Posttraumatic Stress Disorder (PTSD) Case Study

Question 1

1. i.

In Victor’s case, he is likely to be experiencing Posttraumatic Stress Disorder (PTSD) and Panic Disorder. PTSD is defined as a persistent maladaptive reaction that lasts longer than one month after experiencing traumatic events. PTSD may develops by months, years or even prolonged for decades, but in some cases, PTSD may only start developing after many months or years of traumatic events experienced by the patient (Nevid, