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Difficulty: Very hardAnxiety, OCD, and Trauma-Related Disorders

Match each clinical vignette with the most accurate DSM-5 diagnostic category.

  • A 28-year-old musician experiences expected panic attacks exclusively upon entering the stage for solo performances, leading to avoidance of solo gigs, with no spontaneous attacks.Social Anxiety Disorder (Performance type)
  • A 34-year-old new mother has ego-dystonic, horrifying thoughts of dropping her infant. She avoids stairs and silently repeats prayers to neutralize her distress, with no intent to harm.Obsessive-Compulsive Disorder
  • A 52-year-old man avoids subways, enclosed spaces, and crowds for over a year due to intense fear of sudden diarrhea and being unable to easily escape or find a restroom.Agoraphobia
  • A 26-year-old woman presents 3 weeks after a physical assault with dissociative amnesia, intrusive memories, hypervigilance, and avoidance of the location where the event occurred.Acute Stress Disorder
  • A 45-year-old man experienced a life-threatening earthquake 5 years ago. For the past 6 weeks, he has developed recurrent nightmares of the event, emotional numbing, and severe hyperarousal.Posttraumatic Stress Disorder

Answer

The correct matches are: Vignette 1 to Social Anxiety Disorder, Vignette 2 to Obsessive-Compulsive Disorder, Vignette 3 to Agoraphobia, Vignette 4 to Acute Stress Disorder, and Vignette 5 to Posttraumatic Stress Disorder.
Each vignette provides specific temporal or phenomenological clues that map exactly to one DSM-5 diagnosis. Performance-only anxiety indicates Social Anxiety Disorder. Ego-dystonic intrusive thoughts with neutralizing mental rituals define OCD. Fear of difficult escape due to embarrassing symptoms in multiple situations indicates Agoraphobia. Trauma symptoms lasting less than one month denote Acute Stress Disorder, whereas those lasting more than one month denote PTSD, even with delayed onset.

Step-by-Step Solution

1
Analyze Vignette 1 for triggers and types of panic attacks.
Expected panic attacks in performance settings only.
Differentiates Social Anxiety Disorder from Panic Disorder, which requires uncued attacks.
2
Analyze Vignette 2 for the nature of the mother's thoughts.
Intrusive, ego-dystonic thoughts managed with mental compulsions.
Differentiates postpartum OCD (ego-dystonic, no intent to harm) from Postpartum Psychosis (ego-syntonic, high risk of harm).
3
Analyze Vignette 3 for feared scenarios.
Fear of multiple public situations due to inability to escape an embarrassing symptom (diarrhea).
Defines Agoraphobia, distinguishing it from Specific Phobia or Panic Disorder.
4
Analyze Vignette 4 for the trauma timeline.
Trauma symptoms occurring 3 weeks post-event.
The <1 month duration differentiates Acute Stress Disorder from PTSD.
5
Analyze Vignette 5 for the trauma timeline.
Trauma symptoms lasting 6 weeks but starting 5 years post-event.
The >1 month duration defines PTSD. Delayed expression is a recognized subtype.

Key Concept

Differential diagnosis of anxiety, obsessive-compulsive, and trauma-related disorders relies on precise chronological criteria (e.g., ASD vs. PTSD) and the nature of expected vs. unexpected symptoms.
Estimated Time:3m 0s
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Topics

Anxiety, OCD, and Trauma-Related Disorders

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