Post-Traumatic Stress Disorder

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Thompson Family Case Study: Post-Traumatic Stress Disorder

The risk of developing PTSD varies with age and gender. Moreover, the disorder can occur at any age in a person’s lifetime. The case study involves a veteran man Willian Thompson is a married man aged 38 years. He is a brother to Henry Thompson. Originally, Willian lived in New Jersey. He later became homeless due to the inability to raise his mortgage fee. Currently, Willian resides with his older brother and wife at Pasadena, California. He is now a lawyer in a law financing firm. William has PTSD and is addicted to alcohol. Some of his hobbies include listening to Jazz music, running, and playing soccer. People with a history of traumatic events such as grief, rape, accidents are at high risk of developing PTSD (Rosen et al., 2019). People with PTSD usually experience symptoms such as extreme physical reactions, distress, mood, etc. The PTSD is included in DMS-5, but a person has to meet specific criteria to be diagnosed with the disorder (Pai et al., 2017).

Behavior that Aligns with DMS-5 criteria for PTSD

In the US, PTSD is a common mental disorder experienced by people in all stages. The DMS-5 requires clients to achieve the following criterion before being diagnosed with the disorder. The first criterion (A) requires a person to have any of the following experiences: exposure to serious injury, sexual assaults, or even death (Pai et al., 2017). The traumatic event should be witnessed, have direct exposure, learning from a family or friend that has witnessed the trauma, or indirect exposure mainly through professional work. In William Thompson’s case study, William was a veteran; thus, he may have life-threatening experience experiences that exposed him to trauma. According to the research conducted by the US department of veterans in 2018, 12% of all veterans develop PTSD every year. Therefore, William may be one of the veterans who may have witnessed and experienced the traumatic events which lead to the development of the disorder.

The second criterion, as defined by DMS-5 known as (Criterion B), requires the person to have one of the following intrusion symptoms (Pai et al., 2017). The person must re-experience nightmares, Uma wanted and upset memories, physical reactivity, and emotional distress after exposure to the traumatic event constantly. In the case study, the 14-years, Zora Thompson explained how Williams struggles with keeping his job. The intrusion symptoms are exhibited in William’s struggle to maintain his job and alcohol abuse. In most cases, people with PTSD turn to alcohol to relieve the stress of experienced traumatic events. Additionally, victims of PTSD experience flashbacks and nightmares. The lawyer specializing in the finance law indicated that William’s job was in jeopardy because of PTSD and alcohol concerns facilitated by re-experiencing symptoms of PTSD, which interferes with a person’s routine tasks.

Criterion C requires a person to have any of the following symptoms; avoidance of trauma-related stimuli after experiencing a traumatic event, trauma related to external flashbacks, and trauma-related thoughts or feelings (Pai et al., 2017). William has been taking alcohol instead of medicating himself and seeking psychotherapy to ease the disorder’s symptoms. Moreover, William was avoiding the traumatic thoughts but secluding himself from feeling and thoughts related to traumatic events. External feelings and thoughts adversely affect individual performance. Criterion D requires one to exhibit two symptoms related to negative alteration in mood and cognition (Pai et al., 2017). The family is not united, and family members are seen to be interested in personal happiness. Irrespective of what William is experiencing, family members do not show affection, care, and compassion. William is dealing with stress after losing his job and the conditions he is currently living with his brother and wife.

Criterion E requires a person to exhibit alterations in reactivity and arousal (Pai et al., 2017). In the case study, William exhibited these symptoms after being unable to pay for his Mortgage. He became homeless and lost his job as a lawyer in the finance firm due to PTSD and alcohol abuse. Criterion F requires a person to exhibit symptoms that last for one month (Pai et al., 2017). The case study did not mention the actual symptoms experienced by William, which directly relate to PTSD. However, when diagnosing a patient with PTSD, the behavioral changes play a crucial role in the diagnostic process (Rosen et al., 2019). Some of the risky behaviors exhibited by William in the case study that lasted for more than one month are; abusing alcohol, homelessness, and losing a job at a law firm. Criterion G requires a person to experience symptoms that relate to functional significance (Pai et al., 2017). Willian experienced these stressors in the home, inability to maintain his job, and when working as a veteran in Iraq. The last criterion excludes symptoms of PTSD that may be caused by the history of past medication, other diseases/illnesses, and substance use. William’s symptoms were not triggered by the highlighted symptoms.

