A 27-year-old married woman reports to the PMHNP that she is experiencing significant distress in her marriage because she "hates" going to social events, and her husband's job requires attending regular social gatherings. She avoids these activities because she is "terrified" she will do or say something embarrassing, and she has started pretending she has headaches to get out of going to them. Her husband doesn't understand why she doesn't want to go to these parties, which are typically small gatherings of less than 15 people. She admits that when she does go, they end up being "no big deal." The PMHNP will diagnose this woman with which of the following?

Choice A reason: Generalized anxiety disorder involves persistent and excessive worry about a variety of everyday issues rather than specific social situations. This patient’s anxiety is context-specific (social interactions), which does not meet the criteria for generalized anxiety disorder. Choice B reason: Agoraphobia involves fear or avoidance of places or situations where escape might be difficult, often involving crowds or public spaces. Her avoidance is social in nature, not related to leaving home or public spaces, so this diagnosis does not fit. Choice C reason: This is the correct answer. Social anxiety disorder (social phobia) is characterized by intense fear or anxiety in social situations due to potential scrutiny or embarrassment. The patient’s avoidance of social events, fear of saying or doing something embarrassing, and relief when she attends indicate classic features of social anxiety disorder. Choice D reason: Panic disorder is defined by recurrent unexpected panic attacks and persistent concern about having additional attacks. The patient does not report sudden, recurrent panic episodes but rather anticipatory anxiety about social evaluation, making panic disorder an inappropriate diagnosis.