A transdiagnostic, dimensional classification of anxiety shows improved parsimony and predictive noninferiority to DSM.

Journal of Psychopathology and Clinical Science, Vol 132(8), Nov 2023, 937-948; doi:10.1037/abn0000863The current conceptualization of anxiety in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)—which includes 11 anxiety disorders plus additional anxiety-related conditions—does not align with accumulating evidence that anxiety is transdiagnostic and dimensional in nature. Transdiagnostic dimensional anxiety models have been proposed, yet they measure anxiety at either a very broad (e.g., “anxiety”) or very narrow (e.g., “performance anxiety”) level, overlooking intermediate properties of anxiety that cut across DSM disorders. Using indicators from a well-validated semistructured interview of anxiety-related disorders, we constructed intermediate-level transdiagnostic dimensions representing the intensity, avoidance, pervasiveness, and onset of anxiety. We captured these content-agnostic dimensions in a sample representing varying levels and forms of anxiety (N = 268), including individuals with generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, specific phobia, separation anxiety disorder, posttraumatic stress disorder, and obsessive–compulsive disorder (n = 205) and individuals with no psychopathology (n = 63). In preregistered analyses, our dimensional anxiety model showed noninferiority to DSM-5 diagnoses in predicting concurrent and prospective measures of anxiety-related impairment, anxiety vu...
Source: Journal of Abnormal Psychology - Category: Psychiatry & Psychology Source Type: research