Table 32 DSM-5 diagnostic criteria for anxiety and related disorders specific to children

Separation anxiety disorder

• Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by ≥3 of the following:

○ Distress when separation occurs, worry about loss or separation, reluctance to leave home, be alone, or go to sleep because of fear of separation, nightmares involving separation, or complaints of physical symptoms (e.g., headaches, upset stomach) when separation occurs

• Duration of at least 4 weeks

• Onset before 18 years of age

• The disturbance causes clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning

Selective mutism

• Consistent failure to speak in specific social situations in which there is an expectation for speaking (e.g., at school) despite speaking in other situations

Anxiety or related disorder

Changes to adult DSM-5 diagnostic criteria specific to children

Specific phobia

• The fear or anxiety may be expressed by crying, tantrums, freezing, or clinging

• Other specifiers: loud sounds or costumed characters

SAD (social phobia)

• The anxiety must occur in peer settings, not just during interactions with adults

• The fear or anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking, or failure to speak in social situations

OCD, panic disorder

• No pediatric specific criteria

PTSD

• Qualifiers in children

○ Intrusion symptoms: repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed; there may be frightening dreams without recognizable content; trauma-specific re-enactment may occur in play

• Specific subtype for children ≤6 years of age

GAD

• Less stringent criteria for symptoms than in adults