A 34-year-old female teacher develops intrusive recollections, nightmares, avoidance of reminders of a road accident, emotional numbing, hypervigilance, and sleep disturbance beginning 3 weeks after the event. Symptoms cause significant occupational impairment. What is the most accurate DSM-5 diagnosis at this time point?
- A Post-traumatic stress disorder
- B Adjustment disorder with anxious mood
- C Acute stress disorder ✓
- D Specific phobia, situational type
Explanation
DSM-5 acute stress disorder (ASD) is diagnosed when trauma-related symptoms (intrusion, negative mood, dissociation, avoidance, arousal) occur within 3 days to 1 month of the traumatic event. PTSD requires symptom duration of more than 1 month. At 3 weeks post-trauma, the diagnosis is ASD, not PTSD. If symptoms persist beyond 1 month, the diagnosis is revised to PTSD. Adjustment disorder is diagnosed when the stressor does not meet the threshold for a traumatic event as defined in DSM-5 Criterion A for PTSD (exposure to actual or threatened death, serious injury, or sexual violation).
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.