Anxiety disorders

Anxiety disorders

Introduction

Unlike most psychological disorders, the diagnosis of post-traumatic stress disorder (PTSD) involves a clear, definable precipitating incident. According to the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, 2009), a diagnosis of PTSD must rendezvous the next criteria: (A1) exposure to a traumatic happening that involves genuine or endangered death or serious wound, or a risk to the physical integrity of oneself or another person, and (A2) a personal response to such an happening that involves intense worry, helplessness, or horror. Failure to rendezvous either of these criteria rules out a diagnosis of PTSD and precludes the assessment of other PTSD-related diagnostic criteria, such as the presence of re-experiencing, avoidance behaviors, and hyper arousal. (Wrighte,2009)

 

Discussion

Structured and semi-structured interviews are broadly used in both clinical and research settings and have been shown to advance the reliability and validity of psychiatric diagnoses in comparison with unstructured interview methods. One well liked structured interview, the Anxiety Disorder Interview Schedule for DSM-IV is specifically designed to supply diagnoses for a variety of disquiet, feeling, and somatoform disorders, based on the Diagnostic and Statistical Manual (DSM-IV; American Psychiatric Association, 2009). Various versions of the ADIS have been used in over 150 published articles, and multiple studies have supported the psychometric properties of the ADIS-IV in unquestionably classifying a variety of anxiety-related disorders.(Blake,2005)

The ADIS-IV utilizes a branching format that includes gating (i.e., screening) questions for each diagnostic category. Responses to these questions work out if more specific, symptom-related inquiries necessary to affirm a diagnosis should be asked.(Wrighte,2009) In the case of PTSD, two gating questions are asked: (1) “Have you ever skilled or witnessed a traumatic or life-threatening happening such as assault, rape, seeing someone awfully hurt or slain, battle, accidents, or natural or man-made disasters?” and (2) “Do you recall any events of this environment happening when you were a child?” The aim of these questions, which correspond approximately to DSM benchmark A1 documented overhead, is to notice the presence of any traumatic happening that respondents may have experienced. An affirmative response to either gating question is pursued by more specific queries considering the various symptom clusters associated with PTSD. However, if neither question elicits an affirmative response, then the follow-up questions needed for a diagnosis of PTSD are not asked.1 Clearly, the PTSD gating questions on the ADISIV play a key function in working out if an one-by-one can be diagnosed with PTSD. To the stage that these questions make false-negative responses (i.e., those in which a respondent fails to report a traumatic happening that really occurred), PTSD may be under diagnosed using the ADIS-IV.(Blake,2005) To designated day, although, the sensitivity of these questions in noticing a history of trauma exposure has yet to be evaluated. This is in relative to considering that another widespread semi-structured diagnostic interview, the Structured Clinical Interview for, which uses similar screening questions to assess trauma history, has been shown to under diagnose ...