DSM-5 made which significant change to Separation Anxiety Disorder relative to DSM-IV?
A: It removed Separation Anxiety Disorder from the Anxiety Disorders chapter
B: It restricted the diagnosis to children under age 12
C: It expanded the diagnosis to apply across the lifespan, not only to children
D: It added school refusal as a required criterion
Correct: It expanded the diagnosis to apply across the lifespan, not only to children
DSM-IV required that Separation Anxiety Disorder onset occur before age 18. DSM-5 removed this age restriction entirely, recognising that adults can experience clinically significant separation anxiety that was not present in childhood. The diagnosis now applies across the lifespan — with different duration thresholds maintained for different age groups: 4 weeks for children and adolescents, versus 6 months or more for adults.
Under DSM-5, what is the minimum duration of Separation Anxiety Disorder symptoms required in adults?
A: 4 weeks
B: 3 months
C: 6 months
D: 12 months
Correct: 6 months
DSM-5 specifies a minimum duration of 4 weeks for children and adolescents, but 6 months or more for adults. This two-tiered threshold reflects the expectation that separation anxiety is more transient in childhood and requires a longer, more persistent course to be diagnostically meaningful in adults.
In DSM-5, Selective Mutism is classified under which chapter?
A: Neurodevelopmental Disorders
B: Anxiety Disorders
C: Communication Disorders
D: Trauma- and Stressor-Related Disorders
Correct: Anxiety Disorders
DSM-5 places Selective Mutism at the start of the Anxiety Disorders chapter, recognising that the failure to speak in social situations is primarily driven by anticipatory anxiety and fear of negative evaluation rather than a volitional or communication-based process. This classification shift reflects the evidence base supporting anxiety as the core mechanism.
DSM-5 requires that Selective Mutism symptoms interfere with functioning for a minimum of how long before a diagnosis can be made?
A: 1 month
B: 3 months
C: 6 months
D: The criterion specifies "persistent" without a defined minimum
Correct: 1 month
DSM-5 specifies that the failure to speak must last at least 1 month and not be limited to the first month of school — this exclusion prevents diagnosing normal adjustment shyness in new educational settings. The 1-month threshold is notably shorter than the duration criteria for other anxiety disorders, reflecting the fact that Selective Mutism in children can cause rapid and significant functional impairment.
According to DSM-5, which of the following is NOT one of the five Specific Phobia specifier types?
A: Animal type
B: Natural environment type
C: Social type
D: Situational type
Correct: Social type
DSM-5's five Specific Phobia specifiers are: Animal, Natural Environment, Blood-Injection-Injury, Situational, and Other. "Social type" does not exist within Specific Phobia — fear of social scrutiny is separately captured by Social Anxiety Disorder. Conflating the two is a common error, but DSM-5 is explicit that social situations are not a specifier subtype of Specific Phobia.
According to DSM-5, the core fear in Social Anxiety Disorder is exposure to:
A: Any situation involving interaction with unfamiliar people
B: Social situations in which the person may be scrutinised by others
C: Any form of public performance or public speaking
D: Situations in which escape might be difficult or help unavailable
Correct: Social situations in which the person may be scrutinised by others
DSM-5 Criterion A for Social Anxiety Disorder states that the individual fears social situations in which they may be "scrutinised by others." This encompasses social interactions (conversations, meeting new people), being observed (eating, drinking), and performance situations — but the unifying feature is fear of negative evaluation through scrutiny, not merely unfamiliarity or public exposure. Option D describes Agoraphobia's core fear.
DSM-5 extended the 6-month duration criterion for Social Anxiety Disorder to apply universally across all ages (DSM-IV had restricted it to individuals under 18 years). What was the primary rationale for this change?
A: To align Social Anxiety Disorder with the duration requirements of Specific Phobia
B: To prevent over-diagnosis of transient social anxiety in situational contexts
C: To ensure the diagnosis could only be applied to adults
D: To restrict the diagnosis to cases requiring pharmacological treatment
Correct: To prevent over-diagnosis of transient social anxiety in situational contexts
DSM-5 added the 6-month minimum to improve diagnostic specificity and reduce over-diagnosis. Without a duration threshold, normal or situational social anxiety — anxiety about a job interview, a first day at school, or meeting a new peer group — could be pathologised prematurely. The 6-month requirement ensures the fear, anxiety, or avoidance is persistent and clinically significant rather than a transient response to a specific life circumstance.
