Mental health provider knowledge and attitudes toward diagnosing anxiety disorders in the Veterans Health Administration

Abstract: Clinical practice guidelines indicate treatments for specific anxiety diagnoses. Misdiagnosing specific anxiety disorders as unspecified anxiety may prevent patients from receiving appropriate care. Provider knowledge and attitudes may influence diagnostic practices. This study evaluated provider knowledge of diagnostic criteria for anxiety disorders and attitudes toward diagnostic processes and the relevance of diagnosis to patients' treatment. This qualitative analysis of interviews included 32 Veterans Health Administration providers in Primary Care Behavioral Health and Specialty Mental Health. Interview guides were created using a framework that outlines barriers regarding provider knowledge, attitudes, and behaviors as they pertain to following clinical practice guidelines. Most providers described themselves as familiar with diagnostic criteria for anxiety disorders and discussed consulting the Diagnostic and Statistical Manual of Mental Disorders if unsure about criteria. Providers were divided on the relevance of diagnostic specificity to a patient's treatment plan and outcomes. In the Veterans Health Administration, providers across different settings, roles, and tendency toward assigning specific diagnosis disagree on the relevance of diagnostic specificity for a patient's treatment and outcomes. Future research should seek to understand this divide and evaluate methods for optimizing a patient's likelihood of receiving a proper, accurate diagnosis.

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