Aspects of Post-Traumatic Stress Disorder

Introduction

Jane has not had problems maintaining a sleeping schedule of 8 hours a day. However, the accident has caused Jane to be unable to keep up with the schedule, which means that the sleeping time has shortened to 5 hours a night.

Psychological

Jane feels anxiety when recollecting the event which has caused the psychological trauma. Moreover, the fear of driving and being in the car, the irritability, and the overall decrease in work productivity and social challenges are other acquired psychological issues.

Social

The fear of driving has resulted in a lack of social interaction since Jane is not mobile without having the chance to drive to see friends and family members. Colleagues from work also notice the irritability which Jane portrays.

Spiritual

The fear of driving also resulted in Jane’s inability to attend church and bible studies, which were everyday activities prior to the car accident.

Assessment

Using CAPS (The Clinician-Administered PTSD Scale) is a valid assessment tool that can clarify the diagnosis. CAPS is the gold standard for examining patients in regards to the trauma and the psychological outcomes, which is why most clinicians use this particular measure (Weathers et al., 2018). The assessment is useful due to the fact that it identifies the symptoms but also their severity and frequency.

Diagnostic Impressions

Post-Traumatic Stress Disorder (ICD-10 code F43. 1) is illustrated through the symptoms that the patient reports. The behavioral, psychological, social, and spiritual changes suggest that the trauma, which was the car accident, has facilitated the occurrence of PTSD. Panic disorder (F41. 0) is a secondary disorder that manifests itself through recurrent anxiety accompanied by the fear of dying.

Signs and Symptoms

PTSD symptoms require a stressor, in which a person was exposed to death, threatened, violated, or injured, which is what happened to Jane during the car accident when she was injured and unable to move till 45 minutes later when the ambulance arrived. Thus, Jane experienced direct exposure to the traumatic event. The intrusion symptoms include the recurrent, involuntary memories of the traumatic event, which Jane reports to cause her anxiety when she tries to concentrate on work, but the memory overwhelms her. Distressing dreams also cause Jane to sleep less since she has nightmares about the accident. Avoidance of external reminders is suggested by Jane’s unwillingness to drive a car and take the same highway where the accident took place. Irritable behavior is illustrated through the feedback from Janes’ colleagues and the behavior with her husband.

Based on the DSM-5 criteria, panic disorder refers to the experience of recurring panic attacks manifesting at least once, followed by a month of fear of reoccurring panic attacks. The symptom of palpitations, pounding heart, or accelerated heart rate is illustrated in the patient’s report of heart-racing during stressful moments. Another symptom, sweating, has also been reported by Jane. Derealization or depersonalization is suggested by Jane through not knowing where she is during panic attacks. Moreover, Jane’s anxiety when driving the car or just being inside it illustrates the fear of dying.

Other DSM Conditions Considered

Depression was considered due to Jane’s inability to concentrate and the diminished interest in her prior hobbies. However, the minimized interest can be explained by the fear of driving, and Jane has not reported fatigue, guilt, suicidal thoughts, and a reduction in physical movement. Another condition that was considered was social phobia due to Jane’s excessive anxiety and stress that interferes with daily tasks. However, Jane avoids social situations primarily because of her unwillingness to drive.

Consideration of Theories and Factors

Jane’s life prior to the accident does not illustrate abnormal development that would have affected her functioning and behavior.

Multicultural or Social Justice Considerations

The diagnostic thought process considered Jane’s religious beliefs, which have been minimized after the accident, suggesting the severity of the stress leading to a disregard of prior religious practices.

Treatment Recommendations

Key Issues

• Anxiety
• Sleep disturbances
• Irritability

Psychotherapy is a helpful tool often used to reduce anxiety. Talking to a counselor may be effective in identifying and facing the memories and thoughts that cause stress, and certain techniques implemented by the therapist can minimize the negative feelings. Since the patient is not fully ready to drive, counseling can be done via audio and video calls. In terms of sleep disturbances, the patient may benefit from taking medication to ensure an adequate sleep schedule. Moreover, physical activity and healthy lifestyle choices may also positively impact this issue. Talk therapy can also minimize irritability since therapy often provides coping mechanisms during mood swings (for example, through cognitive behavior techniques).

Recommendations for Individual Counseling

Two recommendations that directly combat PTSD symptoms are Cognitive Behavioral Therapy (CBT) ad Eye Movement Desensitization and Reprocessing. CBT has been applied in treating stress-related disorders and has been shown to be effective. Moreover, since the patient cannot freely drive to the therapist’s office, research shows that the same therapy conducted via video calls is also effective (Kumar et al., 2017). Moreover, EMDR is less widely applied but also effective in combating stress and anxiety. Researchers found it to be even more proficient in addressing post-traumatic symptoms compared to CBT (Khan et al., 2018). The two recommendations can address multiple issues reported by Jane and minimize the adverse psychological effects of the car accident.

Jane – Case Study 4

A triggering event causes multiple issues that are to be addressed based on their severity and impact on the patient’s life and well-being. Collaborating with the patient is vital since it can help minimize barriers such as fear of addressing the problem, dishonesty, and unclear communication.

References

Khan, A. M., Dar, S., Ahmed, R., Bachu, R., Adnan, M., & Kotapati, V. P. (2018). Cognitive-behavioral therapy versus eye movement desensitization and reprocessing in patients with post-traumatic stress disorder: Systematic review and meta-analysis of randomized clinical trials. Cureus. Web.

Kumar, V., Sattar, Y., Bseiso, A., Khan, S., & Rutkofsky, I. H. (2017). The effectiveness of internet-based cognitive behavioral therapy in treatment of psychiatric disorders. Cureus. Web.

Weathers, F. W., Bovin, M. J., Lee, D. J., Sloan, D. M., Schnurr, P. P., Kaloupek, D. G., Keane, T. M., & Marx, B. P. (2018). The clinician-administered PTSD scale for DSM–5 (CAPS-5): Development and initial psychometric evaluation in military veterans. Psychological Assessment, 30(3), 383–395. Web.