title: CLINICAL CONSEQUENCES OF THE REVISED DSM-5 DEFINITION OF AGORAPHOBIA IN TREATMENT-SEEKING ANXIOUS YOUTH.
abstract: BACKGROUND
  In DSM-5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic-like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM-IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents.
  
  
  METHODS
  Analyses (N = 151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM-5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM-5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM-5 criteria to SP youth.
  
  
  RESULTS
  One-quarter of youth with symptom presentations consistent with the DSM-IV agoraphobia definition no longer met criteria for DSM-5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM-5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP.
  
  
  CONCLUSIONS
  A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM-5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a "circumscribed" agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains.
authors.affiliation: Department of Psychology, Mental Health Interventions and Technology (MINT) Program, Florida International University, Miami, Florida.
authors.forename: Danielle
authors.initials: D
authors.lastname: Cornacchio
authors.affiliation: Department of Psychology, Mental Health Interventions and Technology (MINT) Program, Florida International University, Miami, Florida.
authors.forename: Tommy
authors.initials: T
authors.lastname: Chou
authors.affiliation: Weill Cornell College of Medicine, New York, New York.
authors.forename: Hayley
authors.initials: H
authors.lastname: Sacks
authors.affiliation: Department of Psychology, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, Massachusetts.
authors.forename: Donna
authors.initials: D
authors.lastname: Pincus
authors.affiliation: Department of Psychology, Mental Health Interventions and Technology (MINT) Program, Florida International University, Miami, Florida.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Comer
mesh_terms: D000293:Adolescent; D000379:Agoraphobia / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology
keywords: agoraphobia; anxiety; assessment; child/adolescent; diagnosis; phobias
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