PTSD and Acute Stress

A 32-year-old male construction worker was trapped under a collapsed scaffolding for 6 hours during a workplace accident 3 weeks ago. He sustained minor injuries and was discharged after 2 days of hospitalization. Since then, he reports intrusive memories of the event occurring multiple times daily, avoids visiting the construction site, and experiences hypervigilance with exaggerated startle responses to loud noises. He has difficulty concentrating at work and reports insomnia. His wife notes he has become emotionally withdrawn and irritable. What is the most likely diagnosis?

Which of the following neurotransmitter systems is primarily implicated in the pathophysiology of PTSD?

A 28-year-old male soldier returns from active combat deployment 6 weeks ago. He reports recurrent nightmares of combat scenes, avoidance of loud noises and crowded places, emotional numbing, difficulty concentrating, and irritability. His wife notes he has become withdrawn and hypervigilant at home. He denies substance use and prior psychiatric illness. What is the most appropriate first-line pharmacological intervention?

A 28-year-old woman is brought to the emergency department 6 weeks after witnessing her husband's fatal cardiac arrest at home. She was performing CPR when he collapsed. She reports recurrent, intrusive flashbacks of his collapse occurring several times daily, accompanied by intense fear and physiological arousal (palpitations, sweating). She has avoided the bedroom and kitchen where the event occurred, and refuses to be alone. She experiences nightmares 4–5 nights per week and has difficulty concentrating at work. She denies suicidal ideation but reports persistent sadness and loss of interest in activities she previously enjoyed. On mental status examination, she appears tearful, with restricted affect. What is the most likely diagnosis?

A 28-year-old male presents to the psychiatry outpatient clinic 3 weeks after a motor vehicle accident in which he was the driver. His car collided head-on with a truck, and he sustained minor injuries. He reports intrusive memories of the crash, avoidance of driving, hypervigilance while traveling as a passenger, and sleep disturbance. He denies substance use and has no prior psychiatric history. On examination, he appears anxious and startles easily at sudden noises. What is the most likely diagnosis?