ASSIGNMENT: Respond to at least two of your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned. Support your responses with evidence-based literature with at least two references in each colleague’s response with proper citation in APA Format. Colleagues Response # 1 Differences between Adjustments Disorders and Anxiety Disorders Adjustment disorder (AjD) and Anxiety disorders (AD) are among the most often diagnosed mental disorders in clinical practice. AjD is recognized as a stress-response syndrome, which is defined as a maladaptive reaction to an identifiable stressor (Zelviene & Kazlauskas, 2018). It is a condition that can occur when you have difficulty coping with a specific, stressful life event - for example, a death or illness in the family, getting fired or laid off from a job, significant relationship issues like break-ups or divorce, or sudden change in social settings such as the pandemic.  Five basic diagnostic criteria of AjD are presented in DSM-5. The first criterion indicates that AjD might only be diagnosed if symptoms occurred within 3 months in the context of identifiable stressor(s). The second criterion specifies clinical significance of AjD symptoms meaning that stress reactions should be out of proportion to the normal reactions of the identified stressor according to the social or cultural context, and there should be significant disturbances in important areas of life. The last 3 criteria point out that 3) the disturbance should not meet criteria or represent a worsening condition of another mental disorder; 4) AjD should not be considered in cases of normal bereavement reactions; and 5) AjD has a tendency to dissipate during 6 months after the stressor has ended (Zelviene & Kazlauskas, 2018).            Individuals with AD often have a lengthy and consistent history of anxiety and excessive worry, whereas individuals with Adjustment Disorder only experience their symptoms in times of or in response to stress or change. Anxiety Disorder can be made worse by stressors such as change or adjusting to new routines. But if you have Adjustment Disorder, you’ll typically see a reduction in your anxiety as you adapt to the change or learn to cope with the stressor, while anxiety and related symptoms are continual for those with GAD. Diagnostic Criteria for Generalized Anxiety Disorders (GAD) According to the DSM IV, “GAD is defined by the following diagnostic criteria: 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 individual finds it difficult to control the worry C. The anxiety and worry are associated with three (or more) of the following six symptoms: Restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentratin.

1. ASSIGNMENT:
Respond
to at least
two
of your colleagues by comparing the differential diagnostic
features of the disorder you were assigned to the diagnostic
features of the disorder your colleagues were assigned.
Support your responses with evidence-based literature with at
least two references in each colleague’s response with proper
citation in APA Format.
Colleagues Response # 1
Differences between Adjustments Disorders and Anxiety
Disorders
Adjustment disorder (AjD) and Anxiety disorders (AD) are
among the most often diagnosed mental disorders in clinical
practice. AjD is recognized as a stress-response syndrome,
which is defined as a maladaptive reaction to an identifiable
stressor (Zelviene & Kazlauskas, 2018). It is a condition that
can occur when you have difficulty coping with a specific,
stressful life event - for example, a death or illness in the
family, getting fired or laid off from a job, significant
relationship issues like break-ups or divorce, or sudden change
in social settings such as the pandemic. Five basic diagnostic

2. criteria of AjD are presented in DSM-5. The first criterion
indicates that AjD might only be diagnosed if symptoms
occurred within 3 months in the context of identifiable
stressor(s). The second criterion specifies clinical significance
of AjD symptoms meaning that stress reactions should be out of
proportion to the normal reactions of the identified stressor
according to the social or cultural context, and there should be
significant disturbances in important areas of life. The last 3
criteria point out that 3) the disturbance should not meet criteria
or represent a worsening condition of another mental disorder;
4) AjD should not be considered in cases of normal bereavement
reactions; and 5) AjD has a tendency to dissipate during 6
months after the stressor has ended (Zelviene & Kazlauskas,
2018).
Individuals with AD often have a lengthy and consistent
history of anxiety and excessive worry, whereas individuals
with Adjustment Disorder only experience their symptoms in
times of or in response to stress or change. Anxiety Disorder
can be made worse by stressors such as change or adjusting to
new routines. But if you have Adjustment Disorder, you’ll
typically see a reduction in your anxiety as you adapt to the
change or learn to cope with the stressor, while anxiety and
related symptoms are continual for those with GAD.
Diagnostic Criteria for Generalized Anxiety Disorders (GAD)
According to the DSM IV, “GAD is defined by the following
diagnostic criteria:
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 individual finds it difficult to control the worry

