当前位置:专业心理学 > 诊断与技能 >

DSM5广泛性焦虑障碍

发布时间:2019-04-09 18:09:06   来源:admin    
字号:
www.nmgpsy.com内蒙古心理网
Generalized Anxiety Disorder 障碍
300.02(F41.1)

  1. 在至少6 个月的多数日子里,对于诸多事件或活动(例如工作或学校表现) ,表现出过分的焦虑和担心(焦虑性期待)。
    }M+^;a'g4Q+m4]j0学空间/m,|.fw4Xy/U)}
  2. 个体难以控制这种担心。
    6K.~`m:q0内蒙古心理网 zF'}Q'y)}
  3. 这种焦虑和担心与下列6 种症状中至少3 种有关(在过去6个月中,至少一些症状在多数日子里存在)。
    注:儿童只需1 项。内蒙古心理网1^|r!_$z|u
    1. 坐立不安或感到激动或紧张。
    p LQ B:AKl02. 容易疲倦。内蒙古心理网/\3P4wR&MuC
    3 注意力难以集中或头脑一片空白。内蒙古心理网[{Xh uQeVR
    4. 易怒。内蒙古心理网,H6SP_i`
    5. 肌肉紧张。
    y7v&CaL`;o G06. 睡眠障碍(难以入睡或保持睡眠状态,或休息不充分、质量不满意的睡眠)。内蒙古心理网 ]p0iM.^ E7qA

    -EI.oT,h$b0
  4. 这种焦虑、担心或躯体症状引起有临床意义的痛苦,或导致社交、职业或其他重要功能方面的损害。内蒙古心理网t-foZ.W g7C]%x
    内蒙古心理网8pq*JI6\ ^?+`Z%|7f
  5. 这种障碍不能归因于某种物质(例如,滥用的毒品、药物)的生理效应,或其他躯体疾病(例如,甲状腺功能亢进) 。
    +i*t {6d7KoS4g0G0
    )U9`[;\$dx0
  6. 这种障碍不能用其他精神障碍来更好地解释(例如,像惊恐碍中的焦虑或担心发生惊恐发作,像社交焦虑障碍[社交恐怖症]中的负性评价,像中的被污染或其他强迫思维,像分离焦虑障碍中的与对象的离别,像后应激障碍中的创伤性事件的提示物,像神经性厌食症中的体重增加,像躯体症状障碍中的躯体不适,像躯体变形障碍中的感到外貌存在瑕疵,像疾病焦虑障碍中的感到有严重的疾病,或像精神分裂症或妄想障碍中的妄想信念的内容)。

Diagnostic Features 诊断特征内蒙古心理网 P9R!uH9p#f(t

内蒙古心理网D0t+\!D-n$cJTd D'A

The essential feature of generalized anxiety disorder is excessive anxiety and worry (apprehensive expectation) about a number of events or activities. The intensity, duration, or frequency of the anxiety and worry is out of proportion to the actual likelihood or impact of the anticipated event. The individual finds it difficult to control the worry and to keep worrisome thoughts from interfering with attention to tasks at hand. Adults with generalized anxiety disorder often worry about everyday, routine life circumstances, such as possible job responsibilities, health and finances, the health of family members, misfortune to their children, or minor matters (e.g., doing household chores or being late for appointments). Children with generalized anxiety disorder tend to worry excessively about their competence or the quality of their performance. During the course of the disorder, the focus of worry may shift from one concern to another.内蒙古心理网T:P(|s-H/{U7Y%d

内蒙古心理网J Jf~e`U$F

广泛性焦虑障碍的基本特征是对于诸多事件或活动产生过度的焦虑和担心(焦虑性期待)。紧张度、持续时间或焦虑和担心出现的频率都与现实可能性或预期事件的冲击不成比例。个体发觉很难控制担心的,难以令担心的想法不打搅注意力,无法专注于手头上的任务。有广泛性焦虑障碍的成年人经常担心常规的生活情况,例如,可能的工作责任、健康状况和财务账目、家庭成员的健康、担心不幸的事儿会发生在身上,或一些很小的事情(例如,做家务或约会迟到)。有广泛性焦虑障碍的倾向于过分担心他们的能力或表现的水准。在这个障碍的病程中,担心的焦点会在不同主题之间迁移。内蒙古心理网!nlBs HR

