Unraveling anxiety and compulsion: Contemporary diagnostic and pharmacogenomic strategies for Nurse Practitioners, featuring Josh Hamilton, DNP, APRN-BC, CTMH, CNE, CLNC, FAANP
Anxiety disorders and compulsive conditions remain among the most prevalent—and often misdiagnosed—mental health challenges encountered in both psychiatric and primary care settings.
With the DSM-5-TR emphasizing refined diagnostic boundaries, and the growing availability of pharmacogenomic tools to personalize treatment, nurse practitioners are uniquely positioned to improve outcomes through precision-based, evidence-informed care.
This interactive session provides an in-depth exploration of updated diagnostic criteria, emerging disease models, and nuanced differentiation among anxiety-related and compulsive disorders, including generalized anxiety disorder (GAD), panic disorder, social anxiety disorder (SAD), and obsessive-compulsive disorder (OCD).
Special attention will be given to compulsive spectrum disorders, examining how dysregulated threat appraisal and maladaptive coping cycles drive symptom persistence, and how these neurobiological underpinnings shape both diagnosis and treatment.
Through clinical vignettes, discussion, and evidence synthesis, participants will:
- Strengthen diagnostic acumen by learning to differentiate between anxiety and compulsive presentations using contemporary frameworks such as the fear-avoidance model, the intolerance of uncertainty model, and the habit-centered model of OCD.
- Apply pharmacogenomic data to tailor pharmacotherapy for individuals with anxiety and compulsive disorders, with emphasis on CYP450 enzyme pathways, serotonin transporter polymorphisms, and pharmacodynamic predictors of treatment response.
- Explore treatment algorithms and management strategies that extend beyond first-line SSRIs—including adjunctive therapies, psychotherapy modalities, neuromodulation, and emerging agents.
- Engage in practical learning that prepares nurse practitioners to navigate common clinical challenges, including treatment-resistant anxiety, medication intolerance, and patient hesitancy regarding pharmacologic options.
Participants will leave with tools to enhance shared decision-making, monitor therapeutic efficacy, and recognize when to refer—all while centering the patient’s goals and values in an evolving treatment landscape.
Session objectives
By the end of this session, participants will be able to:
- Develop a working knowledge of updated diagnostic criteria and neurobiological models to improve case identification and differentiation of anxiety and compulsive disorders.
- Apply concepts of pharmacogenomics to the selection, prescription, and management of psychotropic therapy for individuals with anxiety and compulsive disorders.
- Discuss contemporary approaches to the management of anxiety and compulsive disorders, including practical pharmacologic and non-pharmacologic interventions within the scope of nurse practitioner practice.
Josh Hamilton, DNP, APRN-BC, CTMH, CNE, CLNC, FAANP
Josh is an internationally-recognized speaker. He served on the psychiatric medication working group at the Center of Excellence in Regulatory Science & Innovation, a FDA-sponsored project at the University of Maryland. He is a NEI Master Psychopharmacologist and a fellow of the American Association of Nurse Practitioners. The Point of Care Network proclaimed Josh to be America’s Top Psychiatric NP in 2021 and 2024.
Josh was associate medical director for the largest managed care behavioral health network in the Desert Southwest and, as a university dean and vice president, he built one of the largest portfolio collections of competency-based graduate Nursing degrees in the United States.
His professional interests include neurobiology, pharmacology and epigenetics.