Welcome back to MasterUSMLE, where we break down high-yield Step 2 CK concepts in a way that sticks. Today, we’re tackling anxiety and trauma-related disorders—some of the most commonly tested psychiatric conditions.
- Excessive, persistent worry about multiple aspects of life (work, health, finances).
- Lasts ≥6 months with symptoms like fatigue, restlessness, muscle tension, and irritability.
- Key distinction: Worry is generalized, not tied to a specific object or situation.
- Recurrent, unexpected panic attacks (sudden episodes of intense fear with no clear trigger).
- Diagnostic criteria: After an attack, the patient has ≥1 month of:
- Key distinction: Panic attacks occur spontaneously without an identifiable trigger.
- Intense fear of a specific object or situation (e.g., flying, heights, animals, blood).
- Avoidance behavior reinforces the anxiety.
- Key distinction: Anxiety occurs only in response to the feared stimulus and is disproportionate to the actual danger.
- Fear of situations where escape may be difficult (public transportation, crowded spaces, enclosed places).
- Often associated with panic disorder due to fear of having an attack in public.
- Key distinction: Avoidance involves multiple situations, not just one phobic stimulus.
- Fear of social interactions due to concern about embarrassment or negative evaluation.
- Common triggers: Public speaking, eating in public, social gatherings.
- Key distinction: Fear is tied to social scrutiny, not a specific object or place.
- Both follow a traumatic event (e.g., assault, combat, accidents).
- Duration is the key difference:
- Shared Symptoms:
- Emotional or behavioral distress in response to a stressor, but does not meet criteria for other psychiatric disorders.
- Symptoms resolve within 6 months after the stressor ends.
- Key distinction: Less severe than ASD/PTSD and directly tied to a recent identifiable stressor.
✔ Panic disorder = sudden, unexpected panic attacks + persistent worry/avoidance for ≥1 month.
✔ GAD = excessive worry about multiple life areas for ≥6 months.
✔ Specific phobia = fear of a single object/situation → Avoidance.
✔ Agoraphobia = fear of being trapped in multiple public spaces.
✔ Social anxiety disorder = fear of embarrassment in social settings.
✔ PTSD vs. ASD = PTSD lasts >1 month; ASD resolves within 1 month.
✔ Adjustment disorder = emotional distress from a stressor, but symptoms resolve within 6 months.
Recognizing the differences between these disorders is key for both the exam and clinical practice.
That’s it for today! Stay focused, keep practicing, and master the USMLE.
Comparing Anxiety & Trauma Disorders1. Generalized Anxiety Disorder (GAD)2. Panic Disorder3. Specific Phobia4. Agoraphobia5. Social Anxiety Disorder (SAD)Trauma & Stress-Related Disorders6. Acute Stress Disorder (ASD) vs. Post-Traumatic Stress Disorder (PTSD)7. Adjustment DisorderUSMLE High-Yield Takeaways
