DSM-5 Case Studies Practice Test

The pattern here centers on a child who experiences intense fear and anxiety specifically about being separated from her attachment figures, along with worry about harm befalling them, and physical symptoms or nightmares when separation is anticipated. This constellation lasting at least four weeks in a child is exactly what separates a normal occasional fear of separation from a clinical separation anxiety disorder, which involves distress or impairment in daily functioning tied to separation from trusted caregivers. Why this fits best: the anxiety is clearly anchored to separation from attachment figures, not to a wide range of worries or to a nonspecific fear. The presence of nightmares about separation and physical symptoms when anticipating separation further supports an anxiety pattern focused on separation, and the duration criterion confirms it meets the clinical threshold for a child. Why the other options don’t fit as well: generalized anxiety disorder would involve pervasive worry across multiple domains (school, health, performance) for a longer period and with broader symptoms, not a primary focus on separation from caregivers. a specific phobia centers on a fear of a particular object or situation (like animals, heights, or flying), not the broader fear of separation itself. selective mutism is defined by consistent failure to speak in specific social settings despite speaking in other situations, which is not described here—the issue is anxiety about separation, not inability or reluctance to speak.