CMN 552 Advanced Psychiatric Nursing – Module 2 Primary
Study Guide (Anxiety Disorders, DSM 5 Updates, University of
South Alabama).pdf
Questions
Q1. What is the DSM-5 diagnostic criteria for agoraphobia?
A) Marked fear of a single situation, such as public transportation
B) Marked and disproportionate fear when confronted with at least two different
situations (e.g., open spaces, public transport, crowds), avoidance behaviors,
symptoms lasting at least six months
C) Panic attacks occurring in multiple settings with no specific trigger
D) Fear of social situations where scrutiny by others may occur
Answer-: B) Marked and disproportionate fear when confronted with at least
two different situations (e.g., open spaces, public transport, crowds), avoidance
behaviors, symptoms lasting at least six months
Rationale: DSM-5 requires fear of at least two different situations (open spaces,
public transport, enclosed places, crowds, or being outside home alone), an
immediate anxiety response, avoidance behaviors, and symptoms persisting for
≥6 months .
Q2. What are the psychiatric differential diagnoses for agoraphobia?
A) Bipolar disorder and ADHD
B) Major depressive disorder, schizophrenia, paranoid personality disorder,
avoidant personality disorder, dependent personality disorder
C) Substance use disorders and eating disorders
D) Panic disorder only
,Answer-: B) Major depressive disorder, schizophrenia, paranoid personality
disorder, avoidant personality disorder, dependent personality disorder
Rationale: Agoraphobia must be differentiated from conditions where avoidance
may occur secondary to other psychopathology, including MDD (lack of
motivation), schizophrenia (paranoid ideation), and personality disorders
characterized by dependency or avoidance .
Q3. What pharmacological treatments are used for agoraphobia?
A) Antipsychotics only
B) Benzodiazepines (most rapid acting: alprazolam, lorazepam, clonazepam);
SSRIs (more tolerable, fewer side effects); TCAs (if SSRIs fail, titrate over 8-12
weeks)
C) Mood stabilizers only
D) Stimulant medications
Answer-: B) Benzodiazepines (most rapid acting: alprazolam, lorazepam,
clonazepam); SSRIs (more tolerable, fewer side effects); TCAs (if SSRIs fail,
titrate over 8-12 weeks)
Rationale: Benzodiazepines provide rapid symptom relief but should be avoided
in patients with substance abuse history. SSRIs are first-line due to better
tolerability. TCAs are second-line options requiring slow titration .
Q4. What psychotherapeutic treatments are used for agoraphobia?
A) Psychoanalysis only
B) Supportive, insight-oriented, behavioral, cognitive, and visual therapies
C) Electroconvulsive therapy
D) Hypnosis only
Answer-: B) Supportive, insight-oriented, behavioral, cognitive, and visual
therapies
Rationale: Multiple therapeutic approaches are effective, including cognitive-
behavioral therapy (CBT), exposure therapy, and supportive psychotherapy to
address avoidance behaviors and underlying cognitions .
,Q5. What are the relevant epidemiological characteristics of specific phobias?
A) Equal in males and females, onset in childhood
B) Lifetime prevalence 10%, female-to-male ratio 2:1, peak onset for
natural/environmental and blood types at age 5-9, situational type onset in mid-
20s
C) More common in males, onset after age 40
D) Lifetime prevalence 25%, onset in adolescence
Answer-: B) Lifetime prevalence 10%, female-to-male ratio 2:1, peak onset for
natural/environmental and blood types at age 5-9, situational type onset in
mid-20s
Rationale: Specific phobias affect approximately 10% of the population with 2:1
female predominance. Different subtypes have characteristic age of onset
patterns .
Q6. What are the psychodynamic aspects of phobias?
A) Unresolved grief
B) Oedipal conflicts, separation anxiety, and shame
C) Neurotransmitter imbalance only
D) Genetic predisposition only
Answer-: B) Oedipal conflicts, separation anxiety, and shame
Rationale: Psychodynamic theory views phobias as resulting from unconscious
conflicts, particularly Oedipal issues, separation anxiety, and shame, with the
phobic object symbolically representing the true source of anxiety .