3. C. The anxiety and worry are associated with three (or more) of
the following six symptoms: Restlessness or feeling keyed up or
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)” (The history of generalized anxiety disorder as a
diagnostic category, 2017).
The DSM IV makes it clear that GAD is largely an exclusion
diagnosis. GAD cannot be diagnosed if the anxiety is better
explained by other anxiety disorders (panic, phobic, social
anxiety, or obsessive compulsive disorder) (The history of
generalized anxiety disorder as a diagnostic category, 2017).
Also, GAD cannot be caused directly by stressors or trauma,
contrary to adjustment disorders and PTSD (The history of
generalized anxiety disorder as a diagnostic category, 2017).
Evidenced-based Psychotherapy and Psychopharmacologic
Treatment for GAD
All patients with anxiety disorders require supportive talks and
attention to the emotional problems that are associated with the
anxiety disorder. Psychoeducation includes information about
the physiology of the bodily symptoms of anxiety reactions and
the rationale of available treatment possibilities (Treatment of
anxiety disorders, 2017). Cognitive-behavioral therapy (CBT) is
also one of the best-established psychotherapy treatments for
GAD.
Due to their positive benefit/risk balance, selective serotonin
reuptake inhibitors (SSRIs) and selective serotonin
norepinephrine reuptake inhibitors (SNRIs are recommended as
first-line drugs (Treatment of anxiety disorders, 2017). SSRIs
for GAD include: Escitalopram, Paroxetine and Sertraline.
Pregabalin is a calcium modulator that is also effective in

4. treating GAD (Treatment of anxiety disorders, 2017). However,
there have been concerns about the abuse of pregabalin in
individuals suffering from substance abuse and also withdrawal
syndromes after abrupt discontinuation (Treatment of anxiety
disorders, 2017). Buspirone, a 5-hydroxytryptamine receptor 1A
(5HT1A) agonist, has been shown in some controlled studies to
be effective in the treatment of GAD (Treatment of anxiety
disorders, 2017).
Colleagues Response # 2
Anxiety disorders are among the most prevalent psychiatric and
mental health discoveries globally. Specific phobia is an anxiety
disorder characterized by persistent fear and avoidance.
Specific phobias are associated with childhood-onset (Eaton,
Bienvenu, & Miloyan, 2018). It has high comorbidity with other
mental health illnesses and can be highly disabling if left
untreated. The most common types of specific phobias include
fear of the different types of animals, fear of heights, and
claustrophobia.
Adjustment disorders vs. anxiety disorders
The main cause of adjustment disorder is external stressors and
life changes whereas anxiety disorder are caused by a
combination of genetics, developmental, and behavioral factors.
Individuals living with anxiety disorder tend to present with a
repeated and persistent pattern of excessive worrying whereas
those with adjustment disorders only have excessive worry
when experiencing a stressful life event. Better coping and
adaptation to the stressor among people living with adjustment
disorder tend to reduce the excessive worry as opposed to those
with an anxiety disorder as their symptoms are continuous in

5. nature. For example, to make a diagnosis of adjustment disorder
the client must present with distress that is out of proportion
with expected reactions to the stressor within 3 months of the
onset of the stressor (APA, 2013). When the stressor is
removed, the client begins to cope and the symptoms reduce
within 6 months. On the other hand, anxiety disorders is
characterized by excessive fear and anxiety.
Diagnostic criteria for Specific Phobia
According to the DSM V diagnostic criteria (APA, 2013),
Specific Phobia is characterized by marked fear or anxiety
about a specific situation or object. The dreaded situation or
object elicits
intense fear or anxiety. The phobic object or situation is
avoided or at times endured with intense fear/anxiety. The fear
is always excessive and out of proportion in relation to the
threat of danger posed. The excessive worrying or fear must be
present for a period of at least 6 months. The fear, excessive
anxiety, and avoidance of the dreaded situation or object must
be attributed to significant interference in the person's social
and occupational functioning among other important areas of
functioning. The presenting symptoms should not be attributed
to other mental disorders such as Social Phobia, OCD, PTSD,
and separation anxiety disorder.
Evidence based-psychotherapy and psychopharmacologic
treatment of Specific Phobia
Specific Phobia is treatable through the use of both
psychotherapy and psychopharmacology. Treatment of the
disorder aims at minimizing fear, phobic avoidance, and
improve impaired functionality (Eaton, Bienvenu, & Miloyan,
2018). The use of psychotherapy is a first-line treatment
followed by pharmacotherapy. The evidence-based

6. psychotherapy for the disorder involves the use of Exposure
Therapy which is the treatment of choice (Thng, et al., 2020).
The use of Cognitive Behavioral Therapy is another
psychotherapy approach used in the management of specific
phobias. Exposure therapy involves gradual exposure to the
feared situation/object repeatedly until the object/situation does
not elicit a fear response. The use of exposure therapy is based
on the rationale that continuous and gradual exposure to a safe
but frightening situation or object result in reduced anxiety
levels thus reducing avoidance behavior (Böhnlein, et al.,
2020). Exposure therapy is also used in combination with
Cognitive Behavioral Therapy for increased efficacy. CBT is
essential in helping the client identify the irrational thoughts
and beliefs that may contribute to symptom presentation (Eaton,
Bienvenu, & Miloyan, 2018). Irrational thoughts such as
catastrophizing are identified through the use of CBT thus
helping the client appreciate new realistic and rational thinking.
Pharmacological treatment is used to complement exposure
therapy. The various pharmacological modalities that are used
in the treatment of specific phobias include beta-blockers and
psychotropic medications such as benzodiazepines (Amray, et al
2019). The beta-blockers are used to control increased heart rate
associated with specific phobia. The psychotropic is
administered to minimize the emotional disturbance associated
with the disorder.