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Industrial Psychology
University of San Carlos
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Matrix for Anxiety and Related Disorder
CRITERIA GENERALIZED ANXIETY DISORDER
SEPARATION
ANXIETY
DISORDER
PANIC
DISORDER
SELECTI
VE
MUTISM
AGORAPHOBIA SPECIFIC
PHOBIA
SOCIAL
ANXIETY
DISORDER
(SOCIAL
PHOBIA)
Promine nt Sympto ms
Excessive anxiety and worry over minor concerns everyday
Inappropriate and excessive fear or or anxiety concerning separation from those to whom the individual is attached.
Recurrent unexpected panic attacks.
Consistent failure to speak in specific social situations in which there is an expectation for speaking despite speaking in other situations.
Marked fear or anxiety about using public transportation, being in open spaces, being in enclosed places, standing in line or being in a crowd, or being outside of the home.
Marked fear or anxiety about a specific object or situation.
Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.
Duration of Prominen t Symptom s
At least 6 months
Children: 4 weeks
Adults: 6 months
1 month 1 month 6 months 6 months 6 months
Manifestation
Persistent worries about relationships, health, finances, and daily hassles.
Worry about separation from home or attachment figures, worry about untoward event, refusal to go out, refusal to sleep away from home.
Panic attacks
Failure to speak in social situations which interferes with educational or occupational achievement.
Afraid of being outside the home and that help might not be available. Become housebound.
Goes to great lengths to avoid the feared object or situation. In children, the fear or anxiety may be expressed by crying, tantrums, freezing, or clinging.
Persistent, unrealistically intense fear of social situations that might involve being scrutinized by, or even just exposed to, unfamiliar people. Feel more discomfort socially.
Cause clinically significant distress
Yes Yes Yes Yes Yes Yes Yes
Impairment in social, occupational, or other important areas of functioning
Yes Yes Yes Yes Yes Yes Yes
Attribution
Not attributable to the physiological effects of a substance (e., a drug of abuse, a medication) or another medical condition (e., hyperthyroidism)
Not identified
Not attributable to the physiological effects of a substance (e., a drug of abuse, a medication) or another medical condition (e., hyperthyroidism cardiopulmonary disorders)
Not attributable to a lack of knowledge of, or comfort with, the spoken language required in the social situation.
If another medical condition (e., inflammatory bowel disease, Parkinson’s disease) is present the fear, anxiety, or avoidance is clearly excessive.
Not Identified
Not attributable to the physiological effects of a substance (e., a drug of abuse, a medication) or another medical condition.
Condition
Criterion D: Better not be explained by another mental disorder (e., anxiety or worry about having panic attacks in panic disorder negative evaluation in social anxiety disorder, contamination or obsessions in OCDs, separation from attachment figures in separation anxiety disorder,reminders of traumatic events in PTSD, gaining weight in anorexia nervosa
Criterion D: Better not be explained by another mental disorder, such as refusing to leave home because of excessive resistance to change in ASD; delusions or hallucinations concerning separation in psychotic disorders; refusal to go outside without a trusted companion in agoraphobia; worries about ill
Criterion D: Better not be explained by another mental disorder (e., the panic attacks do not occur only in response to feared social situations, as in SAD: in response to circumscribed phobic objects or situations, as in specific phobia: in response to obsessions, as in OCD: in response to reminders of traumatic events,
Criterion E: Not better explained by a communication disorder (e., childhood onset fluency disorder) and does not occur exclusively during the course of ASD, schizophrenia, or another psychotic disorder.
Criterion I: Not better explained by the symptoms of another mental disorder—for example, the symptoms are not confined to specific phobia, situational type; do not involve only social situations ( as in SAD), perceived defects or flaws in physical appearance ( as in body dysmorphic
Criterion G: Not better explained by the symptoms of another mental disorder, including fear, anxiety, and avoidance of situation associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia): objects or situations related to obsessions (as
Criterion I: Not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmorphic disorder, or ASD.
Criterion J: If another medical condition (e. Parkinson’s disease, obesity, disfigurement from bums or injury) is present, the
physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder)
health or other harm befalling significant others in GAD; or concerns about having an illness in Illness anxiety disorder.
as in posttraumatic events, as in PTSD: or in response to separation from attachment figures, as in separation anxiety disorder).
disorder), reminders of traumatic events ( as in PTSD), or fear of separation (as in separation anxiety disorder).
in OCD): reminders of traumatic events (as in PTSD); separation from home or attachment figures (as in sepration anxiety disorder); or social situations (as in SAD).
clearly unrelated or is excessive.
Specifiers None None None None None
Animal
Natural environme nt
Blood- injection- injury
Situation
al Other
Performance only: If the fear is restricted to speaking or performing in public.
Trauma- and Stressor-Related Disorders
CRITERIA
POSTTRAUMATIC
STRESS DISORDER
(PTSD) 309.
