Question at position 47 Gary spends much of his day wondering “what if” about catastrophic scenarios. This thought process makes him feel he has control over the situation. However, the lack of any catastrophes only reinforces the “what if?” behavior. Gary would most likely be diagnosed with:obsessive compulsive disordersocial anxiety disordermajor depressiongeneralized anxiety disorder

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The question describes Gary spending much of his day wondering “what if” about catastrophic scenarios, and this rumination gives him a sense of control. However, the absence of catastrophes reinforces the pattern. This pattern is most consistent with a broad, persistent tendency to worry about multiple domains, not tied to a single situation, and typically present for many months.

Option 1: obsessive compulsive disorder. OCD involves intrusive obsessions and/or compulsions that are time-consuming or distressful, often with repetitive rituals or mental acts performed to reduce distress. The scenario here centers on general worry about catastrophes across various contexts rather than repetitive compulsions or specific intrusive images or rituals, so OCD is not the best fit.

Option 2: social anxiety disorder. This disorder is characterized by a marked fear of social or performance situations due to potential embarrassment or scrutiny. Gary’s worry is about catastrophic outcomes in general, not specifically tied to social interactions, so social anxiety disorder does not align with the description.

Option 3: major depression. Depression involves persistent low mood or anhedonia, along with fatigue, changes in sleep or appetite, and other cognitive or physical symptoms. The stem emphasizes pervasive worry about what might happen rather than depressive mood or loss of interest, making major depression unlikely.

Option 4: generalized anxiety disorder. GAD is defined by excessive, difficult-to-control worry about a variety of topics (health, work, school, finances, etc.) experienced most days for a substantial period, with accompanying symptoms such as restlessness, fatigue, trouble concentrating, irritability, muscle tension, and sleep disturbance. The described pattern—continuous “what if” catastrophizing, perceived sense of control through worry, and reinforcement when catastrophes don’t occur—fits the hallmark feature of pervasive, generalized anxiety rather than phasic fears or obsessions.

In summary, the scenario’s pervasive, diffuse worry across multiple domains, with the paradoxical feedback loop of worry and perceived control, aligns with generalized anxiety disorder rather than OCD, social anxiety disorder, or major depression. The key distinction is the broad, non-specific worry rather than specific rituals, social fears, or depressive symptomatology.

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