A client reports experiencing recurrent, sudden episodes of intense fear, sweating, and a sense of impending doom. These episodes are often accompanied by feelings of unreality or detachment from the self. The client describes avoiding situations where these episodes might occur. Which anxiety disorder is the client most likely experiencing?
On the social work licensing exam, you’ll get three of four options to choose from. Here, for learning/review, are the whole lot of DSM anxiety disorders plus some crucial close-call differentials worth your time. (We’ll revisit the question at the end of the post.)
- Generalized Anxiety Disorder (GAD): This disorder involves excessive and uncontrollable worry about a variety of everyday things, often accompanied by physical symptoms such as restlessness, muscle tension, and fatigue.
- Panic Disorder: People with panic disorder experience recurring panic attacks, which are sudden and intense episodes of fear or discomfort. These attacks often come without warning and can be accompanied by symptoms like rapid heart rate, sweating, trembling, and a fear of losing control or dying.
- Agoraphobia: Agoraphobia is often associated with panic disorder. It involves an intense fear and avoidance of situations where escape may be difficult or help may not be available in the event of a panic attack. This can lead to significant impairment in a person's daily life.
- Specific Phobia: This disorder involves an intense and irrational fear of a specific object or situation, such as heights, spiders, or flying. The fear is so severe that it leads to avoidance of the phobic stimulus.
- Social Anxiety Disorder (Social Phobia): People with social anxiety disorder have an intense fear of social situations in which they may be scrutinized or judged by others. This fear can lead to avoidance of social interactions and significant distress.
- Selective Mutism: Involves a consistent inability to speak in specific social situations (e.g., at school) despite speaking normally in other situations. It often occurs in response to social anxiety and usually begins in childhood.
- Separation Anxiety Disorder: Typically seen in children, this disorder involves excessive anxiety about separation from attachment figures, such as parents or caregivers. It can lead to reluctance or refusal to go to school or leave home.
- Substance/Medication-Induced Anxiety Disorder: Anxiety symptoms can be induced or exacerbated by substance abuse or withdrawal from certain substances, such as drugs or medications.
- Anxiety Disorder Due to Another Medical Condition: Anxiety symptoms can also be attributed to a medical condition, such as thyroid disorders or cardiovascular problems.
- Other Specified Anxiety Disorder and Unspecified Anxiety Disorder: These categories are used when the specific anxiety disorder does not fit into one of the above categories or when the symptoms do not meet the criteria for a specific disorder but still cause significant distress or impairment.
Some anxiety diagnoses share common symptoms with other diagnoses and can be difficult to differentiate. ASWB exam question writers may be expected to hone in on them, so they’re a good idea to think through:
- Generalized Anxiety Disorder (GAD) vs. Panic Disorder:
- GAD involves excessive worry about various aspects of life, whereas panic disorder is characterized by sudden and intense panic attacks. Some people with GAD may also experience panic attacks, making the distinction more complex.
- Generalized Anxiety Disorder (GAD) vs. Major Depressive Disorder (MDD):
- Both GAD and MDD can involve symptoms like fatigue, irritability, and concentration difficulties. The key difference is that GAD primarily centers around excessive worry, while MDD focuses on persistent low mood and loss of interest.
- Social Anxiety Disorder vs. Avoidant Personality Disorder:
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- Both conditions involve discomfort in social situations. However, social anxiety disorder is primarily characterized by excessive fear of negative evaluation, while avoidant personality disorder reflects a pervasive pattern of social inhibition and feelings of inadequacy.
- Obsessive-Compulsive Disorder (OCD) vs. Obsessive-Compulsive Personality Disorder (OCPD):
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- OCD involves intrusive, distressing thoughts (obsessions) and repetitive behaviors (compulsions) aimed at reducing anxiety. OCPD, on the other hand, is a personality disorder characterized by perfectionism, rigidity, and a preoccupation with rules and order, which can be mistaken for obsessive-compulsive traits.
- Specific Phobia vs. Panic Disorder with Agoraphobia:
- Both can involve avoidance behavior, but specific phobia is limited to a specific object or situation (e.g., spiders), while panic disorder with agoraphobia includes a fear of being in situations where escape might be difficult (e.g., open spaces) due to potential panic attacks.
- Post-Traumatic Stress Disorder (PTSD) vs. Acute Stress Disorder (ASD):
- ASD and PTSD both stem from exposure to trauma, but the difference lies in duration. ASD symptoms occur within three days to four weeks following a trauma, while PTSD symptoms persist for at least a month.
- Separation Anxiety Disorder vs. Normal Separation Anxiety in Children:
- It can be challenging to distinguish between normal separation anxiety experienced by children when away from their caregivers and separation anxiety disorder, which is excessive and age-inappropriate.
- Somatic Symptom Disorder vs. Generalized Anxiety Disorder:
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- Both disorders can involve physical symptoms and excessive worry about health. The key difference is that somatic symptom disorder is primarily characterized by preoccupation with physical symptoms, while GAD encompasses a broader range of worries.
Got it? Great. Back to the question.
A client reports experiencing recurrent, sudden episodes of intense fear, sweating, and a sense of impending doom. These episodes are often accompanied by feelings of unreality or detachment from the self. The client describes avoiding situations where these episodes might occur. Which anxiety disorder is the client most likely experiencing?
Do you know before narrowing down to four options?
A) Generalized Anxiety Disorder (GAD)
B) Panic Disorder
C) Social Anxiety Disorder
D) Specific Phobia
What’s your answer?
Here’s ours: The client's description of recurrent, sudden episodes of intense fear accompanied by physical symptoms (sweating), and a sense of impending doom is characteristic of Panic Disorder. While other anxiety disorders may involve symptoms of anxiety, Panic Disorder specifically features recurrent, unexpected panic attacks as a central diagnostic criterion.
You’re that much more ready to go pass the social work exam.
Want to really prepare? Get started now with SWTP’s full length practice tests. You’ll be glad you did.
Happy studying and good luck on the exam!
September 8, 2023
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