(F43)
ACUTE STRESS
DISORDER 308.
(F43)
REACTIVE
ATTACHMENT
DISORDER 313.
(F94)
DISINHIBITED
SOCIAL
ENGAGEMENT
DISORDER 313.
(F94)
ADJUSTMENT
DISORDER
309.
(F43. 20)
Prominent Symptoms
Intrusively reexperiencing the traumatic event; avoidance; mood and cognitive change; increased arousal and reactivity
Presence of nine (or more) of the following symptoms from any of the five categories of intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic event(s) occurred
Consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers
Child actively approaches and interacts with unfamiliar adults
Distress that is out of proportion to the severity or intensity of the stressor; significant impairment in social, occupational, or other significant areas of functioning
Duration of Prominent Symptoms
1 month (starts 6 years old)
3 days to 1 month 12 months
Children: 4 weeks
Adults: 6 months
3 months
Manifestation
Vivid flashbacks; intrusive thoughts or images; nightmares; intense distress at real or symbolic reminders of the trauma; physical sensations such as pain, sweating, nausea or trembling.
Vivid flashbacks; intrusive thoughts or images; nightmares; intense distress at real or symbolic reminders of the trauma; physical sensations such as pain, sweating, nausea or trembling.
Rarely or minimally seeks and responds to comfort when distressed
Reduced or absence of reticence in interacting with unfamiliar adults; overly familiar verbal and physical behavior
Anxious reaction to life stress
Cause clinically significant distress
Yes Yes No No Yes
Other Specifier
With dissociative symptoms:
1. Depersonalization
2. Derealization
With delayed
expression:
- At least 6 months
None None None
• 309 (F43)
With depressed mood: Low mood, tearfulness, or feelings of hopelessness are predominant.
- (F43) With anxiety: Nervousness , worry, jitteriness, or separation anxiety is predominan t.
- (F43) With mixed anxiety and depressed mood: A combination of depression and anxiety is predominant.
309 (F43) With disturbance of conduct: Disturbance of conduct is predominant.
• 309 (F43)
With mixed disturbance of emotions and conduct: Both emotional symptoms (e., depression, anxiety) and a disturbance of conduct are predominant.
- 309 (F43) Unspecified: For maladaptive reactions that are not classifiable as one of the specific subtypes of adjustment disorder.
Attribution
Not attributable to the physiological effects of a substance
Not identified
Not attributable to another medical condition (e., Brain injury, cerebrovascular disease, Prader-Willi syndrome)
Not attributable to another medical condition
Not attributable to the physiological effects of a substance or another medical condition
Condition
Criterion D: Better not be explained by other disorder (including OCRDs) or medical condition
Criterion D: Appearance preoccupation better not explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder.
Criterion F: Not better explained by the symptoms of another mental disorder (including OCRDs)
Criterion E: Not better explained by the symptoms of another mental disorder (e., Attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder).
Criterion E: Not better explained by symptoms of another mental disorder (e., Delusions or tactile hallucinations in a psychotic disorder, or attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder)
Specifiers (degree of insight): With Good or Fair Insight; With Poor Insight; With Absent Insight/Delusio nal Beliefs.
Yes Yes Yes None None
Other Specifier Tic-related With muscle dysmorphi a
With excessive acquisition
None None
Manifestation
Disproportionate and persistent thoughts about the seriousness of one’s symptoms;
Persistent high level of anxiety about symptoms or health concerns;
Excessive time and energy devoted to these symptoms or health concerns
High level of anxiety about health;
Easily alarmed about personal health status;
Performs excessive health- related behaviors;
Exhibits maladaptive avoidance to medical things
Altered voluntary motor or sensory functions
The factors influence the course and treatment of the medical condition
The factors constitute additional well- established health risks
The factors influence underlying pathophysiology to precipitate or exacerbate symptoms or necessitating medical condition
Presents himself to others as ill, impaired, or injured;
The deceptive behavior is evident even in the absence of obvious external rewards
Presents another individual to others as ill, impaired, or injured;
The deceptive behavior is evident even in the absence of obvious external rewards
Cause clinically significant distress
No No Yes No No No
Impairment in social, occupational, or other important areas of functioning
No No Yes No No No
Attribution Not identified Not identified Not identified Not identified Not identified Not identified
Condition Not identified
Criterion F: The preoccupation is not better explained by another mental disorder (somatic symptom disorder, panic disorder, GAD, OCD, body dysmorphic disorder, or delusional disorder)
Criterion C: The symptom or deficit is not better explained by another medical or mental disorder
Criterion C: The psychological and behavioral factors are not better explained by another mental disorder (Panic disorder, MDD, PTSD)
Criterion D: The behavior is not better explained by another mental disorder (delusional disorder, another psychotic disorder)
