| ANXIETY DISORDERS | |
| Generalized anxiety disorder |
Patient will present as → a 33-year-old accountant with 8 months of uncontrollable worry about work, finances, and her children’s health, with restlessness, muscle tension, and poor sleep. She “can’t remember the last time she felt relaxed,” and her TSH is normal. Excessive worry about MULTIPLE domains, more days than not, for ≥ 6 months
DX: DSM-5 — excessive anxiety and worry, difficult to control, more days than not for ≥ 6 months, with ≥ 3 of 6 somatic symptoms and functional impairment
TX: SSRI or SNRI first-line + CBT
|
| Panic disorder |
Patient will present as → a 24-year-old woman with recurrent, out-of-the-blue episodes of palpitations, chest pain, dyspnea, and fear of dying that peak within minutes. ECG, troponin, and TSH are normal, and she now avoids driving for fear of another attack. Recurrent UNEXPECTED panic attacks + ≥ 1 month of worry about further attacks or maladaptive behavior change
DX: DSM-5 — recurrent unexpected panic attacks, with ≥ 1 month of persistent worry about further attacks or maladaptive behavior change
TX: SSRI first-line + CBT
|
| Phobic disorders |
Patient will present as → a 28-year-old who fears and avoids a specific trigger — flying for one patient, public speaking for another — with immediate anxiety on exposure and insight that the fear is excessive. Excessive, persistent fear of a specific object, situation, or activity — with avoidance out of proportion to the danger
DX: DSM-5 — marked fear or anxiety, provoked immediately by the trigger, avoided or endured with intense distress, out of proportion, lasting ≥ 6 months
TX: Exposure-based CBT first-line
|
| Separation anxiety disorder |
Patient will present as → a 7-year-old girl with stomachaches and headaches every school morning that vanish on weekends. She refuses sleepovers, follows her mother from room to room, and fears “something bad will happen to Mom” while they are apart. Pediatric workup is normal. Recurrent physical complaints timed to separations (school mornings) with a normal medical workup
DX: DSM-5 — developmentally inappropriate, excessive fear of separation from attachment figures with ≥ 3 of 8 symptoms (distress at separation · worry about losing attachment figures · worry an event causes separation · school refusal · fear of being alone · refusal to sleep away · separation nightmares · somatic complaints)
TX: CBT first-line — graded separations with parent coaching (stop accommodating avoidance)
|
| Social anxiety disorder |
Patient will present as → a college student who avoids presentations, dating, and eating in public for the past year, terrified she will embarrass herself in front of others. Her grades are slipping because she cannot join required seminars. Marked fear of scrutiny by others — public speaking, eating in public, meeting strangers — lasting ≥ 6 months
DX: DSM-5 — marked fear of ≥ 1 social situation with possible scrutiny, almost always provoking anxiety, avoided or endured with distress, out of proportion, ≥ 6 months
TX: SSRI/SNRI + CBT first-line
|
| Specific phobias |
Patient will present as → a 30-year-old man who faints at the sight of needles — anxiety begins the moment a blood draw is mentioned, and he has skipped recommended labs for years to avoid it. Excessive, persistent fear of a specific object or situation with IMMEDIATE anxiety on exposure, ≥ 6 months
DX: DSM-5 — marked fear or avoidance of a specific object/situation, immediate anxiety on exposure, out of proportion, ≥ 6 months, with impairment
TX: Exposure-based CBT first-line
|
| TRAUMA- AND STRESS-RELATED DISORDERS | |
| Acute stress disorder |
Patient will present as → a 35-year-old with nightmares, flashbacks, and hypervigilance 2 weeks after a motor vehicle collision, feeling detached and “in a fog,” avoiding driving past the intersection where it happened. Same symptoms as PTSD, but lasting 3 days to 1 month after the trauma
