EVALUATION OF THE RATINGS COMPRISING THE ASSOCIATED SYMPTOM CRITERIONOF DSM-III-R GENERALIZED ANXIETY DISORDER

In light of ongoing considerations for DSM-IV, the 18 ratings comprisi ng the associated symptom criterion of DSM-III-R generalized anxiety d isorder were evaluated. The interrater reliability and endorsement rat es of each symptom were calculated from interview-based ratings of gen eralized anxiety disorder patients at four sites (total N = 204). Inte rrater reliability analyses indicated high agreement for the majority of the 18 symptoms. Regarding the frequency of symptom endorsement, si gnificant Spearman correlations range = .69 to .94) revealed marked co nsistency in the rates of symptom endorsement across the four sites. A list of ''satisfactory'' symptoms was generated from those meeting ce rtain reliability and endorsement criteria. Seven symptoms were identi fied: irritability, restlessness, muscle tension, difficulty concentra ting, sleep difficulties, feeling keyed up, and easy fatigability. Int erestingly, all of the above belong to either the motor tension or vig ilance and scanning clusters of the DSM-III-R associated symptom ratin gs. In contrast, symptoms belonging to the autonomic hyperactivity clu ster were endorsed infrequently at all sites. Although additional rese arch is needed (e.g., examination of the symptoms' discriminant validi ty), these findings essentially support revising the associated sympto m criterion of generalized anxiety disorder in accord with option E3 i n the DSM-IV Options Book.