Friday, June 14, 2013

Changing scales for social phobia or anxiety













Last month the American Psychological Association released the latest revision to their Diagnostic and Statistical Manual of Mental Disorders. Their DSM-IV has been replaced by DSM-5. A fact sheet describes what has been changed for anxiety disorders.  

The condition that used to be called social phobia has been renamed as social anxiety disorder. (Public speaking anxiety is one type of social anxiety). Two changes have been made in the definition.

First:

“The symptoms must be persistent, lasting six months or longer. In DSM-IV, the time frame was required only for children; DSM-5 expands this criterion to include adults as well. The minimum symptom period reduces the possibility that an individual is experiencing only transient or temporary fear.”

Second:

“To be diagnosed with social anxiety disorder, the person must suffer significant distress or impairment that interferes with his or her ordinary routine in social settings, at work or school, or during other everyday activities. Unlike in DSM-IV, which requires that the individual recognize that his or her response is excessive or unreasonable, the DSM-5 criteria shift that judgment to the clinician.”

I suspect that the first change will tend to reduce the number of people diagnosed, while the second will increase it. Years from now we will see surveys of US adults and adolescents done with these new criteria. The percent of people with social anxiety or public speaking anxiety won’t be the same as with the DSM-IV criteria.

It will be like comparing apples and oranges. But, I expect there again will be people who attempt to shock us by noting those differently measured percentages either have gone up or down. 

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