5. Have a hard time concentrating
Difficulty focusing is a prevalent diagnostic criterion throughout DSM-5 categories, particularly among emotional (mood- and anxiety-related) disorders. A considerable body of work has used objective (behavioral) computerized cognitive tests to evaluate cognitive performance in emotional disorders. However, most diagnoses are based on subjective (self-reported; clinician-rated) judgments of symptoms, and little is known about trouble focusing as a symptom. These questions are especially pertinent for generalized anxiety disorder (GAD), which has long been the subject of nosological debates and for which several theoretical models have been proposed that suggest a central role for cognitive impairments (including difficulty concentrating) in the maintenance of psychopathology.
Even in the lack of diagnostic specificity, difficulty focusing may be an essential symptom of GAD. If difficulty concentrating strongly characterizes GAD (i.e., is present at clinically significant levels in the vast majority of GAD cases) or demonstrates incremental utility (i.e., predicts clinical severity beyond variance explained by other symptoms), its inclusion may improve the validity of the GAD diagnosis. More broadly, if trouble focusing represents a mechanism of GAD pathophysiology, it would merit further investigation regardless of its eventual position as a diagnostic criteria.
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