A 35-year-old woman survived a severe motor vehicle accident 6 months ago. She experiences intrusive flashbacks, avoids driving, has persistent negative beliefs about herself ('I am broken'), difficulty experiencing positive emotions, hypervigilance, and sleep disturbance. Which of the following DSM-5 symptom clusters for PTSD is represented by the 'persistent negative alterations in cognition and mood'?

• A Intrusion symptoms
• B Avoidance
• C Marked alterations in arousal and reactivity
• D Negative alterations in cognition and mood ✓

Explanation

DSM-5 reorganized PTSD into 4 symptom clusters: (1) Intrusion symptoms (flashbacks, nightmares, distressing memories), (2) Avoidance (avoidance of trauma-related stimuli), (3) Negative alterations in cognitions and mood (persistent negative beliefs, distorted blame, persistent negative emotions, anhedonia, detachment, restricted affect), and (4) Alterations in arousal and reactivity (hypervigilance, exaggerated startle, sleep disturbance, irritability). The patient's persistent negative self-beliefs and inability to experience positive emotions fit cluster 3. This 4-cluster model replaced the previous 3-cluster DSM-IV structure.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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Written and medically reviewed by the StethoPrep medical team.