Q7. What is a counterphobic attitude?
A) Avoiding all feared situations
B) Actively challenging fear, such as rock climbing to overcome fear of heights
C) Taking medication to reduce anxiety
D) Seeking reassurance from others
, Answer-: B) Actively challenging fear, such as rock climbing to overcome fear of
heights
Rationale: Counterphobic attitude involves actively confronting and challenging
feared situations as a defense mechanism against anxiety .
Q8. What are the differential diagnoses for social anxiety disorder (SAD)?
A) Only panic disorder
B) Normal fear and shyness, agoraphobia (another person comforts them), panic
disorder (SOB, dizziness, fear of dying vs. blushing/muscle twitching in SAD),
avoidant personality disorder, MDD, schizoid personality disorder
C) Only generalized anxiety disorder
D) Only specific phobia
Answer-: B) Normal fear and shyness, agoraphobia (another person comforts
them), panic disorder (SOB, dizziness, fear of dying vs. blushing/muscle
twitching in SAD), avoidant personality disorder, MDD, schizoid personality
disorder
Rationale: Social anxiety disorder must be distinguished from normal shyness and
other conditions where social avoidance occurs for different reasons. Panic
disorder involves fear of panic symptoms, while SAD involves fear of scrutiny .
Q9. What is the pharmacological treatment for social anxiety disorder
associated with performance situations?
A) Antipsychotics only
B) SSRI, benzodiazepines, venlafaxine, buspirone; MAOIs for severe cases
(phenelzine, moclobemide); beta-blockers (atenolol) for performance-related
anxiety; lorazepam, alprazolam PRN
C) Lithium only
D) Stimulants only
Answer-: B) SSRI, benzodiazepines, venlafaxine, buspirone; MAOIs for severe
cases (phenelzine, moclobemide); beta-blockers (atenolol) for performance-
related anxiety; lorazepam, alprazolam PRN
Study Guide (Anxiety Disorders, DSM 5 Updates, University of
South Alabama).pdf
Questions
Q1. What is the DSM-5 diagnostic criteria for agoraphobia?
A) Marked fear of a single situation, such as public transportation
B) Marked and disproportionate fear when confronted with at least two different
situations (e.g., open spaces, public transport, crowds), avoidance behaviors,
symptoms lasting at least six months
C) Panic attacks occurring in multiple settings with no specific trigger
D) Fear of social situations where scrutiny by others may occur
Answer-: B) Marked and disproportionate fear when confronted with at least
two different situations (e.g., open spaces, public transport, crowds), avoidance
behaviors, symptoms lasting at least six months
Rationale: DSM-5 requires fear of at least two different situations (open spaces,
public transport, enclosed places, crowds, or being outside home alone), an
immediate anxiety response, avoidance behaviors, and symptoms persisting for
≥6 months .
Q2. What are the psychiatric differential diagnoses for agoraphobia?
A) Bipolar disorder and ADHD
B) Major depressive disorder, schizophrenia, paranoid personality disorder,
avoidant personality disorder, dependent personality disorder
C) Substance use disorders and eating disorders
D) Panic disorder only
,Answer-: B) Major depressive disorder, schizophrenia, paranoid personality
disorder, avoidant personality disorder, dependent personality disorder
Rationale: Agoraphobia must be differentiated from conditions where avoidance
may occur secondary to other psychopathology, including MDD (lack of
motivation), schizophrenia (paranoid ideation), and personality disorders
characterized by dependency or avoidance .
Q3. What pharmacological treatments are used for agoraphobia?
