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Dimensional anxiety scales for DSM-5: Sensitivity to clinical severity

Published online by Cambridge University Press:  15 April 2020

S. Knappe*
Affiliation:
Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
J. Klotsche
Affiliation:
Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
A. Strobel
Affiliation:
Department of Process-oriented Assessment, TU Dresden, Dresden, Germany
R.T. LeBeau
Affiliation:
Department of Psychology, University of California, Los Angeles, California, United States
M.G. Craske
Affiliation:
Department of Psychology, University of California, Los Angeles, California, United States
H.-U. Wittchen
Affiliation:
Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
K. Beesdo-Baum
Affiliation:
Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
*
*Corresponding author. TU Dresden, Institute of Clinical Psychology and Psychotherapy, Chemnitzer Straβe Street 46, 01187 Dresden, Germany. Tel.: +49 351 463 39727; fax: +49 351 463 36984. E-mail address:knappe@psychologie.tu-dresden.de (S. Knappe).
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Abstract

Purpose

Psychometric properties and clinical sensitivity of brief self-rated dimensional scales to supplement categorical diagnoses of anxiety disorders in the DSM-5 were recently demonstrated in a German treatment seeking sample of adults. The present study aims to demonstrate sensitivity of these scales to clinical severity levels.

Methods

The dimensional scales were administered to 102 adults at a university outpatient clinic for psychotherapy. Diagnostic status was assessed using the Munich-Composite International Diagnostic Interview. To establish a wide range of clinical severity, we considered subthreshold (n = 83) and threshold anxiety disorders (n = 49, including Social Phobia, Specific Phobia, Agoraphobia, Panic Disorder, and Generalized Anxiety Disorder).

Results

Individuals with either subthreshold or threshold anxiety disorder scored higher on all dimensional scales relative to individuals without anxiety. In addition, individuals with a threshold anxiety disorder scored higher on the dimensional scales than individuals with a subthreshold anxiety disorder (except for specific phobia). Disorder-related impairment ratings, global functioning assessments and number of panic attacks were associated with higher scores on dimensional scales. Findings were largely unaffected by the number of anxiety disorders and comorbid depressive disorders.

Conclusion

The self-rated dimensional anxiety scales demonstrated sensitivity to clinical severity, and a cut-off based on additional assessment of impairment and distress may assist in the discrimination between subthreshold and threshold anxiety disorders. Findings suggest further research in various populations to test the utility of the scales for use in DSM-5.

Type
Original article
Copyright
Copyright © European Psychiatric Association

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Footnotes

This article was generated as part of the DSM-5 Work Group activities, ©2012 by the American Psychiatric Association.

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