Out S2. Refer or Assess
Test
Child Depression Inventory
Washington U Schedule for
Affective Disorders and
Schizophrenia
YMRSYoung Mania Rating Scale
S4.Treatment
Therapy
ExposureTherapy—best
CBT—best
Coping Cat manualized
Diagnosis
Consistent failure to speak in specific social
situations where there is the expectation for
speaking (such as school) despite speaking in other
situations
Interferes with work or school or with social
communication
Duration is at least 1 month
Not attributed to lack of knowledge or comfort
with the spoken language
Not better explained by a communication disorder
Rule Out
Communication
disorder
Social phobia
Schizophrenia
Autism
Comorbid
Depression
OCD
Other anxiety
 Often with depression,
OCD, anxiety.
Rule out
Schizophrenia
Autism, or other MH.
Treatment
Psychotherapy
Behavior mod
Family involvement,
Medication
S4.Treatment
1. Psychotherapy
Behavior mod
Family involvement, Medication
2. Medication
Diagnosis
Panic attacks or anxiety is predominant
Developed during or soon after substance intoxication or withdrawal or
after exposure to a medication
Substance/medication is capable of producing the symptoms

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Anxiety Disorders for NCMHCE Study

  • 1. Review of DSM5 Mental Disorders for NCMHCE Study
  • 2. 1. Agoraphobia 2. Generalized Anxiety Disorder 3. Panic Disorder 4. Separation Anxiety Disorder 5. Social Anxiety Disorder (Social Phobia) 6. Specific Phobia 7. Substance/medication induced anxiety disorder 8. Anxiety due to medical condition 9. Other specified or unspecified anxiety disorder
  • 3. Assessments BAI Beck Anxiety Inventory Penn State Worry Questionnaire Anxiety Interview Schedule SIAS Fear of Negative Evaluation and Social Interaction Anxiety Scale ASEBA Achebach System of Empirically Based Assessment RCMAS-2 Revised Children Manifest Anxiety Scale
  • 4. S4. Treatment Medications Anti depressants Anti-anxiety Benzodiazepine sedatives Therapy CBT, Cognitive Restructuring Affective Therapy AWARE ACT Acceptance Commitment Therapy PCT Panic Control Therapy Exposure therapy Mindfulness Social skills training
  • 5. Manage anxiety before it escalates 1. Mild anxiety Can motivate one to positively perform at a high level Helps person to focus on the situation at hand 2. Moderate anxiety Narrowing of the perceptual field Trouble attending to their surroundings Can follow commands/direction 3. Severe anxiety Unable to attend to surroundings except for maybe a detail. Physical symptoms may develop Anxiety relief is the goal. 4. Panic attack Terror; only concern is to escape Communication impossible at this point
  • 6.
  • 7. Diagnosis Excessive anxiety and uncontrollable, unrealistic worry about a number of topics Occurs most days for at least 6 months With the following symptoms:  Restlessness  Easily fatigued  Difficulty concentrating  Irritability  Muscle tension  Sleep disturbances Comorbidity Unipolar disorder
  • 8. S1. Find Out S2. Refer or Assess BAI Beck Anxiety Inventory Penn State Worry Questionnaire Anxiety Interview Schedule
  • 9. S4. Treatment Medications Anti depressants Anti-anxiety Benzodiazepine sedatives Therapy CBT, Cognitive Restructuring Behavior thrapy Affective Therapy AWARE ACT Acceptance Commitment Therapy Expressive Therapy Behavioral Relaxation training
  • 10.
  • 11. Diagnosis Overwhelming worry and self consciousness about everyday social situations  In children the anxiety must occur in peer settings and not just during interactions with adults Fear is out of proportion to the actual threat caused by social situation Fear of being judged by others or behaving in a way that would cause embarrassment or lead to ridicule Lasting for more 6 months or more Specify if: performance only Comorbid: Major Depressive Disorder Substance Use Disorders Other anxiety disorders
  • 12. S1. Find Out S2. Refer or Assess SIAS Fear of Negative Evaluation and Social Interaction Anxiety Scale ASEBA Acheback System of Empirically Based Assessment RCMAS-2 Revised Children Manifest Anxiety Scale
  • 13. S4. Treatment Medications Antidepressants, SSRIs, SNRIs Antihistamines Beta blockers Anti-anxiety Therapy CBT, Cognitive Restructuring Exposure therapy Mindfulness Social skills training
  • 14. S5. Monitoring S6. Termination
  • 15.