Criterion D: The behavior is not better explained by another mental disorder (delusional disorder, another psychotic disorder)
Specifiers -With predominant pain
-Persistent
-Care-seeking type: medical care is frequently used
-Care-avoidant type: medical care is rarely used
Symptom Type:
-With weakness or paralysis
-With abnormal movement
-With swallowing
-Mild: increases medical risk
-Moderate: aggravates underlying medical condition
-Severe: results in medical
-Single episode
-Recurrent episodes
-Single episode
-Recurrent episodes
-With speech symptom
-With attacks or seizures
-With anesthesia or sensory loss
-With special sensory symptoms
-With mixed symptoms
emergency room visit
-Extreme: results in severe, life- threatening risk
Other Specifier
-Mild: one symptom fulfilled in Criterion B
-Moderate: two or more symptoms fulfilled in Criterion B
-Severe: two or more symptoms fulfilled in Criterion B, plus multiple somatic complaints
None
-Acute episode: symptoms present for less than 6 months
-Persistent: symptoms occur for 6 months or more
-With psychological stressor
-Without psychological stressor
None None
*Note: The perpetrator, not the victim, receives the diagnosis
DISSOCIATIVE DISORDERS
CRITER
IA
DISSOCIATIVE
IDENTITY
DISORDER
DISSOCIATIVE AMNESIA DEPERSONALIZATION/DEREALIZ
ATION DISORDER
Prominent Symptoms Disruption of identity characterized by two or more distinct personality states and involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning.
Inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. Localized. An event or period of time. Selective. Specific aspect of an event. Generalized. Identity and life history.
Presence of persistent/recurrent experiences of depersonalization (unreality, detachment, or being an outside observer of one’s thoughts, feelings, sensations, body, or actions), derealization (unreality/detachment from surroundings), or both.
Duration of Prominent Symptoms
None None None
Manifestation Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.
Memory loss that is more severe than forgetfulness and that cannot be explained by medical condition.
Depersonalization
- Perceptual alterations
- Distorted sense of time
- Unreal or absent self
- Emotional and/or physical
numbing
- Reality testing remain intact
Derealization
- Individuals or objects are
experienced as unreal, dreamlike, foggy, lifeless, or visually distorted.
- Reality testing remain intact.
BIPOLAR DISORDERS AND OTHER RELATED DISORDERS
CRITERIA Bipolar I Disorder Bipolar II Disorder Cyclothymic Disorder Substance/medication- induc ed bipolar disorder
Bipolar disorder due to another medical condition.
Prominent There must be at least one
This diagnosis requires These patients have had Alcohol or other substances A variety of medical and
Symptoms manic episode; most at least one hypomanic repeated mood swings, (intoxication or withdrawal) neurological conditions can patients with bipolar I episode plus at least one
but none that are severe can cause manic or produce manic or
have also had a major major depressive enough to be called major
hypomanic symptoms [ these
hypomanic symptoms.
depressive episode episode. depressive episodes or need not meet criteria for any
[these need not meet
manic episodes. of the conditions above]. criteria for any of the conditions above].
Duration of Prominen t Symptom s
lasting 1 week and present for most days for manic,
4 consecutive days for Hypomanic Episode.
For at least 2 years (at least 1 year in children and adolescents)
None None
lasting 4 consecutive days and present most days for Hypomanic
2 week period for Major Depressive Episode
or Major depressive episode for 2 week period.
Manifestation 1. Inflated self-esteem
or grandiosity.
2. Decreased need
for sleep
3. More talkative than
usual or pressure to keep talking.
1. Depressed mood
most of the day, nearly every day, as indicated by either subjective report
2. Markedly
diminished interest or pleasure in all
3. Significant weight
loss when not dieting or weight gain
1. Inflated self-
esteem or grandiosity.
2. Decreased need
for sleep
3. More talkative
than usual or pressure to keep talking.
1. Depressed mood
most of the day, nearly every day, as indicated by either subjective report
2. Markedly
diminished interest or pleasure in all
3. Significant weight
loss when not dieting or weight gain
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. mood swings, but none that are severe enough to be called major depressive episodes or manic episodes.
A prominent and persistent disturbance in mood that predominates in the clinical picture and is characterized by elevated, expansive, or irritable mood, with or without depressed mood, or markedly diminished interest or pleasure in all, or almost all, activities.
A prominent and persistent period of abnormally elevated, expansive, or irritable mood and abnormally increased activity or energy that predominates in the clinical picture
Cause clinically significant distress
Yes Yes Yes Yes Yes
Impairment in social, occupational, or other important areas of functioning
Yes Yes Yes Yes Yes
Attribution Manic. A full manic episode that emerges during antidepressant treatment
Hypomanic. A full hypomanic episode that emerges during antidepressant
Not identified Not identified Not identified
Disorders - just read
Course: Industrial Psychology
University: University of San Carlos
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