CLINICAL CONSEQUENCES OF THE REVISED DSM‐5 DEFINITION OF AGORAPHOBIA IN TREATMENT‐SEEKING ANXIOUS YOUTH. Issue 7 (4th April 2015)

• Record Type: Journal Article
• Authors: Cornacchio, Danielle; Chou, Tommy; Sacks, Hayley; Pincus, Donna; Comer, Jonathan
• Is Part Of: Depression and anxiety. Volume 32:Issue 7(2015:Jul.)
• Page Start: 502
• Page End: 508
• Publication Date: 2015-04-04
• Subjects: Anxiety -- Periodicals; Depression, Mental -- Periodicals; Depression -- Periodicals; Anxiety -- Periodicals; Anxiety Disorders -- Periodicals; 616.8527005
• DOI: 10.1002/da.22361
• Languages: English
• ISSNs: 1091-4269

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="da22361-sec-0010" sec-type="section"> <title>Background</title> <p>In DSM‐5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic‐like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM‐IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents.</p> </sec> <sec id="da22361-sec-0020" sec-type="section"> <title>Method</title> <p>Analyses (<italic>N</italic> = 151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM‐5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM‐5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM‐5 criteria to SP youth.</p> </sec> <sec id="da22361-sec-0030" sec-type="section"> <title>Results</title> <p>One‐quarter of youth with symptom presentations consistent with the DSM‐IV agoraphobia definition no longer met criteria for DSM‐5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM‐5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP.</p> </sec> <sec id="da22361-sec-0040" sec-type="section"> <title>Conclusions</title> <p>A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM‐5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a "circumscribed" agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains.</p> </sec> </abstract>