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Difficulty: MediumAnxiety, OCD, and Trauma-Related Disorders

Match the following brief clinical scenarios and symptom duration timelines with the most appropriate DSM-5 psychiatric diagnosis.

  • A 32-year-old experiences intrusive flashbacks, hyperarousal, and avoidance of driving exactly 2 weeks after surviving a severe car accident.Acute stress disorder
  • A 41-year-old has experienced daily, uncontrollable worry about multiple everyday life events (finances, health, work), accompanied by sleep disturbance and muscle tension for the past 9 months.Generalized anxiety disorder
  • A 24-year-old military veteran experiences significant emotional numbing, nightmares, and exaggerated startle response that began shortly after returning from deployment 8 months ago.Posttraumatic stress disorder
  • A 28-year-old develops prominent anxiety, insomnia, and tearfulness 2 months after an unexpected romantic breakup; symptoms cause significant distress but do not meet full criteria for a major depressive episode.Adjustment disorder
  • A 19-year-old experiences overwhelming fear and autonomic arousal exclusively when anticipating or giving a public speech, avoiding these situations entirely for the past year.Social anxiety disorder

Answer

The correct pairings align specific triggers and timelines to their respective DSM-5 criteria: 2-week trauma symptoms match Acute Stress Disorder, 8-month trauma symptoms match PTSD, 9-month multi-domain worry matches Generalized Anxiety Disorder, 1-year specific fear of public speaking matches Social Anxiety Disorder, and 2-month post-breakup distress matches Adjustment Disorder.
Each diagnosis in the DSM-5 for anxiety and trauma-related disorders relies heavily on the temporal relationship to a trigger and the total duration of symptoms. Acute Stress Disorder and PTSD share symptom clusters but are divided by the 1-month mark. Generalized Anxiety Disorder requires 6 months of multi-domain worry. Adjustment disorder requires symptom onset within 3 months of a stressor and resolves within 6 months of the stressor's termination. Social anxiety focuses specifically on the fear of scrutiny in performance or social situations.

Step-by-Step Solution

1
Analyze trauma-related scenarios for timeline distinctions.
The 2-week post-accident scenario fits Acute Stress Disorder (<1 month), while the 8-month post-deployment scenario fits PTSD (>1 month).
Symptom duration is the key distinguishing factor between Acute Stress Disorder and PTSD following a severe trauma.
2
Evaluate non-trauma anxiety presentations.
The 9-month pervasive worry fits Generalized Anxiety Disorder (>6 months required). The specific fear of public speaking fits Social Anxiety Disorder.
Generalized Anxiety Disorder requires excessive worry across multiple life domains, whereas Social Anxiety Disorder is restricted to fear of scrutiny or negative evaluation by others.
3
Assess the psychosocial stressor scenario.
The distress occurring 2 months after a breakup fits Adjustment Disorder.
Adjustment disorder occurs within 3 months of an identifiable stressor and does not meet the full criteria for another major psychiatric disorder.

Key Concept

Diagnostic timelines and core features of DSM-5 Anxiety and Trauma-Related Disorders
Estimated Time:1m 30s
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Topics

Anxiety, OCD, and Trauma-Related Disorders

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