Therapeutic Approaches

PTSD is a treatable disorder. The commonly used treatments include short terms of psychotherapy and medications. Cognitive behavior therapy is the most effective psychotherapy for people with PTSD because it treats patients with short and long-term PTSD. The approach involves identifying factors triggering the disorder, comprehending them, and changing thinking and behavioral patterns. The component of the therapy includes exposure therapy and cognitive restructuring (Shubina, 2015). Other treatments for PTSD include present-centered therapy and Eye movement desensitization reprocessing, but for William, the best-preferred therapy will be CBT (Shubina, 2015). There are various medications used to treat patients with PTSD. However, medications are used as the adjunct to the therapies include selective serotine reuptake inhibitors, which are antidepressants used to depress PTSD moods (Kamo et al., 2016). The current FDA approved medications for treating PTSD are Zoloft and paroxetine (Kamo et al., 2016). However, benzodiazepines are fast-acting medicines used to treat PTSD but have side effects and treat short-terms PTSD. And thus, Zoloft, combined with CBT, would be preferred therapeutic approach for William Thompson.

Expected outcomes

The expected outcome after treatment is that the client will be able to shoe improvement at every stage of medication and therapy. Zoloft works by preventing serotine intake in the nervous system, which leads to an increased serotonin concentration in the nerve synapse. Therefore, since Zoloft dose is started at small doses and continue to increase based on patient response, the expected outcome is that after every stage e.g., after four weeks the client will reduce some of the symptoms up to the end of medication where the patient will reduce all the symptoms (Kamo et al., 2016). The CBT will help the client to adopt a coping mechanism that will help him to reduce stress linked to past traumatic events and how to quit abusing alcohol (Shubina, 2015). Therefore, the outcome would be that the combination of Zoloft antidepressant and CBT will effectively treat William Thompson’s health condition.

References

Kamo,T., Maeda,M., Oe,M., Kato,H., Shigemura,J., Kuribayashi,K., & Hoshino,Y. (2016). Dosage, effectiveness, and safety of sertraline treatment for posttraumatic stress disorder in a Japanese clinical setting: A retrospective study.BMC Psychiatry,16(1).https://doi.org/10.1186/s12888-016-1138-5

Pai,A., Suris,A., & North,C. (2017). Posttraumatic stress disorder in the DSM-5: Controversy, change, and conceptual considerations.Behavioral Sciences,7(4), 7.https://doi.org/10.3390/bs7010007

Rosen,C.S., Bernardy,N.C., Chard,K.M., Clothier,B., Cook,J.M., Crowley,J., Eftekhari,A., Kehle-Forbes,S.M., Mohr,D.C., Noorbaloochi,S., Orazem,R.J., Ruzek,J.I., Schnurr, P. P., Smith, B. N., & Sayer, N. A. (2019). Which patients initiate cognitive processing therapy and prolonged exposure in the Department of Veterans Affairs PTSD clinics? Journal of Anxiety Disorders,62, 53-60.https://doi.org/10.1016/j.janxdis.2018.11.003

Shubina,I. (2015). Cognitive-behavioral therapy of patients with PTSD: Literature review.Procedia – Social and Behavioral Sciences,165, 208-216.https://doi.org/10.1016/j.sbspro.2014.12.624

The US. Department of Veterans Affairs. (2018). VA.gov | Veterans Affairs. https://www.ptsd.va.gov/