Question

Juan, a17-year-old Hispanic youth, was referred to the school psychologist at the end of the first school term because of apparent academic and emotional concerns. His grades were slipping, and it looked like he might not get any credits his first term. The counselor has also explained that Juan was the driver in a fatal car wreck at the end of the previous academic year, in which his bestfriend was killed. Although Juan was hospitalized, the counselo rsaid that he insisted on going to the funeral, even though he could barely move, having suffered several broken ribs. When the psychologist met with Juan, he was initially reluctant to discuss the accident but as rapport was established, he admitted to feeling helpless, feeling fatigued because of lack of sleep, and having problems concentrating on his schoolwork. He wanted to quit school, because he did not want to be in the same class with students who blamed him for his friend’s death, and furthermore he did not see why he should plan for a future. He admitted to having vivid dreams of his friend, seeing him as if he were alive. Often he would wakeup, startled.He had no recollection of how the accident happened, as he could not remember the details, even though a witness had said that another car was involved. Although he has a girlfriend, Juan rarely feels like doing anything, and in the past few month she has preferred to be alone. Although he was very close to his deceased friend’s family(theywereinseparable), he has not seen them since the funeral. In this case, Juan is faced with the aftermath of a traumatic experience in which he was seriously injured and his friend was killed. He feels helpless because of the accidental nature of the wreck. Undoubtedly, Juan has significant survivor guilt. Faced with traumatic events of this nature, individuals react with fear, horror, or helplessness. In younger children, these feelings are often expressed in disorganized anda gitated behaviors.

IN 250 words:

Identify at least three stressor-related features that Juan’s case presents.

Explain the significance of the symptoms affecting Juan.

Answer 1

Juan is an adolescent and underwent a tragic accident. Not only he was seriously injured but also loose his dear friend in that accident. Moreover he was driving the car during the accident, hence surely he was the one to blame for the death.

This is case of PTSD(post-traumatic stress disorder) where the victim though healed physically experiences reenactment of the tragic accident. Here Juan seems to be having nightmares of his friend's appearance even after his death. A sense of self-blame has caused this.

Also he is unable to perform in his academics, this leads to display of anxiety towards the agents that may remind him of the accident. When it is clearly mentioned his friends do believe him to be the culprit in accident this anxiety driven avoidance towards classes and studies is a predictable behaviour.

Aversion from academic performance and future is also due to PTSD wherein Juan also experiences survivors guilt. It is a very serious dilemma where he cannot justify his surviving over his friend's death. This led to apathy towards his future and other zests to living.

Juan is in a relationship but he has not been in touch with his girlfriend since the accident. His lack of interest in his relationship aslo implies that he unable to justify worldly comforts that he may experience even though being a cause for someone's death. His girlfriend has also been distant towards him, this shows that either she was also blaming Juan for accident or she couldn't put up with the guilty and gloomy state that Juan was in.

Symptoms that indicates PTSD and comorbidity are discussed below ;

• Recurrent intrusive images

Juan has been having thoughts of accident and he sees images of events relating to accident.

• Reliving experience through flashbacks

Juan has been having flashbacks of the traumatic accident which has been cause for Amnesia. This has caused a sense of fatigue in his day to day activities and has made his disinterest towards everything very visible from his appearance and attitude.

• Intense psychological distress in presence of triggers

Though wrong, Juan's friends blame him for death of their friends. They are the triggers mentioned here. When Juan overhears the judgmental comments it triggers his psychological distress and intensifies his self-guilt and makes him utterly unsocial towards anyone around him. He is in constant state of emotional breakdown I'm presence of these triggers. It is very clear that going to classes is doing more harm than good to Juan.