A. A marked and persistent fear of “outsiders” gaining access to policies, processes, or procedures such as the American Psychiatric Association’s process of putting together the fifth edition of the Diagnostic and Statistical Manual (DSM) of Mental Disorders.

The individual with ESD fears that he or she will be “outed” in a way that will be humiliating or embarrassing, such as being accused of having Conflict of Interest Syndrome (COIS); eg, when psychiatrists working on DSM V receive “consultant” fees from pharmaceutical companies that market psychiatric drugs.

B. Exposure to the feared security breach situation almost invariably provokes anxiety, which may take the form of situationally bound or situationally predisposed panic attack.

C. The person recognizes that the fear is excessive or unreasonable, but the fear of losing income outweighs any other concern such as the fear of being labeled a “ secrecy nut” by peers.

D. The feared social or performance situations are endured with a pathological absence of anxiety or distress.

E. The anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships with pharmaceutical companies ONLY if Sen. Grassley has a hearing and “outs” the person in a press release.

Backstory: “DSM psychiatry manual’s secrecy criticized