A): Marked fear or anxiety about TWO OR MORE SITUATIONS:
1. Using public transportation
2. Being in open spaces
3. Being in enclosed places
4. Standing in line or being in a crowd
5. Being outside of the home alone
B. 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 sxs or other incapacitating/embarrassing sxs
C. The situations almost always provoke fear/anxiety
D. Situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety
E. The fear/anxiety is out of proportion to the actual danger posed
F. Lasts 6+ months
G. The fear/anxiety/avoidance causes clinically significant distress or impairment
H. If another medical condition is present (e.g., IBS, Parkinson’s), the fear/anxiety/avoidance is unrelated or excessive
I. The fear/anxiety/avoidance are not better explained by another psych dx
Full-symptom panic attacks: 4+ sxs (see Panic Disorder)
Limited-symptom attacks: < 4
DSM IV:
a discrete period of intense fear or discomfort, in which four or more of the following symptoms developed abruptly and reached a peak within 10 minutes:
1) palpitations,
2) sweating
3) trembling/shaking
4) sensations of shortness of breath
5) feeling of choking
6)chest pain/discomfort
7) nausea/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 tightening sensation)
13) chills or hot flashes
Types of Panic Attacks:
1. Unexpected (uncued) – comes out of the blue
2. Situationally predisposed – situations will sometimes cause an attack, but not always
3. Situationally bound – person only has panic attack if in that situation
A.Recurrent unexpected panic attacks – an abrupt surge of intense fear or discomfort that reaches a peak within minutes and during which 4+ sxs occur: NOTE: 3-5 panic attacks in one month
A. Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others (e.g., social interactions, being observed, performing in front of others) -In kids, must occur in peer settings, not just around adults
B. Individual fears that they will act in a way or show sxs that will be negatively evaluated by others (e.g., will be humiliating/embarrassing, will lead to rejection or offend others)
C. Situations almost always provoke fear/anxiety -In kids, may be expressed by crying, tantrums, freezing, clinging, shrinking, or failing to speak )
D. Situations are avoided or endured with intense fear/anxiety
E. The fear/anxiety is out of proportion to the actual threat posed by social situation or sociocultural context
F. Last 6+ months
G. Causes clinically significant distress/impairment
H. Not attributable to physiological effects of a substance or another medical condition
I. Not better explained by sxs of another mental dx
J. If another medical condition in present (e.g., Parkinson’s, obesity, disfigurement, stuttering), the sxs are unrelated or are excessive
**Specify if:
1. Performance only (restricted to speaking or performing in public)
