Exploring anxiety
Exploring anxiety

Start this free course now. Just create an account and sign in. Enrol and complete the course for a free statement of participation or digital badge if available.

Free course

Exploring anxiety

PTSD and OCD in DSM-5

Post-traumatic stress disorder (PTSD) and acute stress disorder have been moved from ‘Anxiety Disorders’ to an independent category of ‘Trauma and Stressor-Related Disorders’ or TSRD. PTSD has been traditionally conceptualised as a ‘fear disorder’ defined by three clusters of symptoms: (i) re-experiencing of fear (intrusive memories), (ii) avoidance of the reminders of trauma (amnesia, withdrawal, avoidance of situational reminders), and (iii) hyperarousal (disturbances in sleep, heightened startle response) (Nemeroff et al., 2013). DSM-5 has moved beyond the fear-based anxiety construct, and PTSD criteria have been revised to include negative emotional states and symptoms of distress – dysphoria, aggression, guilt and shame − on account that those with PTSD (e.g. war veterans and victims of crime or of abuse) often present for clinical assistance with such negative emotional states. A new PTSD subtype introduced for children aged 6 and under is considered to take into account the variation of symptom presentation in young children.

DSM-5 also lists obsessive-compulsive disorder and related disorders (OCRDs) as a separate category (along with new conditions such as hoarding disorder and excoriation or ‘skin-picking’ disorder). The decision was based on a review of evidence suggesting that OCD differs from anxiety disorders on a number of diagnostic validators and psychobiological and phenomenological overlap between OCD and some related conditions. The ‘close relationship’ with anxiety disorders is still reflected by the sequential order of corresponding chapters in DSM-5 (Nemeroff et al., 2013).

An emphasis − the potential advantage for clinical practice − of segregating PTSD and OCRDs from anxiety-related disorders, was to raise awareness amongst clinicians and the public, of these 'underdiagnosed and undertreated conditions', encouraging 'researchers to use structured diagnostic interviews and standardised symptom measures to investigate and evaluate the full range of these conditions in a systematic way' (Nemeroff et al., 2013).

Critics of the DSM continue to debate the definition and classification of ‘psychiatric disorders’ stressing that is important to avoid medicalising problems of daily living (Stein et al., 2010; Aftab, 2014). While acknowledging this view, proponents of the DSM stress that 'those who meet diagnostic criteria for these conditions experience distress or impairment and deserve appropriate intervention' (Nemeroff et al., 2013).

s826_1

Take your learning further

Making the decision to study can be a big step, which is why you'll want a trusted University. The Open University has 50 years’ experience delivering flexible learning and 170,000 students are studying with us right now. Take a look at all Open University courses.

If you are new to University-level study, we offer two introductory routes to our qualifications. You could either choose to start with an Access module, or a module which allows you to count your previous learning towards an Open University qualification. Read our guide on Where to take your learning next for more information.

Not ready for formal University study? Then browse over 1000 free courses on OpenLearn and sign up to our newsletter to hear about new free courses as they are released.

Every year, thousands of students decide to study with The Open University. With over 120 qualifications, we’ve got the right course for you.

Request an Open University prospectus371