DX: DSM-5 — trauma exposure + ≥ 9 of 14 symptoms across intrusion, negative mood, dissociation, avoidance, and arousal clusters, lasting 3 days to 1 month
TX: Trauma-focused CBT — reduces progression to PTSD
|
| Post-traumatic stress disorder |
Patient will present as → a 31-year-old combat veteran with 4 months of nightmares and flashbacks, avoiding crowds and news coverage, on edge with an exaggerated startle, and feeling emotionally detached from his family. Trauma + ≥ 1 month of intrusion, avoidance, negative mood/cognition, and hyperarousal
DX: DSM-5 — trauma exposure + symptoms from all 4 clusters: ≥ 1 intrusion · ≥ 1 avoidance · ≥ 2 negative cognition/mood · ≥ 2 arousal, lasting > 1 month with impairment
TX: Trauma-focused psychotherapy first-line (CPT, prolonged exposure, EMDR) and/or SSRIs/SNRIs (sertraline, paroxetine, venlafaxine)
|
| Adjustment disorders |
Patient will present as → a 45-year-old man tearful and unable to focus at work for 6 weeks after losing his job. Symptoms began within a month of the layoff and are out of proportion, but he does not meet criteria for a major depressive episode. Disproportionate response to an identifiable stressor — beginning within 3 months, resolving within 6 months of the stressor's end
DX: DSM-5 — emotional or behavioral symptoms within 3 months of a stressor, out of proportion to it or functionally impairing
TX: Psychotherapy is the treatment
|
| Bereavement |
Patient will present as → a widow who tears up in waves when reminded of her husband, sometimes hears his voice, but keeps her self-esteem, accepts support, and is slowly resuming her routine. Grief comes in WAVES triggered by reminders — with preserved self-esteem
DX: Clinical — distinguish normal grief from a major depressive episode and from prolonged grief disorder
TX: Support and time — no medication for normal grief
|
| Prolonged grief disorder |
Patient will present as → a mother still consumed by daily yearning for her son well over a year after his death — “part of me died with him.” She avoids anything that reminds her of him and feels life is meaningless. Intense yearning or preoccupation with the deceased, nearly every day, ≥ 12 months after the death (≥ 6 months in children)
DX: DSM-5-TR — ≥ 12 months since the death (≥ 6 months in children) + intense yearning/preoccupation nearly daily + ≥ 3 of 8 accompanying symptoms
TX: Grief-targeted psychotherapy (complicated grief therapy) — more effective than antidepressants for the grief itself
|
| Reactive attachment disorder |
Patient will present as → a 3-year-old girl recently placed in foster care after removal from a home with severe neglect. She is withdrawn and watchful, does not seek or respond to comfort when she scrapes her knee, and shows little positive emotion. Developmental screening excludes autism. A neglected child who is emotionally withdrawn and rarely seeks or responds to comfort when distressed
DX: DSM-5 — inhibited, emotionally withdrawn behavior toward caregivers (rarely seeks AND rarely responds to comfort) + ≥ 2 of: minimal responsiveness · limited positive affect · unexplained irritability/fearfulness
TX: One consistent, emotionally available caregiver + dyadic caregiver-child therapy — the caregiving environment IS the treatment
|
Psychiatry EOR: Anxiety Disorders; Trauma and Stress Related Disorders (Pearls)
📌 2026 blueprint note: On the updated (July 2026) exam, this content spans two areas — Trauma and Stress-Related Disorders; Abuse and Neglect (PTSD, acute stress, adjustment, grief, reactive attachment — pair with the Abuse & Neglect Pearls) and Anxiety; Somatic Symptom and Related Disorders (GAD, panic, phobias, social and separation anxiety — pair with the Somatic Symptom Pearls). Testing on the legacy (pre-July 2026) exam? This page still matches your Anxiety Disorders; Trauma- and Stress-Related Disorders area exactly.
Flashcards ready when you areYou have opened several Quizlet sets recently. Loading this one only when needed helps prevent a temporary Quizlet limit.