308.3 (F43.0) Acute Stress Disorder
Evidence for Diagnosis:
A 39-year-old female television reporter referred to as K.D. is describing symptoms that meet the criteria for acute stress disorder (ASD) in the trauma- and stressor-related disorder category of the Diagnostic Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013). Therefore, a diagnosis of acute stress disorder is presently appropriate. At this point in time, however, it is uncertain if the presenting symptoms are or are not transient responses to the traumatic event. Regardless, this diagnosis is given so that K.D. can receive immediate psychotherapeutic intervention that she will benefit from significantly, as it has been shown in the literature.
For one, K.D. describes that she was recently exposed to the gruesome, shocking, and prolonged execution of a murderer whose story she had been following for years. In Criterion A of ASD, it is outlined that exposure to one or more traumatic events involving actual or threatened death, serious injury, or sexual violation must occur through one or more various ways (i.e., through direct experience, observation, learning of details regarding family members, or recurrent or extreme exposure to details) for the criterion to be met (APA, 2013). Since K.D. did observe the execution (the actual death) of the murderer in person—in fact, she reported that she and her colleagues were 10 feet away as they witnessed through the gas chamber windows the murderer convulse involuntarily, drool, and gasp as he took his last breaths—Criterion A is met.
Following the traumatic event, K.D. has experienced and is still experiencing a multitude of varied distressing and impairing sympt...
... middle of paper ...
... stressor that K.D. was exposed to meets Criterion A of ASD or PTSD (i.e., exposure to actual or threatened death, serious injury, or sexual violation [APA, 2013]) and her symptom pattern (e.g., experiencing dissociative and intrusion symptoms) meets the criteria for and is therefore characteristic of individuals with ASD or PTSD, as can be recalled above. The diagnosis of an adjustment disorder would only be appropriate in this case if K.D. had experienced a stressor that met Criterion A for ASD or PTSD and did not display a characteristic symptom pattern, or if K.D. had displayed a characteristic symptom pattern of ASD or PTSD but did not experience a stressor that met Criterion A. Because K.D.’s stressor meets Criterion A and the associated symptoms meet the criteria for symptomology of ASD or PTSD, the diagnosis of an adjustment disorder is not appropriate.
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