A nurse is providing information to a client about risk factors for developing an anxiety-related disorder. Which of the following clients is at greatest risk for developing an anxiety-related disorder?

Choice A reason: A family history of anxiety disorders increases risk via genetic predisposition (e.g., serotonin transporter gene variants), but positive childhood experiences (PCEs) build resilience, reducing risk. This client has a moderate risk but is less vulnerable than one with adverse experiences and genetic predisposition. Choice B reason: Multiple adverse childhood experiences (ACEs), like abuse or neglect, elevate anxiety risk by increasing stress hormone dysregulation (e.g., cortisol) and altering brain development (e.g., amygdala hyperactivity). Combined with a parental history of anxiety disorders, indicating genetic risk, this client faces the greatest risk for developing an anxiety-related disorder. Choice C reason: A family history of cancer and recent unemployment are stressors but not specific risk factors for anxiety disorders. Unemployment may increase stress, but without genetic or trauma-related predispositions, this client’s risk is lower than one with ACEs and family history. Choice D reason: Not graduating high school or completing a GED may limit opportunities, increasing stress, but is not a direct risk factor for anxiety disorders. Genetic predisposition and adverse childhood experiences have stronger links to anxiety development, making this client less at risk.