Problem 3 - Abnormal Psychology: An Integrative Approach

Question

Match the correct preliminary diagnosis with the cases below: (a) posttraumatic stress disorder, (b) acute stress disorder, and (c) delayed onset posttraumatic stress disorder. Patricia was raped at the age of 17, 30 years ago. Just recently, she has been having flashbacks of the event, difficulty sleeping, and fear of sexual contact with her husband. ______________

Step-by-Step Solution

Answer

Patricia's case is Delayed Onset Posttraumatic Stress Disorder.

Step 1: Identify the Key Features

First, evaluate the description of Patricia's symptoms. She has started experiencing flashbacks, difficulty sleeping, and fear of sexual contact 30 years after the traumatic event occurred. These symptoms have recently begun and are associated with a traumatic event that happened in the past.

Step 2: Understand Diagnostic Criteria for PTSD

Posttraumatic Stress Disorder (PTSD) typically involves symptoms that appear long after the traumatic event, such as flashbacks and disturbances in daily functioning. If these symptoms appear months or years after the event, it's often diagnosed as delayed-onset PTSD.

Step 3: Compare Symptoms with Acute Stress Disorder

Acute Stress Disorder occurs immediately following a traumatic event and typically lasts for a few days to a month. Patricia's case involves symptom onset many years after the trauma, not immediately after.

Step 4: Compare Symptoms with Posttraumatic Stress Disorder

PTSD can occur soon after the trauma but may also present as delayed-onset if the symptoms appear much later, which fits Patricia's recent experience 30 years after the trauma.

Step 5: Determine Most Suitable Diagnosis

Since Patricia's symptoms have appeared 30 years after the traumatic event and align with PTSD characteristics, this suggests a delayed onset of PTSD. Therefore, the appropriate preliminary diagnosis for her situation is Delayed Onset Posttraumatic Stress Disorder.

Key Concepts

Acute Stress Disorder

Acute Stress Disorder (ASD) is a mental health condition that can occur shortly after someone experiences a traumatic event. It is characterized by a range of symptoms that mimic those of PTSD, but these symptoms are short-lived and occur soon after the trauma. Typically, ASD lasts from three days to one month following the traumatic incident.

Key symptoms may include:

• Intrusive memories or flashbacks
• Avoidance of reminders of the trauma
• Negative mood and dissociation
• Marked anxiety and sleep disturbances

Unlike PTSD, which persists beyond a month, ASD is often considered a precursor to PTSD if symptoms continue or intensify beyond the early period.

Addressing ASD with early intervention can be crucial in preventing the development of full PTSD. Therapy might involve cognitive-behavioral techniques to help reduce symptoms and provide coping strategies.

Delayed Onset PTSD

Delayed Onset Posttraumatic Stress Disorder is a form of PTSD where symptoms manifest long after the initial trauma. While some individuals may seem to initially cope well after a traumatic event, certain triggers or stressors might cause symptoms to emerge years or even decades later.

In the context of delayed onset PTSD, individuals might suddenly begin to experience:

• Recurrent intrusive memories or flashbacks
• Heightened arousal or jumpiness
• Emotional numbness or avoidance
• Negative changes in thoughts and mood

These symptoms disrupt daily life and can be very distressing. Understanding that PTSD symptoms like Patricia's may have a delayed onset is crucial for proper diagnosis and treatment.

Treatment options are similar to those for standard PTSD, which can include therapy and medication. Seeking help as soon as symptoms are recognized, even if they appear long after the initial trauma, is important.

Diagnostic Criteria for PTSD

Posttraumatic Stress Disorder (PTSD) has specific diagnostic criteria that must be met for a proper diagnosis. These criteria are detailed in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) and encompass several key areas:

• Exposure to Trauma: Direct experience, witnessing, or learning about a traumatic event.
• Intrusive Symptoms: Recurrent, involuntary memories, flashbacks, or dreams related to the trauma.
• Avoidance: Persistent efforts to avoid trauma-related thoughts, feelings, or reminders.
• Negative Alterations in Cognition and Mood: Negative beliefs, emotional numbness, or detached feelings since the trauma.
• Arousal and Reactivity Changes: Irritability, hypervigilance, or an exaggerated startle response.

For a PTSD diagnosis, these symptoms should persist for more than one month and cause significant distress or impairment in functioning. Understanding these criteria is essential for distinguishing PTSD from other related disorders and determining an accurate diagnosis.