The DSM-5-TR (Text Revision) does not provide direct definitions for fear, anxiety, and stress in one section but discusses them in the context of anxiety disorders, trauma- and stressor-related disorders, and other psychiatric conditions. Below is a summary based on the DSM-5-TR’s conceptual framework:
Notice: You may want to take a look at other posts with the same topic:
(1) Psychological Concepts: Fear, Stress, and Anxiety
(2) Psychological Concepts: The Connection between Fear, Stress, and Anxiety
(3) Psychological Concepts: Feedback Loop
1. Fear (Immediate Emotional Response)
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DSM-5-TR Definition (Implied in Anxiety Disorders Chapter):
- Fear is an emotional response to an imminent threat, whether real or perceived.
- It is associated with autonomic arousal, triggering fight-or-flight responses.
- It is often tied to specific phobias and panic attacks, where the body reacts as if a severe threat is present.
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Clinical Relevance in DSM-5-TR:
- Fear is central to disorders such as Specific Phobia and Panic Disorder, where exposure to the feared stimulus leads to an intense autonomic response.
2. Anxiety (Anticipatory Emotional State)
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DSM-5-TR Definition (Anxiety Disorders Chapter):
- Anxiety is the anticipation of a future threat, leading to excessive worry and behavioral avoidance.
- Unlike fear, anxiety is not necessarily tied to an immediate external stimulus and is more persistent and pervasive.
- It is associated with muscle tension, vigilance, and avoidance behaviors.
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Clinical Relevance in DSM-5-TR:
- Anxiety underlies disorders such as Generalized Anxiety Disorder (GAD), Social Anxiety Disorder, and Panic Disorder.
- Anxiety-related avoidance behaviors contribute to functional impairments in daily life.
3. Stress (Response to External Pressures)
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DSM-5-TR Perspective:
- Stress itself is not classified as a disorder in the DSM-5-TR.
- However, stress is a key component of Trauma- and Stressor-Related Disorders, such as Post-Traumatic Stress Disorder (PTSD) and Adjustment Disorders.
- Stress responses involve activation of the hypothalamic-pituitary-adrenal (HPA) axis, leading to physiological and emotional strain.
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Clinical Relevance in DSM-5-TR:
- The DSM-5-TR includes “stressor” as a necessary component in disorders like PTSD and Adjustment Disorders, meaning that these conditions arise due to exposure to an identifiable stressor or traumatic event.
- Chronic stress can contribute to the development of mood and anxiety disorders.
Key Takeaways from DSM-5-TR
| Concept | Definition | DSM-5-TR Context | Related Disorders |
|---|---|---|---|
| Fear | Emotional response to real or perceived imminent danger | Immediate fight-or-flight reaction | Specific Phobias, Panic Disorder |
| Anxiety | Anticipation of a future threat, leading to excessive worry and avoidance | Persistent and future-oriented | Generalized Anxiety Disorder, Social Anxiety Disorder, Panic Disorder |
| Stress | Response to external demands or pressures, often triggering HPA activation | Can lead to trauma- and stressor-related disorders if prolonged | PTSD, Adjustment Disorder |
