After a neighbor's dog attacked and bit her, a child now avoids dogs, has nightmares, and seems to 'replay' the event. The most likely diagnosis is which?

• A. Post-traumatic stress disorder.
• B. Adjustment disorder.
• C. Specific phobia.
• D. Acute stress disorder.

Answer: (A)

When someone has gone through a traumatic event, the pattern to watch for is intrusion and avoidance that persist and cause clinically significant distress or impairment. In this scenario, the child is experiencing re-experiencing the event (replaying it) and nightmares, along with avoidance of dogs. These are the hallmark clusters of post-traumatic stress disorder.

The key factor is duration. PTSD requires symptoms that last more than one month and cause impairment. Acute stress disorder can look similar but is limited to a shorter window—within days to about one month after the event. Given the description of ongoing avoidance and nightmares, PTSD is the best fit when the symptoms have persisted beyond the acute period.

Adjustment disorder would involve emotional or behavioral symptoms to a stressor but wouldn’t typically include re-experiencing the trauma or persistent nightmares. Specific phobia would focus on a fear of dogs itself and wouldn’t usually include intrusive memories or trauma reenactment.