The current conceptualization of anxiety in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)-which includes 11 anxiety disorders plus additional anxiety-related conditions-does not align with accumulating evidence that anxiety is transdiagnostic and dimensional in nature. Transdiagnostic dimensional anxiety models have been proposed, yet they measure anxiety at either a very broad (e.g., "anxiety") or very narrow (e.g., "performance anxiety") level, overlooking intermediate properties of anxiety that cut across DSM disorders. Using indicators from a well-validated semistructured interview of anxiety-related disorders, we constructed intermediate-level transdiagnostic dimensions representing the intensity, avoidance, pervasiveness, and onset of anxiety. We captured these content-agnostic dimensions in a sample representing varying levels and forms of anxiety (N = 268), including individuals with generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, specific phobia, separation anxiety disorder, posttraumatic stress disorder, and obsessive-compulsive disorder (n = 205) and individuals with no psychopathology (n = 63). In preregistered analyses, our dimensional anxiety model showed noninferiority to DSM-5 diagnoses in predicting concurrent and prospective measures of anxiety-related impairment, anxiety vulnerabilities, comorbid depression, and suicidal ideation. These results held regardless of whether the dimensions were combined into a single composite or retained as separate components. Our transdiagnostic dimensional model offers meaningful gains in parsimony over DSM, with no loss of predictive power. This project provides a methodological framework for the empirical evaluation of other transdiagnostic dimensional models of psychopathology that have been proposed as alternatives to the DSM. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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焦虑的跨诊断、维度分类显示出相对于 DSM 的简约性和预测性非劣效性的改善。

《精神疾病诊断与统计手册》第五版 (DSM-5) 中目前对焦虑的概念化——其中包括 11 种焦虑症以及其他与焦虑相关的病症——与越来越多的证据表明焦虑本质上是跨诊断和维度的并不相符。跨诊断维度焦虑模型已经被提出，但它们在非常广泛（例如“焦虑”）或非常狭窄（例如“表现焦虑”）水平上测量焦虑，忽略了跨越 DSM 障碍的焦虑的中间属性。利用经过充分验证的焦虑相关疾病半结构化访谈的指标，我们构建了代表焦虑强度、回避、普遍性和发作的中级跨诊断维度。我们在代表不同水平和形式焦虑的样本中捕获了这些与内容无关的维度（N = 268），包括患有广泛性焦虑症、社交焦虑症、恐慌症、广场恐惧症、特定恐惧症、分离焦虑症、创伤后应激障碍的个体，和强迫症（n = 205）以及没有精神病理学的个体（n = 63）。在预先注册的分析中，我们的维度焦虑模型在预测焦虑相关障碍、焦虑脆弱性、共病抑郁和自杀意念的同时和前瞻性测量方面显示出不劣于 DSM-5 诊断。无论尺寸是组合成单个复合材料还是保留为单独的组件，这些结果都成立。我们的跨诊断维度模型在简约性方面比 DSM 提供了有意义的收益，并且不损失预测能力。该项目为其他精神病理学跨诊断维度模型的实证评估提供了一个方法框架，这些模型已被提议作为 DSM 的替代方案。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。