Doubtless, their understanding of impairment was looser than that of the task force. After all, despite the impairment clause, the anxiety disorder mushroomed; by 2000, it was the third most common psychiatric disorder in America, behind only depression and alcoholism.
为了避免给人以将普通恐惧变成疾病的印象， DSM 的第四版特别增加了一条规定，即社交焦虑行为必须在“造成损害”的情况下才能被诊断为疾病。但谁能确保处方的出具者贯彻这一标准呢？毫无疑问，他们对造成伤害的理解比工作小组要宽松。毕竟，即便在有了这条规定的情况下，焦虑症患者还是急剧增加；到2000年，它已排在抑郁和酗酒之后成为美国的第三大精神疾病。