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A. Recurrent unexpected panic attacks. Abrupt

surge of intense fear or intense discomfort that
reaches a peak within minutes and has 4+:
1. Palpitations, pounding heart, or accelerated
heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or
smothering
5. Feelings of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
Panic Disorder 8. Chills or heat sensations
9. Paresthesias (numbness or tingling)
10. Derealization or depersonalization
12. Fear of losing control or going crazy
13. Fear of dying
B. At least one of the attacks followed by a month
of 1. persistent concern or worry about
additional panic attacks
2. Signi!cant maladaptive change in behavior
related to the attacks and designed to avoid
having panic attacks
Di"erential Diagnosis: substance use, medical
condition, SAD, SP, OCD, PTSD

A. Marked fear or anxiety about 2+:

1. Using public transportation
2. Being in open spaces
3. Being in enclosed spaces
4. Standing in line or being in a crowd
5. Being outside of the home alone
B. Avoids these situations because of thoughts
that escape might be di"cult or help might not
be available in the event of developing panic-like
Agoraphobia
symptoms
C. Situations almost always provoke fear or
anxiety
D. Actively avoiding situations that produce
anxiety
E. Out of proportion to actual danger posed
F. Persistent Sx for 6+ months
G. Distress and impairment
Di"erential Diagnosis: SP, OCD, BDD, SAD

A. Excessive anxiety or worry occurring more

days than not for 6+ mos
B. Di"culty controlling worry
C. 3+ Sx:
1. Restlessness or feeling keyed up or on edge
2. Being easily faigued
3. Di"culty concentrating or mind going blank
Generalized Anxiety Disorder 4. Irritability
5. Muscle tension
6. Sleep disturbance
D. Distress or impairment
Di"erential Diagnosis: PD, SAD, OCD, PTSD,
Anorexia Nervosa, Somatic Symptom Disorder,
BDD, Illness Anxiety Disorder, Schizophrenia,
Delusional Disorder

A. Presence of obsessions, compulsions, or both

Obsessions:
1. Recurrent and persistent thoughts, urges, or
images that are intrusive and unwanted and that
cause anxiety or distress
2.Attempts to ignore or suppress such thoughts,
urges, or images or to neutralize them

Compulsions:
1. Repetitive behaviors or mental acts that you
feel driven to do in response to an obsession or
rules
Obsessive-Compulsive Disorder
2. Aimed at preventing or reducing anxiety or
distress or preventing some dreaded event or
situation
B. o/c are time consuming or cause distress or
impairment
Speci#ers: With good/fail insight, With poor
insight, With absent insight/delusional beliefs,
Tic-related

Di"erential Diagnosis: GAD, BDD, Hoarding

Disorder, Trichomania, Illness Anxiety Disorder,
Eating disorder, ADHD, MDD, ASD

A. Preoccupation with one or more perceived

defects or #aws in physical appearance
B. Performed repetitive or mental acts in
response
C. Distress or impairment
Body Dysmorphic Disorder
D. Not better explained by eating disorder

Speci#ers: With muscle dysmorphia, With

good/fail insight, With poor insight, With absent
insight/delusional beliefs

A. Exposure to actual or threatened death,

serious injury, or sexual violence in 1+ ways:
1. Direct experience
2. Witnessing event
3. Learning event occurred to a close family
member or friend
4. Experiencing repeated or extreme exposure to
aversive details of event through work

B. Presence of 1+ intrusion symptoms:

1. Recurrent, involuntary, and intrusive
distressing memories of event
2. Distressing dreams in which content/a$ect are
related to event
3. Dissociative reactions - feels like event is
recurring (#ashback)
4. Intense or prolonged psychological distress at
exposure to internal or external cues that
symbolize or resemble an aspect of the event
5. Physiological reactions to internal or external
cues

C. Persistent avoidance of stimuli associated with

the event
1. Avoidance or e$orts to avoid distressing
memories, thoughts, or feelings
2. Avoidance or e$orts to avoid external
reminders

D. Negative alterations in cognitions and mood

associated with event - 2+:
Posttraumatic Stress Disorder 1. Inability to remember an important aspect of
the event
2. Persistent and exaggerated negative beliefs or
expectations about oneself, others, or the world
3. Persistent distorted cognitions about the cause
or consequences of event, self-blame
4. Persistent negative emotional state
5. Markedly diminished interest or participation
in signi!cant activities
6. Feelings of detachment or estrangement from
others.
7. Persistent inability to experience positive
emotions

E. Marked alterations in arousal and reactivity

associated with the traumatic event - 2+:
1. Irritable behavior or angry outbursts
2. Reckless or self-destructive behavior
3. Hypervigilance
4. Exaggerated startle response
5. Problems with concentration
6. Sleep disturbance

F. Duration is more than one month

G. Distress and impairment

Speci#ers: with dissociative symptoms

(depersionalization or derealization) or with
delayed expression

Di"erential Diagnosis: Substance use or

medical condition

A. Exposure to actual or threatened death,

serious injury, or sexual violence in 1+ ways:
1. Direct experience
2. Witnessing event
3. Learning event occurred to a close family
member or friend
4. Experiencing repeated or extreme exposure to
aversive details of event through work

B. Presence of 9+ symptoms:
1. Recurrent, involuntary, and intrusive
distressing memories of event
2. Distressing dreams in which content/a$ect are
related to event
3. Dissociative reactions - feels like event is
recurring (#ashback)
4. Intense or prolonged psychological distress at
exposure to internal or external cues that
Acute Stress Disorder symbolize or resemble an aspect of the event
5. Persistent inability to experience positive
emotions
6. Avoidance or e$orts to avoid distressing
memories, thoughts, or feelings
7. Avoidance or e$orts to avoid external
reminders
8. Marked alterations in arousal and reactivity
associated with the traumatic event - 2+:
9. Irritable behavior or angry outbursts
10. Hypervigilance
11. Exaggerated startle response
12. Problems with concentration
13. Sleep disturbance
C. 3 days to 1 month after trauma exposure
D. clinically signi!cant impairment

Di"erential Diagnosis: Substance use or

medical condition, Breif psychotic disorder

A. The development of emotional or behavioral

sx in response to identi!able stressors occurring
within 3 mos of onset
B. Clinically signi!cant sx. At least 1:
1. Marked distress that is out of proportion to
severity of stressor
2. Impairment in fx
Adjustment Disorder
Speci#ers: with depressed mood, with anxiety,
with mixed anxiety and depressed mood, with
disturbance of conduct, with mixed disturbance
of emotions and conduct, unspeci!ed

Di"erential DIagnosis: Normal breavement

A. Disruption of identity characterized by 2+

distinct personality states, which may be
described in some cultures as an experience of
possession. marked discontinuity in sense of self
and sense of agency, accompanied by related
alteration in perception, cognition, a$ect,
behavior, consciousness, memory, and/or
sensory-motor fx.
Dissociative Identity Disorder
B. Recurrent gaps in the recall of everyday
events, important personal info, and/or
traumatic events not consistent with ordinary
forgetting
C. Distress and impairment
D. Not a normal part of a broadly accepted
cultural or religious practice
E. Not due to substance or medical condition

A. Inability to recall important autobiographical

information, usually of a traumatic or stressful
nature, that is not consistent with ordinary
forgetting
B. Distress and impairment
C. Not due to substance or neurological or
Dissociative Amnesia
medical condition

Speci#ers: with dissociative fugue

Di"erential Diagnosis: DID, PTSD, ASD, somatic

symptom disorder, or neurocognitive disorders

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