PSYCHOLOGY

CASE STUDY
ROUGH COPY

Submitted by Aaliyah Abdul Kabeer

Class : XII-H
Roll : 06
Date : 10/05/2018
 SUBJECT PROFILE
Age : 18
Name : ABCD
Gender : Male
Emotional level : Gets frequent panic attacks when
placed in particular situations, excessive worrying
and stress.
Family background : He has a nuclear family
consisting of a younger sister and he is the eldest.
Social background : He has a healthy relationship
with his mother and sister but a weak relation with
his father since he is busy person. He has a good
number of trusted friends and is sociable.
Onset of disorder : 16yrs old
 POST-TRAUMATIC STRESS DISORDER
INTRODUCTION
Post-traumatic stress disorder (PTSD) is a mental health
condition that's triggered by a terrifying event, either
experiencing it or witnessing it. A traumatic event is an
incident that causes physical, emotional, spiritual, or
psychological harm. Mental illness a condition which
causes serious disorder in a person's behavior or
thinking.
The person experiencing the distressing event may feel
threatened, anxious, or frightened as a result. In some
cases, they may not know how to respond, or may be in
denial about the effect such an event has had. The
person will need support and time to recover from the
traumatic event and regain emotional and mental
stability. Most people who go through traumatic events
may have temporary difficulty adjusting and coping, but
with time and good self-care, they usually get better.
People respond to traumatic events in different ways.
Often there are no visible signs, but people may have
serious emotional reactions.
All forms of post-trauma response are typically
characterized by the presence of three classes of
symptoms. First, the post-trauma victim typically
experiences intrusive memories of the traumatic event.
Intrusive recollections may occur during waking hours or
sleep (in the form of repetitive vivid recreation
nightmares involving the trauma). Second, the post-
trauma victim makes efforts to avoid exposure to
anything that might cause them to recall the trauma they
experienced. Third, the post-trauma victim typically
shows an exaggerated startle response and heightened
anxiety levels. As a result of these sorts of symptoms,
experienced on a consistent basis day in and day out,
PTSD can be a very debilitating condition.
Not all trauma victims experience PTSD immediately
after exposure to trauma. Some persons react quickly to
traumatic exposure, while others appear to emerge from
traumatic exposure unscathed, only to experience the
sudden emergence of PTSD-type symptoms months or
years later.
PTSD is also part of anxiety disorder, this is because a
trauma disorders involve heightened anxiety
symptomology. However, unlike other anxiety disorders,
trauma disorders also frequently may involve
Dissociative symptomology. In its mildest form,
dissociation involves 'spacing out' so that events that are
occurring appear to be unreal. In more severe forms of
dissociation, memory for events may be misplaced (as in
amnesia), or a person may be so unnerved by what they
have experienced that they take on another persona. The
most tenacious and difficult to treat forms of PTSD are
sometimes those that have formed when a trauma victim
was dissociative during his or her experience of the
trauma.
 SYMPTOMS OF PTSD
PTSD is diagnosed after a person experiences symptom
for at least one month following a traumatic event.
However, symptoms may not appear until several
months or even years later. The disorder is characterized
by three main types of symptoms :-
 Re-experiencing the trauma through intrusive
distressing recollections of the event, flashbacks,
and nightmares.
 Emotional numbness and avoidance of places,
people, and activities that are reminders of the
trauma.
 Increased arousal such as difficulty in sleeping and
concentrating, feeling jumpy, and being easily
irritated and angered.
PTSD in Children and Teens
Children and teens could have PTSD if they have lived
through an event that could have caused them or
someone else to be killed or badly hurt. Such events
include sexual or physical abuse or other violent crimes.
Disasters such as floods, school shootings, car crashes, or
fires might also cause PTSD. Other events that can cause
PTSD are war, a friend's suicide, or seeing violence in the
area they live.
What are the risk factors for PTSD?
Three factors have been shown to raise the chances that
children or teen will get PTSD. These factors are:
 How severe the trauma is
 How the parents react to the trauma
 How close or far away the child is from the trauma
Studies show that about 15% to 43% of girls and 14% to
43% of boys go through at least one trauma. Of those
children and teens who have had a trauma, 3% to 15% of
girls and 1% to 6% of boys develop PTSD. Rates of PTSD
are higher for certain types of trauma survivors.
Children and teens that go through the most severe
traumas tend to have the highest levels of PTSD
symptoms. The PTSD symptoms may be less severe if the
child has more family support and if the parents are less
upset by the trauma.
 PTSD IN ADULTS
Not every traumatized person develops ongoing
(chronic) or even short-term (acute) PTSD. Not everyone
with PTSD has been through a dangerous event. Some
experiences, like the sudden, unexpected death of a
loved one, can also cause PTSD.
There is no one type of trauma that can lead to PTSD.
Rather, there are several different kinds of traumatic
situations that can do this, all of which have certain
common elements:
1. The trauma was life threatening or it led to
an actual or potentially serious injury
2. The individual reacted to the trauma with intense
fear, helplessness, or horror.
People can develop PTSD if you have been directly
involved in a serious traumatic event, or if
you witnessed a traumatic event. Shock and denial
shortly after the event is a normal reaction. Shock and
denial are often used to protect oneself from the
emotional impact of the event. They may feel numb or
