Question

tisha has been worrying and has had difficulty concentrating for over a year. in addition, she often feels dizzy and irritable. tisha is considering psychotherapy but wonders if it is appropriate, since she has not had panic attacks and still goes to work. her work performance has suffered, however, and her boss has spoken to her about it.

tisha is likely experiencing which of the following?

panic disorder (with agoraphobia)
generalized anxiety disorder
obsessive-compulsive disorder
agoraphobia (without panic disorder)

Explanation:

Analyze the clinical presentation

Tisha presents with chronic worry and concentration difficulties lasting over a year. She also experiences physical symptoms including dizziness and irritability.

Evaluate DSM-5 duration criteria

Generalized anxiety disorder (GAD) requires excessive anxiety and worry occurring more days than not for at least 6 months. Tisha's symptoms have persisted for over a year, satisfying this timeline.

Assess associated physical symptoms

GAD requires at least three associated somatic or cognitive symptoms (one for children). Tisha exhibits difficulty concentrating, irritability, and dizziness (muscle tension/restlessness/sleep disturbance are also common), which align with GAD.

Rule out alternative diagnoses

• Panic disorder: Ruled out because Tisha explicitly states she has not had panic attacks.
• Obsessive-compulsive disorder: There is no mention of obsessions (intrusive, unwanted thoughts) or compulsions (repetitive behaviors).
• Agoraphobia: Ruled out because she still goes to work and there is no reported fear of public spaces or difficulty escaping.

Formulate diagnostic conclusion

Tisha's persistent, generalized worry and physical symptoms in the absence of panic attacks or situational phobias point directly to Generalized Anxiety Disorder.

Answer:

• (A) Panic disorder (with agoraphobia)
• (B) Generalized anxiety disorder (Correct answer)
• (C) Obsessive-compulsive disorder
• (D) Agoraphobia (without panic disorder)