If a Somali woman presents with nightmares and flat affect after moving to the U.S., what could be a suspected diagnosis?

In considering the case of a Somali woman experiencing nightmares and flat affect after relocating to the U.S., Post-Traumatic Stress Disorder (PTSD) stands out as the most likely diagnosis. PTSD often arises after an individual has undergone significant trauma, which can include experiences related to war, displacement, or persecution—circumstances that many Somali individuals coped with prior to migration.

The clinical features of PTSD include re-experiencing the traumatic event (e.g., through nightmares), avoidance of reminders of the trauma, negative alterations in cognition and mood (which can manifest as flat affect), and heightened physiological arousal. In this case, the nightmares represent that re-experiencing aspect, while the flat affect could reflect a numbing or emotional withdrawal, which often occurs in individuals dealing with PTSD.

Additionally, it's important to recognize that while depression and anxiety could also be potential diagnoses, the specific combination of symptoms and the context of her recent experiences suggest that trauma-related pathology is more plausible. Factors such as the cultural background and the challenges faced during migration further reinforce this understanding. Ultimately, PTSD aligns closely with the presenting symptoms and the individual's trauma history.