A key structural change in DSM-5 relative to DSM-IV is that Panic Disorder and Agoraphobia are now:
A: Merged into a single unified diagnosis
B: Coded as two fully independent diagnoses that can co-occur
C: Both reclassified under Trauma- and Stressor-Related Disorders
D: Distinguished only by the presence or absence of a safety behaviour
Correct: Coded as two fully independent diagnoses that can co-occur
In DSM-IV, clinicians could diagnose "Panic Disorder with Agoraphobia" or "Panic Disorder without Agoraphobia," treating Agoraphobia as a specifier of Panic Disorder. DSM-5 separated them into two independent diagnoses: Panic Disorder and Agoraphobia. They can be comorbid (both diagnosed simultaneously), but neither requires the other. Research showed that a substantial minority of people develop Agoraphobia without Panic Disorder, justifying the separation.
Under DSM-5, following at least one unexpected panic attack, how long must persistent concern about further attacks or maladaptive behaviour continue for a Panic Disorder diagnosis?
A: 2 weeks
B: 1 month
C: 3 months
D: 6 months
Correct: 1 month
DSM-5 requires (a) recurrent unexpected panic attacks AND (b) at least 1 month of persistent concern about further attacks, their implications, or significant maladaptive behavioural change. The 1-month threshold distinguishes Panic Disorder from acute stress reactions or isolated panic attacks, which are relatively common in the general population and do not in themselves warrant a Panic Disorder diagnosis.
DSM-5 defines a panic attack as an abrupt surge of intense fear or discomfort reaching a peak within minutes, during which at least how many of the 13 listed symptoms must be present?
A: 3
B: 4
C: 5
D: 6
Correct: 4
DSM-5 requires 4 or more of 13 symptoms for a full panic attack. These span somatic domains (palpitations or accelerated heart rate, sweating, trembling, shortness of breath, choking sensations, chest pain, nausea, dizziness, chills or hot flushes, paraesthesias) and cognitive domains (derealisation or depersonalisation, fear of losing control or "going crazy," fear of dying). Attacks with fewer than 4 symptoms are termed "limited-symptom attacks" and do not meet the full threshold, though they may still be clinically significant.
DSM-5 Criterion A for Agoraphobia requires marked fear or anxiety about at least how many of the five listed situational categories?
A: One
B: Two
C: Three
D: All five
Correct: Two
DSM-5 requires fear or anxiety about two or more of five situations: (1) using public transportation, (2) being in open spaces, (3) being in enclosed places, (4) standing in line or being in a crowd, and (5) being outside the home alone. This two-situation minimum prevents diagnosing Agoraphobia from a single feared place and reflects the broad avoidance pattern typically seen in the disorder.
DSM-5 requires excessive anxiety and worry (apprehensive expectation) to occur more days than not for a minimum of:
A: 1 month
B: 3 months
C: 6 months
D: 12 months
Correct: 6 months
GAD in DSM-5 requires a 6-month duration of excessive anxiety and worry, occurring more days than not, about a number of events or activities. The extended threshold distinguishes the pervasive, chronic worry of GAD from time-limited anxiety responses to specific life stressors, and helps ensure that the diagnosis captures a stable, trait-like pattern rather than a situational reaction.
An adult meeting DSM-5 criteria for GAD must exhibit at least how many of the six associated symptoms?
A: 1
B: 2
C: 3
D: 4
Correct: 3
DSM-5 requires that adults with GAD show three or more of six associated symptoms: restlessness or feeling on edge, being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, and sleep disturbance. Children require only one of these six symptoms — a lower threshold reflecting developmental considerations and the different way anxiety presents in younger populations.
Which of the following is NOT among the six associated symptoms listed in DSM-5 Criterion C for Generalised Anxiety Disorder?
