Rosh Psychiatry Board Practice Exam

What behavior suggests panic disorder in a patient experiencing intense fear episodes?

1. Avoiding crowds and social events

2. Avoiding travel longer than five miles

3. Avoiding going outdoors

4. Avoiding being away from her husband

The correct answer is: Avoiding travel longer than five miles

The behavior that suggests panic disorder in a patient experiencing intense fear episodes is avoidance, particularly in relation to situations that may trigger a panic attack. In this scenario, avoiding travel longer than five miles indicates a specific fear or anxiety about being in situations away from home where a panic attack might occur. Patients with panic disorder often develop agoraphobia, where they avoid places or situations that feel unsafe or where escape may be difficult, leading to limited mobility and increased dependence on familiar environments. The avoidance of longer travel distances might be tied to a perception that being far from a safe space (like home) would trigger fear or anxiety about potential panic attacks, reinforcing the notion of panic disorder. While the other behaviors listed also indicate anxiety and avoidance, they may not be as directly linked to the specific nature of panic attacks themselves or the potential severity of symptoms that arise during those episodes.