Depress Anxiety. 2015 Jul;32(7):502-8. doi: 10.1002/da.22361. Epub 2015 Apr 4.


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.

Method: 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.

Keywords: agoraphobia; anxiety; assessment; child/adolescent; diagnosis; phobias.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Agoraphobia / classification
  • Agoraphobia / diagnosis*
  • Agoraphobia / physiopathology
  • Child
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Female
  • Humans
  • Male
  • Phobic Disorders / classification
  • Phobic Disorders / diagnosis*
  • Phobic Disorders / physiopathology

Supplementary concepts

  • Phobia, Specific