Anxiety Disorder

Which of the following disorders is included in the “Anxiety Disorders” chapter

of DSM-5?

• Obsessive-compulsive disorder.

• Posttraumatic stress disorder.

• Acute stress disorder.

• Panic disorder with agoraphobia.

• Separation anxiety disorder.

A 9-year-old boy cannot go to sleep without having a parent in his room. While

falling asleep, he frequently awakens to check that a parent is still there. One

parent usually stays until the boy falls asleep. If he wakes up alone during the

night, he starts to panic and gets up to find his parents. He also reports frequent

nightmares in which he or his parents are harmed. He occasionally calls out

that he saw a strange figure peering into his dark room. The parents usually

wake in the morning to find the boy asleep on the floor of their room. They

once tried to leave him with a relative so they could go on a vacation; however,

he became so distressed in anticipation of this that they canceled their plans.

What is the most likely diagnosis?

• Specific phobia.

• Nightmare disorder.

• Delusional disorder.

• Separation anxiety disorder.

• Agoraphobia.

Which of the following is considered a culture-specific symptom of panic attacks?

• Derealization.

• Headaches.

• Fear of going crazy.

• Shortness of breath.

• Heat sensations

Which of the following statements best describes how panic attacks differ from

panic disorder?

• Panic attacks require fewer symptoms for a definitive diagnosis

• Panic attacks are discrete, occur suddenly, and are usually less severe.

• Panic attacks are invariably unexpected

• Panic attacks represent a syndrome that can occur with a variety of other

  disorders.

• Panic attacks cannot be secondary to a medical condition.

The determination of whether a panic attack is expected or unexpected is ultimately

best made by which of the following?

• Careful clinical judgment.

• Whether the patient associates it with external stress.

• The presence or absence of nocturnal panic attacks.

• Ruling out possible culture-specific syndromes.

• 24-Hour electroencephalographic monitoring.

A 50-year-old man reports episodes in which he suddenly and unexpectedly

awakens from sleep feeling a surge of intense fear that peaks within minutes.

During this time, he feels short of breath and has heart palpitations, sweating,

and nausea. His medical history is significant only for hypertension, which is

well controlled with hydrochlorothiazide. As a result of these symptoms, he

has begun to have anticipatory anxiety associated with going to sleep. What is

the most likely explanation for his symptoms?

• Anxiety disorder due to another medical condition (hypertension).

• Substance/medication-induced anxiety disorder.

• Panic disorder.

• Sleep terrors.

• Panic attacks.

A 65-year-old woman reports being housebound despite feeling physically

healthy. Several years ago, she fell while shopping; although she sustained no

injuries, the situation was so upsetting that she became extremely nervous

when she had to leave her house unaccompanied. Because she has no children

and few friends whom she can ask to accompany her, she is very distressed

that she has few opportunities to venture outside her home. What is the most

likely diagnosis?

• Specific phobia, situational type.

• Social anxiety disorder (social phobia).

• Posttraumatic stress disorder.

• Agoraphobia.

• Adjustment disorder.

A 32-year-old man has regularly experienced panic attacks when out of his

home alone and when on the bus. He now avoids leaving home for fear of experiencing

these attacks. What is the most appropriate diagnosis?

• Panic disorder with agoraphobia.

• Agoraphobia with panic attacks.

• Specific phobia, situational type.

• Two separate disorders: panic disorder and agoraphobia.

• Delusional disorder.

A 35-year-old man is in danger of losing his job because it requires frequent

long-range traveling and for the past year he has avoided flying. Two years

earlier he was on a particularly turbulent flight, and although he was not in

any real danger, he was convinced that the pilot minimized the risk and that

the plane almost crashed. He flew again 1 month later and, despite having a

smooth flight, the anticipation of turbulence was so distressing that he experienced

a panic attack during the flight; he has not flown since. What is the most

appropriate diagnosis?

• Agoraphobia.

• Acute stress disorder.

• Specific phobia, situational type.

• Social anxiety disorder (social phobia).

• Panic disorder.

Which of the following types of specific phobia is most likely to be associated

with vasovagal fainting?

• Animal type.

• Natural environment type.

• Blood-injection-injury type.

• Situational type.

• Other (e.g.,. in children, loud sounds or costumed characters).