Question

Case Vignette: Which Trauma based disorder (Posttramatic stress disorder (PTSD), Acute stres disorder (ASD) or adjusment disorder is Bethany and Charles each suffering from and why? Dignosis Bethany and Charles and use symptoms from the case vignette (story below) to supportthe dignosis.

Bethany Pinsky, age 23, has gone to a theater to see the local premiere of a big-budget movie. As she settles into her seat, waiting for the show to begin, a young man in a ski mask suddenly appeared in front of the screen. Brandishing an assault rifle, he fired directly into the audience. She saw many people get shot, including the woman sitting next to her. People all around began screening, and there was a confused stampede for the exit door. Terrified, she somehow fought her way to the exit and escaped, uninjured, to the parking lot, where police cars were just arriving.

Charles Quigley, age 25, went to the same movie theater at the same time. He too feared for his life. Hiding behind a row of seats, he was able to crawl to the aisle and quickly sprint to the exit.   Although covered in blood, he escaped without physical injury.

Bethany, Two Weeks Later

Bethany comes to see you. She has not recovered 2 weeks later. She feels emotionally constricted, and unable to experience pleasant or positive feelings. She jumps at the slightest sound, she is unable to focus on her work and her sleep has been fitful and marked by traumatic nightmares. She has tried to avoid any reminders of the shooting but nevertheless relentlessly recalls the sounds of gunfire, the screams, and the sticky feel of the blood pouring out of her neighbor's chest in the movie theater. She feels the experience has changed her life forever.

Charles, Two Months Later

Charles comes to see you as he has been having a difficult time sleeping and concentrating. He feels like he wasn't impacted as much as others by the event but continues to think about the shooting. He finds himself sad at times and easily cries. He feels his heart rate increase and becomes slightly nervous at a loud sound. He feels anger towards others who tell him that they understand how he feels. When asked about his job and personal relationships, he states that he has been able to keep his job. However, he is afraid he may get fired soon as his performance at work has been poor due to his inability to concentrate. His girlfriend tries to help him but he feels she can't understand his pain since she wasn't there. She has noticed his low energy and feeling of hopelessness lately and suggested that he see someone.

Answer 1

1)Case study

Here Bethany is suffering from Post Traumatic Stress Disorder (PTSD). PTSD is a stressful condition of a person who has a traumatic experience. This kind of mental condition stays for at least 1 month. This kind of mental illness can hamper someone’s life. Some common symptoms are associated with PTSD.

Symptoms of PTSD  

• Feeling of irritability
• Feeling of extreme fear
• Lack of interest in even pleasant activities
• Flashback of fearful memories
• Feeling of extreme level of stress or anxiety.
• Nightmares
• Unwanted thoughts

Diagnosis

These all are symptoms of PTSD. These symptoms are common in the patient of PTSD. After listening all the problems of Bethany I can conclude that she is suffering from PTSD. Because, here all her symptoms are similar to the symptoms of PTSD.

Here Bethany is suffering from these entire problems because of her fearful and unforgettable experience. She is afraid for that traumatic experience. Here unconditioned stimulus is present in her present situation so she is jumping in even a slightest sound. Because, the sound of Gun here paired with a neutral stimulus (slightest sound). This is the main symptom of PTSD. In PTSD, a fearful stimulus can pair up with a neutral stimulus and can create the feared situation in even a normal situation.

Not only that, people can get fearful nightmare in PTSD. Here Bethany also suffering for nightmare. So after a complete diagnosis I can conclude that Bethany is suffering for the Post Traumatic Stress Disorder.

Case Study 2

After listening all the problems of Charles I can conclude that, He is suffering from Adjustment disorder. Adjustment disorder refers to a group of issues that can occur when someone is unable to cope with a stressful or traumatic event of the life. This kind of problem can ruin personal relationship and also can hamper professional activities.

Symptoms of Adjustment Disorder

• Feeling of Impulsiveness
• Lack of self-esteem
• Lack of Concentration power
• Easily crying
• abandonment attitude
• Feeling of sadness in all the time
• Feeling of Irritability
• Increased heart rate for sometimes
• Body pain
• Sleeping Difficulty

Diagnosis

Here Charles failed to cope with the traumatic experience so he is facing problem in his regular activities. His professional and personal life is getting hampered for this adjustment problem. He tries to forget the traumatic experience but not able to do so.

He feels sad all the time for this kind of adjustment problem. So we can say that he is unable to adopt his present situation and also unable to live a normal life. Not only that, his girlfriend also noticed his hopelessness in him, which is also similar to the symptom of Adjustment Disorder.His symptoms are similar to the symptoms of Adjustment Disorder. So I can conclude that he is suffering from adjustment Disorder.