A 16-year-old boy presents after several episodes of sudden, intense fear that peak within minutes. During these episodes he experiences palpitations, sweating, trembling, chest tightness, dizziness, and fear of dying. The attacks occur unexpectedly, including once while watching television. He now avoids going out alone due to fear of another attack.

An 11-year-old boy refuses to go to school and becomes distressed whenever his mother leaves the house. He repeatedly worries that something bad will happen to her and complains of abdominal pain and headaches on school mornings. He has frequent nightmares about being separated from his parents. Symptoms have been present for over 2 months.

What is the most likely diagnosis?

A 14-year-old girl avoids speaking in class and refuses to attend social gatherings. She reports intense fear of being judged or embarrassed by peers. In social situations, she becomes visibly anxious, freezes, and sometimes cries. Symptoms have persisted for more than 6 months and have led to declining academic participation.

What is the most likely diagnosis?

A 13-year-old boy has an intense fear of dogs. When he sees a dog, he experiences immediate fear with sweating and trembling. He avoids parks and friends’ houses where dogs may be present. He recognizes that his fear is excessive but cannot control it. Symptoms have been present for over 6 months.

What is the most likely diagnosis?

A 15-year-old boy is brought to the clinic by his school counselor for repeated behavioral problems. Over the past 18 months, he has:

• Frequently initiated physical fights

• Bullied younger students

• Stolen money from classmates

• Deliberately damaged school property
  He shows little remorse, blames others for his behavior, and has been suspended multiple times. There is no history of mood symptoms, hallucinations, or substance intoxication at the time of incidents.

What is the most likely diagnosis?

A 10-year-old boy is brought by his parents for behavioral concerns at home and school. For the past 8 months, he has:

• Frequently argued with adults

• Actively refused to follow rules

• Often lost his temper

• Blamed others for his mistakes

He has not engaged in physical fights, theft, or property destruction. His academic performance is appropriate for age.

What is the most likely diagnosis?

A 10-year-old boy is evaluated for poor school performance. Teachers report that he:

• Is easily distracted

• Frequently leaves his seat

• Interrupts others

• Fails to complete tasks

Symptoms are present in both school and home, started before age 7, and there is no aggression or deliberate rule-breaking.

What is the most likely diagnosis?

A 14-year-old boy presents with recurrent episodes of sudden, intense anger resulting in:

• Verbal aggression

• Throwing objects

• Physical outbursts

The episodes are brief, impulsive, and out of proportion to the trigger. Between episodes, he behaves normally and feels remorseful afterward. There is no ongoing pattern of rule-breaking.

What is the most likely diagnosis?