detached and may not feel the event’s full intensity right
away.
 TREATMENT FOR PTSD
Effective treatments for PTSD include different types of
psychotherapy (talk therapy) or medication.
Trauma-focused Psychotherapies
Trauma-focused psychotherapies are the most highly
recommended type of treatment for PTSD. "Trauma-
focused" means that the treatment focuses on the
memory of the traumatic event or its meaning. These
treatments use different techniques to help you process
your traumatic experience. Some involve visualizing,
talking, or thinking about the traumatic memory. Others
focus on changing unhelpful beliefs about the trauma.
They usually last about 8-16 sessions. The trauma-
focused psychotherapies with the strongest evidence
are:
 Prolonged Exposure (PE)
Teaches how to gain control by facing negative
feelings. It involves talking about the trauma with a
provider and doing some of the things the client
have avoided since the trauma.
 Cognitive Processing Therapy (CPT)
Teaches to reframe negative thoughts about the
trauma. It involves talking with the clients provider
 about their negative thoughts and doing short
writing assignments.
 Eye-Movement Desensitization and Reprocessing
(EMDR)
Helps to process and make sense of the trauma. It
involves calling the trauma to mind while paying
attention to a back-and-forth movement or sound
(like a finger waving side to side, a light, or a tone).
Antidepressants (SSRIs and SNRIs)
Medications that have been shown to be helpful in
treating PTSD symptoms are some of the same
medications also used for symptoms of depression and
anxiety. These are antidepressant medications called
SSRIs (selective serotonin reuptake inhibitors) and SNRIs
(serotonin-norepinephrine reuptake inhibitors). SSRIs
and SNRIs affect the level of naturally occurring
chemicals in the brain called serotonin or
norepinephrine. These chemicals play a role in brain cell
communication and affect how you feel.
There are four antidepressant medications that are
recommended for PTSD :-
 Sertraline (Zoloft)
  Paroxetine (Paxil)
 Fluoxetine (Prozac)
 Venlafaxine (Effexor)
Some psychotherapies do not focus on the traumatic
event but do helps to process the clients reactions to the
trauma and manage symptoms related to PTSD. The
research behind these treatments is not as strong as the
research supporting trauma-focused psychotherapies
(listed above). However, these psychotherapies may be a
good option if the clients are not interested in trauma-
focused psychotherapy :-
 Stress Inoculation Training (SIT)
A cognitive-behavioral therapy that teaches skills
and techniques to manage stress and reduce
anxiety.
 Present-Centered Therapy (PCT)
Focuses on current life problems that are related to
PTSD.
 Interpersonal Psychotherapy (IPT)
Focuses on the impact of trauma on interpersonal
relationships.
 CONCLUSION
The subject suffered from a car accident when he was
16yrs old, he was hospitalized due to neck fracture and
other minor fractures. After being discharged from the
hospital after a month, he had a tough time getting
inside the car because he strongly refused. He is not only
scared of cars but any vehicle, this has led to many day-
to-day problems. Since he is the eldest there were many
responsibilities for him to do, but the fear has stopped
him (for example, grocery shopping etc.). His father was
supportive of him at the first but as days went by he
started getting frustrated and tired that his own son
couldn’t overcome a simple fear of riding a car. His father
used to have small fights and sometimes forces him to go
inside a car, this has made the subject tired and sad. But,
on the other hand, the subject was trying his hard to
improve and not to be stressed out near cars. After full
body recovery, instead of taking a bus or a car ride to the
college, he would go for a walk. The subject’s mother,
younger sister and friends were very supportive of him,
but he knew that it was quite difficult to overcome this
fear. So, with the help of his mother he decided to get
professional help.
He visited a close by Therapist who was well know for
her qualifications. The therapist studied the subject’s
problem and chose to do a trauma focused therapy as it
was more effective. Trauma-focused psychotherapies are
the most highly recommended type of treatment for
PTSD. This treatment focuses on the memory of the
traumatic event or its meaning. Some involve visualizing,
talking, or thinking about the traumatic memory. Talking
about the incident was quite difficult for the first few
sessions but because the therapist was very calm,
patient, understanding and did not force the client to say
the details he didn’t want to say.
The subject visited the therapist three times a week for
two hours and he had a total of 20 sessions. The therapy
also helped him do the things he thought he couldn’t do.
Like, facing his biggest fear which was getting into to a
vehicle. But that was only done only after the client was
convinced and ensured about it.
During the process of getting into the car with the
therapist for the first few times was very hard; the client
would have a severe panic attack, but it would die down
slowly. After many sessions with the therapist and
practices from the client’s side, it was his final session
and the therapist was ready to leave the client because
he has finally faced his fear.
The process of overcoming the fear was a long and
difficult one but, with the help and support of the
subject’s family, friends and the therapist he overcame it.
The subject also had a few follow up because he relapsed
a few times. Now it has been two years after the accident
and the therapy, the subject has been doing well. The
subject has started riding the bus and now he even has a
car of his own. The family of the subject is also happy,
the father is now proud of his son for overcoming his
fear. The treatment was very effective, and it has
definitely improved the subject’s life.