内蒙古心理网*Wtp;G$Fn'^_%e9@1n

Several features distinguish generalized anxiety disorder from nonpathological anxiety. First, the worries associated with generalized anxiety disorder are excessive and typically interfere significantly with psychosocial functioning, whereas the worries of everyday life are not excessive and are perceived as more manageable and may be put off when more pressing matters arise. Second, the worries associated with generalized anxiety disorder are more pervasive, pronounced, and distressing; have longer duration; and frequently occur without précipitants. The greater the range of life circumstances about which a person worries (e.g., finances, children's safety, job performance), the more likely his or her symptoms are to meet criteria for generalized anxiety disorder. Third, everyday worries are much less likely to be accompanied by physical symptoms (e.g., restlessness or feeling keyed up or on edge). Individuals with generalized anxiety disorder report subjective distress due to constant worry and related impairment in social, occupational, or other important areas of functioning.

.G,W(MX%o1o&ICZ0内蒙古心理网a Hj9O&@m7Y

用来鉴别广泛性焦虑障碍与非病理性焦虑的特征为:第一,与广泛性焦虑障碍有关的担心是过度的,且通常显著干扰心理社交功能,然而日常生活性的担心不过度且更可控,当更为紧急的事情出现时,可以暂时放下。第二,与广泛性焦虑障碍有关的担心更广泛、明显、令人痛苦,病程更长,在没有促发因素的前提下频繁发生。一个人对生活状况的焦虑越广泛(例如,财务情况、孩子的安全、工作业绩),他的症状就越可能符合广泛性焦虑障碍的诊断标准。第三,日常的担心伴随躯体症状(例如,坐立不安,感觉紧张或烦躁不安)的可能性较小。有广泛性焦虑障碍的个体会报告由于持续的焦虑和相关的社交、职业或其他重要功能领域受损所致的主观痛苦。内蒙古心理网3s(T0}5Ds'q0e;J

内蒙古心理网v:|2M;[,TO&ks

The anxiety and worry are accompanied by at least three of the following additional symptoms: restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, and disturbed sleep, although only one additional symptom is required in children.内蒙古心理网,Z4rx"l9B

内蒙古心理网k8L1cZO

除了焦虑和担心外,还需具备下列额外症状中的至少三种:坐立不安,感觉紧张或烦躁,容易疲劳,注意力集中困难或思维出现空白,易激惹,肌肉紧张,睡眠紊乱;而在儿童身上,只需具备一种额外症状即可。内蒙古心理网 SN(P+};{

Associated Features Supporting Diagnosis 支持诊断的有关特征内蒙古心理网2U(`p1?"z YftU

:y/a!f E7IYG9HXQ0Associated with muscle tension, there may be trembling, twitching, feeling shaky, and muscle aches or soreness. Many individuals with generalized anxiety disorder also experience somatic symptoms (e.g., sweating, nausea, diarrhea) and an exaggerated startle response. Symptoms of autonomic hyperarousal (e.g., accelerated heart rate, shortness of breath, dizziness) are less prominent in generalized anxiety disorder than in other anxiety disorders, such as panic disorder. Other conditions that may be associated with stress (e.g., irritable bowel syndrome, headaches) frequently accompany generalized anxiety disorder.内蒙古心理网+Suv7NP%TI

内蒙古心理网A|/es'k1E1m

与肌肉紧张有关,可能出现震颤、抽搐、感觉颤抖、肌肉酸痛。许多有广泛性焦虑障碍的个体也经历过躯体症状(例如,出汗、恶心、腹泻)和过度的惊跳反射。自主神经过度觉醒的症状(例如,心跳加快、呼吸急促、眩晕)在广泛性焦虑障碍中不如其他焦虑障碍中明显(例如,惊恐障碍)。那些与应激有关的其他疾病(例如,肠易激综合征、头痛)频繁伴随广泛性焦虑障碍。内蒙古心理网U pX4h`5`?

Prevalence 患病率内蒙古心理网w3l+u? J|#ob0wE

6]AH