Counseling Diagnostic Assessment Vignette #27 - Symptoms of Posttraumatic Stress Disorder

Summary

Jessica recounts her struggle with anxiety and intrusive memories following a car accident. She experiences flashbacks, avoidance of driving, and heightened startle responses. Her emotional state is predominantly down, with depressive symptoms and difficulty concentrating. She occasionally feels detached from her body. The conversation suggests the need for counseling to manage her distressing symptoms.

Takeaways

• 😟 Jessica is experiencing significant anxiety and stress, along with intrusive memories.
• 🚗 The source of Jessica's distress is a recent car accident where she wasn't injured, but the other driver was.
• 💭 Jessica frequently relives the accident, often triggered by random events or reminders like a car scene in a movie.
• 🏠 The distress has led her to avoid socializing and stay home, avoiding activities she used to enjoy.
• 😠 Jessica experiences frequent irritability and mood swings, with occasional anger outbursts.
• 🚗 She's been avoiding driving since the accident, and when she does drive, it causes severe anxiety.
• 😨 Jessica is constantly on edge, experiencing heightened startle responses to small sounds or movements.
• 🛏️ She's struggling with sleep, often waking up in the middle of the night due to nightmares or general anxiety.
• 🧠 Jessica has had episodes of dissociation, where she feels detached from her body and experiences time slowing down.
• 👩‍⚕️ The interviewer plans to refer Jessica to a counselor to help manage her symptoms and improve her mental health.

Q & A

What symptoms is the individual experiencing?

The individual is experiencing anxiety, intrusive memories, irritability, avoidance behaviors, trouble concentrating, disturbed sleep, and feelings of depression.

What specific event does the individual keep remembering?

The individual keeps remembering a car accident they were involved in a few months ago, even though they were not physically injured.

How does the individual describe the intrusive memories of the accident?

The individual describes the intrusive memories as recurring suddenly, sometimes triggered by related events like seeing a car accident in a movie, or sometimes happening out of nowhere. The memories can be vivid and overwhelming.

How has the car accident affected the individual’s daily life?

The individual avoids driving unless necessary, feels anxious when doing so, and avoids social activities or going out with friends. Their mood is consistently low, and they feel disconnected from things that once made them happy.

What is the individual’s emotional response to the car accident?

The individual feels responsible for the car accident, blaming themselves for taking an unfamiliar route, despite the fact that the other driver received a ticket for reckless driving.

How has the individual’s startle response changed since the accident?

The individual has become more easily startled by everyday occurrences such as the doorbell ringing or small noises, leading to heightened vigilance and tension.

How has the individual’s sleep been affected since the accident?

The individual reports difficulties with sleeping, waking up frequently during the night, sometimes due to fear or disturbing dreams, which leaves them feeling unrested.

Has the individual experienced any dissociative symptoms?

Yes, the individual has experienced feelings of detachment from their body, where everything seems to slow down, and they feel disconnected from their surroundings, like watching a movie. This has happened multiple times in different settings.

How has the individual’s driving behavior changed since the accident?

The individual is more cautious while driving, constantly aware of other cars, driving slower, and feeling anxious about causing another accident. They often avoid driving altogether.

What actions are being taken to address the individual’s symptoms?

The interviewer suggests getting the individual in to see a counselor, and the individual agrees that counseling could be helpful in managing their symptoms.