A: Restlessness or feeling keyed up or on edge
B: Muscle tension
C: Excessive sweating or palpitations
D: Sleep disturbance (difficulty falling or staying asleep, or restless sleep)
Correct: Excessive sweating or palpitations
The six DSM-5 GAD associated symptoms are: (1) restlessness or feeling keyed up or on edge, (2) being easily fatigued, (3) difficulty concentrating or mind going blank, (4) irritability, (5) muscle tension, and (6) sleep disturbance. Excessive sweating and palpitations are autonomic arousal symptoms more characteristic of panic attacks — they do not appear in the GAD symptom criterion, which centres on cognitive and tension-related symptoms rather than acute autonomic activation.
DSM-5 requires adults with GAD to show at least 3 of the 6 associated symptoms. How many are required for children?
A: 1
B: 2
C: 3 — the same threshold as adults
D: None — children do not need associated symptoms for a GAD diagnosis
Correct: 1
Children diagnosed with GAD under DSM-5 need only 1 of the 6 associated symptoms (restlessness, fatigue, concentration difficulties, irritability, muscle tension, sleep disturbance), compared to 3 or more for adults. This age-differentiated threshold reflects developmental considerations: children may not experience or articulate the full adult symptom profile, and even a single associated symptom alongside excessive, difficult-to-control worry can represent clinically significant psychopathology in a child.
In DSM-5, Illness Anxiety Disorder (previously known as Hypochondriasis) is classified under which chapter?
A: Anxiety Disorders
B: Obsessive-Compulsive and Related Disorders
C: Somatic Symptom and Related Disorders
D: Dissociative Disorders
Correct: Somatic Symptom and Related Disorders
Despite its historical association with anxiety, DSM-5 places Illness Anxiety Disorder in the "Somatic Symptom and Related Disorders" chapter — alongside Somatic Symptom Disorder, Conversion Disorder, and Factitious Disorder. This reflects the defining feature: preoccupation with having or acquiring a serious illness, rather than pathological worry alone. Individuals may or may not have somatic symptoms, but illness preoccupation is central to the diagnosis.
When would a presentation of anxiety during substance intoxication NOT qualify for a DSM-5 diagnosis of Substance/Medication-Induced Anxiety Disorder?
A: When symptoms develop within 1 month of intoxication
B: When the substance is a prescribed medication
C: When the anxiety symptoms are better explained by an independent Anxiety Disorder that preceded substance use
D: When symptoms cause clinically significant distress
Correct: When the anxiety symptoms are better explained by an independent Anxiety Disorder that preceded substance use
DSM-5 specifies that Substance/Medication-Induced Anxiety Disorder should NOT be diagnosed if the disturbance is better explained by an independent Anxiety Disorder. Clinical indicators of independence include: the anxiety preceded substance use onset, the anxiety persists for a substantial period after cessation, or there is other evidence of an independent non-substance-induced disorder. Substances and medications can cause anxiety during intoxication, withdrawal, or as a side effect.
Under DSM-5, a diagnosis of Anxiety Disorder Due to Another Medical Condition requires that the anxiety is:
A: The patient's psychological response to knowing they have a medical diagnosis
B: A direct physiological consequence of the medical condition
C: Present before the medical condition was identified
D: The individual's primary concern rather than the medical symptoms themselves
Correct: A direct physiological consequence of the medical condition
DSM-5 requires that the anxiety is a direct physiological consequence of another medical condition — for example, hyperthyroidism producing anxiety via thyroid hormone effects on the CNS, or a phaeochromocytoma causing episodic anxiety through catecholamine release. A psychological reaction to having an illness (e.g., worrying about a cancer prognosis) would not qualify: that would be captured by an adjustment disorder or another anxiety diagnosis, not this category.
DSM-5 Classification of Anxiety Disorders
DSM-5 made which significant change to Separation Anxiety Disorder relative to DSM-IV?
About this quiz
Test your knowledge of how DSM-5 classifies the major anxiety disorders — from Separation Anxiety Disorder and Selective Mutism to Panic Disorder, Agoraphobia, and GAD — plus Illness Anxiety Disorder, a condition commonly confused with anxiety disorders but classified elsewhere in DSM-5. Questions cover chapter placements, diagnostic criteria, duration thresholds, symptom counts, and key changes from DSM-IV.