DSM-IV-TR® Handbook of Differential Diagnosis Chapter 2. Differential Diagnosis by the Trees > Trees Based on Presenting Symptoms > Decision Tree for Anxiety Topics Discussed: adjustment disorder; anxiety; panic attacks; post-traumatic stress disorder; stress disorders, traumatic, acute. Excerpt: "See Decision Tree. As is always the case, the first step in the differential diagnosis is to rule out a general medical condition or substance use as the direct physiological cause of the anxiety. When the anxiety occurs in discrete episodes with a sudden onset and is accompanied by a number of somatic (e.g., palpitations, shortness of breath, dizziness) and cognitive symptoms (e.g., fear of going crazy or having a heart attack), it is diagnosed as a "panic attack." Because of the specific treatment implications of panic attacks, a separate decision tree is also provided for them (see Decision Tree for Panic Attacks).The remaining differential steps in this tree are determined by the content of the anxiety. It is important in the assessment to determine what the individual is afraid of, the situations that are avoided, and whether the anxiety is in response to a stressor. In Panic Disorder, With or Without Agoraphobia, the anxiety is related to the fear of having additional panic attacks and the possible consequences of these attacks. Agoraphobia Without History of..." DOI: 10.1176/appi.books.9781585622658.119073 The content above is only an excerpt. For full access subscribe now or log into your account below. You can also purchase 24- or 48-hour access; learn more Username: Password:   FORGOT your subscriber username and/or password? Get a reminder via email: The email I registered with is:  Not a subscriber? Subscribe Today PsychiatryOnline is a powerful website that features DSM-IV-TR® and The American Journal of Psychiatry as the cornerstones of an unsurpassed collection of psychiatric references, including books, journals, and self-assessment tools. PsychiatryOnline’s innovative platform makes these resources easy and convenient to use, offering Precise and powerful searching across books and journals. Quick pathways to related material. Mobile access from any computer with a Web connection. Ability to download any book section to PDA. Links from bibliographic references to the full text of journal articles. References to material not located in the PsychiatryOnline collection lead you to PubMed. Learn more about PsychiatryOnline Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).