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 of anxiety.
While anxiety can cause gastrointestinal distress, it is considered a secondary physical manifestation rather than a primary symptom used for diagnosis.
The primary symptoms of anxiety are cognitive (worry), behavioral (nervousness), and motor (restlessness).

Why Other Options Were Wrong

Option B: Nervous behavior, such as fidgeting, irritability, and fearful expressions, is a classic and primary behavioral symptom of anxiety.
Option C: Excessive and uncontrollable worry is a core cognitive feature and a diagnostic criterion for Generalized Anxiety Disorder (GAD).
Option D: Restlessness, described as feeling 'keyed up' or 'on edge,' is a key physiological and motor symptom of anxiety.

Related Visual

An infographic that categorizes the symptoms of anxiety into three groups: Psychological e.g., worry, fear, poor concentration, Behavioral e.g., avoidance, nervous habits, ir...

Clinical Relevance

Nursing practice connection: Use the key finding related to Primary manifestations of anxiety to guide bedside assessment, documentation, and the next nursing action.
Nurses must be able to differentiate between primary anxiety symptoms and somatic complaints to ensure accurate assessment and appropriate intervention.
Patients, especially in certain cultures or age groups (like children and the elderly), may present primarily with somatic symptoms like stomach pain, making it crucial for nurses to probe for underlying anxiety.
What if? If a patient presents only with chronic abdominal pain and all organic causes have been ruled out, a nurse should consider screening for an underlying anxiety disorder as the root cause.

How to Approach the Question

First, identify the negative framing of the question by spotting the keyword 'not'. This means you are looking for the option that does not fit with the others.
Next, recall the core, defining symptoms of anxiety. Think about the psychological, behavioral, and physiological signs.
Evaluate each option against your knowledge of primary anxiety symptoms.
Worry, nervous behavior, and restlessness are all classic, primary signs of anxiety.
Abdominal pain is a physical (somatic) complaint. While it can be caused by anxiety, it's not considered a primary manifestation in the same way as the others.
Therefore, 'Pain abdomen' is the correct answer as it is the exception among the choices.

Concept Tested & Keywords

Concept Tested: Primary manifestations 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 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

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1284-1286, 623-625

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