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Difficulty: MediumAnxiety, OCD, and Trauma-Related Disorders

Match the following brief clinical presentations to their most appropriate DSM-5 psychiatric diagnosis.

  • A 26-year-old man avoids public transportation and shopping malls due to a terrifying fear of being unable to easily escape or get help if he develops incapacitating anxiety symptoms.Agoraphobia
  • A 23-year-old woman frequently declines invitations to dinner parties and avoids speaking in meetings due to an overwhelming fear of being judged negatively by her peers.Social Anxiety Disorder
  • A 31-year-old man presents with recurrent, sudden episodes of palpitations and a feeling of impending doom, leading to constant worry about experiencing another episode.Panic Disorder
  • A 38-year-old woman reports feeling constantly 'on edge' for the past 8 months, uncontrollably worrying about her children, job, and finances, accompanied by chronic muscle tension.Generalized Anxiety Disorder
  • A 29-year-old veteran experiences recurrent distressing nightmares, avoids fireworks, and feels emotionally detached from his family for the past year.Posttraumatic Stress Disorder

Answer

The correct matches align each patient's core clinical fear and timeline with the definitive DSM-5 criteria: Patient 1 matches Agoraphobia, Patient 2 matches Social Anxiety Disorder, Patient 3 matches Panic Disorder, Patient 4 matches Generalized Anxiety Disorder, and Patient 5 matches Posttraumatic Stress Disorder.
Each diagnosis in the DSM-5 is defined by a specific core fear and symptom timeline. Agoraphobia focuses on escape and access to help; Social Anxiety focuses on interpersonal scrutiny; Panic Disorder focuses on the fear of the panic attacks themselves; Generalized Anxiety focuses on pervasive daily worry; and Posttraumatic Stress Disorder focuses on a constellation of intrusion, avoidance, and arousal symptoms following a traumatic event.

Step-by-Step Solution

1
Analyze the clinical presentation of the 26-year-old man avoiding public transport and malls.
Matches Agoraphobia.
The core fear is being unable to easily escape or obtain help in the event of developing panic-like symptoms, which is the defining feature of Agoraphobia.
2
Analyze the clinical presentation of the 23-year-old woman avoiding parties and meetings.
Matches Social Anxiety Disorder.
Her avoidance is driven by a fear of negative evaluation and scrutiny by peers, which defines Social Anxiety Disorder.
3
Analyze the clinical presentation of the 31-year-old man with sudden palpitations and worry about future episodes.
Matches Panic Disorder.
The presence of recurrent unexpected panic attacks followed by anticipatory anxiety (worry about the next attack) is the criteria for Panic Disorder.
4
Analyze the clinical presentation of the 38-year-old woman with chronic worry and muscle tension.
Matches Generalized Anxiety Disorder.
Excessive worry across multiple domains lasting more than 6 months, combined with somatic symptoms like muscle tension, is the classic presentation of Generalized Anxiety Disorder.
5
Analyze the clinical presentation of the 29-year-old veteran with nightmares and emotional detachment.
Matches Posttraumatic Stress Disorder.
The symptoms of re-experiencing (nightmares), avoidance (fireworks), and negative mood alterations (detachment) lasting longer than 1 month following trauma exposure indicate Posttraumatic Stress Disorder.

Key Concept

Differentiating anxiety and trauma-related disorders requires identifying the patient's primary underlying fear, the specific trigger for the anxiety, and the duration of the symptoms.
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Topics

Anxiety, OCD, and Trauma-Related Disorders

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