Rosh Psychiatry Board Practice Exam

A young woman exhibits anxiety at a clinic due to fear of needles. What is the most likely diagnosis?

1. Panic disorder

2. Generalized anxiety disorder

3. Agoraphobia

4. Specific phobia

The correct answer is: Specific phobia

The most likely diagnosis in this scenario is specific phobia. Specific phobia is characterized by an intense, irrational fear of a specific object or situation, which in this case is fear of needles (also known as trypanophobia). Individuals with specific phobias often go to great lengths to avoid their phobic stimuli, and when confronted with it, they may experience significant anxiety. This aligns well with the young woman's reported anxiety at the clinic due to her fear of needles. In contrast, panic disorder involves recurrent and unexpected panic attacks along with persistent concern about having more attacks or behavioral changes related to the attacks. Generalized anxiety disorder is characterized by excessive worry about various aspects of life, rather than a singular focus like a fear of needles. Agoraphobia is primarily the fear of being in situations where escape might be difficult or help unavailable in the event of a panic attack or other incapacitating symptoms, which does not fit this case focused on a specific fear. Thus, given the nature of her fear, a diagnosis of specific phobia is appropriate.