A) Antipsychotics only
B) Benzodiazepines (most rapid acting: alprazolam, lorazepam, clonazepam);
SSRIs (more tolerable, fewer side effects); TCAs (if SSRIs fail, titrate over 8-12
weeks)
C) Mood stabilizers only
D) Stimulant medications
Answer-: B) Benzodiazepines (most rapid acting: alprazolam, lorazepam,
clonazepam); SSRIs (more tolerable, fewer side effects); TCAs (if SSRIs fail,
titrate over 8-12 weeks)
Rationale: Benzodiazepines provide rapid symptom relief but should be avoided
in patients with substance abuse history. SSRIs are first-line due to better
tolerability. TCAs are second-line options requiring slow titration .
Q4. What psychotherapeutic treatments are used for agoraphobia?
A) Psychoanalysis only
B) Supportive, insight-oriented, behavioral, cognitive, and visual therapies
C) Electroconvulsive therapy
D) Hypnosis only
Answer-: B) Supportive, insight-oriented, behavioral, cognitive, and visual
therapies
Rationale: Multiple therapeutic approaches are effective, including cognitive-
behavioral therapy (CBT), exposure therapy, and supportive psychotherapy to
address avoidance behaviors and underlying cognitions .
,Q5. What are the relevant epidemiological characteristics of specific phobias?
A) Equal in males and females, onset in childhood
B) Lifetime prevalence 10%, female-to-male ratio 2:1, peak onset for
natural/environmental and blood types at age 5-9, situational type onset in mid-
20s
C) More common in males, onset after age 40
D) Lifetime prevalence 25%, onset in adolescence
Answer-: B) Lifetime prevalence 10%, female-to-male ratio 2:1, peak onset for
natural/environmental and blood types at age 5-9, situational type onset in
mid-20s
Rationale: Specific phobias affect approximately 10% of the population with 2:1
female predominance. Different subtypes have characteristic age of onset
patterns .
Q6. What are the psychodynamic aspects of phobias?
A) Unresolved grief
B) Oedipal conflicts, separation anxiety, and shame
C) Neurotransmitter imbalance only
D) Genetic predisposition only
Answer-: B) Oedipal conflicts, separation anxiety, and shame
Rationale: Psychodynamic theory views phobias as resulting from unconscious
conflicts, particularly Oedipal issues, separation anxiety, and shame, with the
phobic object symbolically representing the true source of anxiety .
Q7. What is a counterphobic attitude?
A) Avoiding all feared situations
B) Actively challenging fear, such as rock climbing to overcome fear of heights
C) Taking medication to reduce anxiety
D) Seeking reassurance from others
, Answer-: B) Actively challenging fear, such as rock climbing to overcome fear of
heights
Rationale: Counterphobic attitude involves actively confronting and challenging
feared situations as a defense mechanism against anxiety .
Q8. What are the differential diagnoses for social anxiety disorder (SAD)?
A) Only panic disorder
B) Normal fear and shyness, agoraphobia (another person comforts them), panic
disorder (SOB, dizziness, fear of dying vs. blushing/muscle twitching in SAD),
avoidant personality disorder, MDD, schizoid personality disorder
C) Only generalized anxiety disorder
D) Only specific phobia
Answer-: B) Normal fear and shyness, agoraphobia (another person comforts
them), panic disorder (SOB, dizziness, fear of dying vs. blushing/muscle
twitching in SAD), avoidant personality disorder, MDD, schizoid personality
disorder
Rationale: Social anxiety disorder must be distinguished from normal shyness and
other conditions where social avoidance occurs for different reasons. Panic
disorder involves fear of panic symptoms, while SAD involves fear of scrutiny .
Q9. What is the pharmacological treatment for social anxiety disorder
associated with performance situations?
A) Antipsychotics only
B) SSRI, benzodiazepines, venlafaxine, buspirone; MAOIs for severe cases
(phenelzine, moclobemide); beta-blockers (atenolol) for performance-related
anxiety; lorazepam, alprazolam PRN
C) Lithium only
D) Stimulants only
Answer-: B) SSRI, benzodiazepines, venlafaxine, buspirone; MAOIs for severe
cases (phenelzine, moclobemide); beta-blockers (atenolol) for performance-
related anxiety; lorazepam, alprazolam PRN
