For each of the following brief clinical presentations, identify the most accurate DSM-5 diagnosis based on the specific symptom triggers, core fears, and duration thresholds.
- A 26-year-old presents with severe hypervigilance, emotional numbing, and intrusive flashbacks of a severe motor vehicle collision that occurred 22 days ago.Acute Stress Disorder
- A 41-year-old reports an 8-month history of marked distress and active avoidance of public transportation and movie theaters, fearing an inability to quickly escape or get help if they develop sudden dizzy spells.Agoraphobia
- A 33-year-old has avoided eating in cafeterias and writing in front of others for the past 14 months due to an intense, persistent fear that their mild physiologic hand tremor will be noticed and judged as a sign of weakness.Social Anxiety Disorder
- A 39-year-old presents with an 8-month history of near-constant, exhausting worry regarding their family's health, financial security, and daily chores, accompanied by pronounced sleep disturbance, muscle tension, and occasional palpitations.Generalized Anxiety Disorder
- A 19-year-old describes a lifelong history of profound, immediate dread that occurs exclusively when they have to receive an injection or see medical needles, which frequently culminates in bradycardia and fainting.Specific Phobia
Cevap
The presentations correctly map as follows: the recent trauma survivor has Acute Stress Disorder; the patient fearing inability to escape public places has Agoraphobia; the patient fearing judgment for a tremor has Social Anxiety Disorder; the patient with pervasive multi-domain worry has Generalized Anxiety Disorder; and the patient with needle-triggered syncope has Specific Phobia.
Each diagnosis is established by synthesizing the unique core feature and timeline: Acute Stress Disorder is characterized by trauma symptoms lasting 3 days to 1 month. Agoraphobia involves fear of two or more specific situations (e.g., public transport, enclosed spaces) due to fear of difficult escape. Social Anxiety Disorder involves fear of social or performance situations due to potential scrutiny. Generalized Anxiety Disorder involves excessive, difficult-to-control worry about multiple domains for at least 6 months. Specific Phobia involves fear restricted to a highly specific trigger, such as needles.
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Anahtar Kavram
Accurate diagnosis of anxiety and trauma-related disorders relies on identifying the specific core fear driving avoidance behavior (e.g., negative evaluation vs. inability to escape) and applying strict temporal criteria (e.g., < 1 month for Acute Stress Disorder).
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