A risk factor for generalized anxiety disorder is:

Choice A reason: Personality disorders are a recognized risk factor for generalized anxiety disorder (GAD). Clients with maladaptive personality traits such as perfectionism, dependency, or avoidant tendencies are more prone to chronic worry and anxiety. These traits interfere with coping mechanisms and increase vulnerability to persistent anxiety symptoms. Choice B reason: Anorexia nervosa is an eating disorder characterized by restrictive eating and distorted body image. While anxiety can coexist with anorexia, it is not considered a direct risk factor for GAD. The primary pathology in anorexia is related to eating behaviors and body image rather than generalized worry. Choice C reason: Schizophrenia is a psychotic disorder involving hallucinations, delusions, and disorganized thinking. It is not a risk factor for GAD. Although anxiety can occur in schizophrenia, the two conditions are distinct and schizophrenia does not predispose someone to generalized anxiety disorder. Choice D reason: Substance abuse is a major risk factor for GAD. Substances such as alcohol, stimulants, and sedatives can alter brain chemistry, impair coping mechanisms, and trigger or worsen anxiety symptoms. Withdrawal from substances also contributes to heightened anxiety, making substance abuse a strong risk factor.