  • 16. Diagnosis 1. Feelings of intense fear/discomfort that can occur suddenly (from a calm state) or an anxious state Recurrent and unexpected Sweating, chest pains and palpitations, as if choking or having a heart attack 2. At least 1 attack has been followed by 1 month of: Persistent concern or worry about additional panic attacks or their consequences Significant maladaptive change in behavior related to the attacks Comorbid: Agoraphobia Major Depression Bipolar Disorders Alcohol Use Disorder
  • 17. S1. Find Out Medical history S2. Refer or Assess ADVIS Burns Anxiety Inventory Medical evaluation
  • 18. S4. Treatment Medications Anti anxiety, benzodiazapines (acute panic attack) Therapy CBT-best PCT Panic Control Therapy ACT Acceptance Commitment Therapy EMDR
  • 19.
  • 20. Diagnosis 1. Fear/anxiety about two or more of: Using public transit; being in open space; being in enclosed places; standing in line or being in a crowd; being outside of the home alone 2. Avoidance of these situations because the thoughts that escape may be difficult or help might not be available if symptoms develop Comorbidity Panic Disorder Social Anxiety Disorder Major Depressive Disorder PTSD Alcohol Use Disorder
  • 21. S1. Find Out S2. Refer or Assess Psychiatric evaluation Tests BAI Beck Anxiety Inventory Mobility Inventory for Agoraphobia Agoraphobic Cognition Questionnaire
  • 23.
  • 24. Diagnosis 1. Intense fear of specific object or situation In children the fear/anxiety my be expressed by crying, tantrums, freezing or clinging 2. Level of fear is inappropriate to the situation and may cause person to avoid common every day situations 3. Specify feared stimulus
  • 25. S1. Find Out S2. Refer or Assess Psychiatric evaluation Tests Beck Anxiety Inventory Burns Anxiety Inventory
  • 26. S4. Treatment Therapy Exposure Therapy--best Relaxation Training Breathing Retraining
  • 27.
  • 28. Diagnosis 1. Excessive fear or anxiety around separation from attachment figures Recurrent, excessive distress when anticipating or experiencing separation Worry about losing or possible harm to those figures Fear of being alone, refusal to sleep away from home or this attachment figure Nightmares and physical symptoms with anxiety Reluctance or refusal to go out, away from home, to school, to work for fear of separation 2. Lasting at least 4 weeks in children and adolescents or 6 months or more in adults Comorbidity GAD Phobias PTSD Agoraphobia Social Anxiety Disorder OCD Personality Disorders
  • 29. S1. Find Out S2. Refer or Assess Test Child Depression Inventory Washington U Schedule for Affective Disorders and Schizophrenia YMRSYoung Mania Rating Scale
  • 31.
  • 32. Diagnosis Consistent failure to speak in specific social situations where there is the expectation for speaking (such as school) despite speaking in other situations Interferes with work or school or with social communication Duration is at least 1 month Not attributed to lack of knowledge or comfort with the spoken language Not better explained by a communication disorder Rule Out Communication disorder Social phobia Schizophrenia Autism Comorbid Depression OCD Other anxiety
  • 33.  Often with depression, OCD, anxiety. Rule out Schizophrenia Autism, or other MH. Treatment Psychotherapy Behavior mod Family involvement, Medication
  • 34. S4.Treatment 1. Psychotherapy Behavior mod Family involvement, Medication 2. Medication
  • 35.
  • 36. Diagnosis Panic attacks or anxiety is predominant Developed during or soon after substance intoxication or withdrawal or after exposure to a medication Substance/medication is capable of producing the symptoms