AIIMS Delhi NO - 2018
Psychiatric Nursing
Medium
Which symptom is typically not a primary manifestation in a patient with anxiety?
Appeared in: AIIMS Delhi NO - 2018
Explanation
- Pain in the abdomen is a somatic (physical) symptom, not a core psychological or behavioral feature required for diagnosing an anxiety disorder.
- While anxiety can cause physical manifestations like stomach discomfort, they are considered secondary to the primary cognitive and emotional symptoms (SRC_18531).
- The core, or primary, symptoms of anxiety are psychological (worry), behavioral (nervousness), and motor (restlessness) (SRC_18532).
Why Other Options Were Wrong
- Option B: Nervous behavior, such as fidgeting or an inability to sit still, is a classic and primary behavioral manifestation of anxiety.
- Option C: Worry, specifically excessive and uncontrollable worry about various events or activities, is a hallmark cognitive feature of Generalized Anxiety Disorder and a primary symptom of anxiety in general (SRC_18533).
- Option D: Restlessness, or feeling keyed up or on edge, is a key physiological and motor symptom listed in the diagnostic criteria for anxiety disorders (SRC_18531).
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Primary vs. Somatic Symptoms of Anxiety to guide bedside assessment, documentation, and the next nursing action.
- Nurses must perform a holistic assessment. When a patient presents with physical complaints like abdominal pain, it's crucial to rule out organic causes before attributing them solely to anxiety.
- Recognizing the primary symptoms of anxiety helps in early identification and intervention, preventing the condition from becoming chronic and more debilitating.
- Patient education is key. Nurses can teach patients about the connection between mind and body, explaining how psychological distress can manifest as physical pain, which can help in managing their symptoms.
How to Approach the Question
- First, identify the core of the question. It asks what is NOT a primary symptom of anxiety. This is a negative-framing question.
- Review the options provided: Pain abdomen, Nervous behavior, Worry, and Restlessness.
- Think about the classic definition of anxiety. It's primarily a mental health condition characterized by feelings of worry, fear, and unease.
- Categorize each option. 'Worry' is a cognitive symptom. 'Nervous behavior' and 'Restlessness' are behavioral/motor symptoms. These are all core features of anxiety.
- 'Pain abdomen' is a physical or somatic complaint. While it can be caused by anxiety, it's a physical manifestation rather than a primary psychological symptom.
- The option that stands out as different from the others is 'Pain abdomen'. The other three are all classic, primary signs of anxiety. Therefore, abdominal pain is the symptom that is not a primary manifestation.
Concept Tested & Keywords
- Concept Tested: Primary vs. Somatic Symptoms of Anxiety
- Stem keywords: symptom, anxiety, primary manifestation
- Lead-in keywords: not
- Negative lead-in flag: Question asks for the symptom that is NOT a primary manifestation.
Question ID
Qu_Sspkp-qmT85ETvlsxt8
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1284-1286, 623-625
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 3864-3866
Practise the full AIIMS Delhi NO - 2018
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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