Anxiety, Obsessive-Compulsive and Trauma-Related Disorders
What this domain tests
This domain tests duration thresholds, the boundary between normal distress and disorder, and first-line psychological treatment. Trauma timing questions recur.
Core rules and concepts
- Panic disorder: recurrent unexpected attacks plus a month of worry or behaviour change; agoraphobia is coded separately.
- GAD: excessive worry across domains for six months or more with somatic symptoms. Social anxiety disorder: six months or more, with a performance-only specifier.
- OCD: obsessions and/or compulsions that consume an hour a day or cause impairment; specifiers for insight (good/fair, poor, absent/delusional) and for tic-related disorder. First-line treatment is exposure and response prevention plus an SSRI, often at higher doses for 8–12 weeks.
- PTSD: exposure to actual or threatened death, serious injury or sexual violence, then four symptom clusters - intrusion, avoidance, negative cognitions and mood, arousal and reactivity - lasting more than one month. Acute stress disorder covers three days to one month. Complex PTSD (ICD-11) adds affect dysregulation, negative self-concept and interpersonal disturbance.
- Treatment: trauma-focused CBT, prolonged exposure and EMDR are first-line; SSRIs are drug first-line. Benzodiazepines should not be used in PTSD.
Worked example
A man has flashbacks and hypervigilance three weeks after a road traffic collision. Because symptoms began within three days and have lasted under a month, this is acute stress disorder, not PTSD. Trauma-focused CBT is offered, with reassessment at one month.
Traps that cost marks
- Diagnosing PTSD before one month has elapsed.
- Calling ordinary worry GAD without the six-month duration.
- Offering only medication for OCD when ERP is the evidence-based core.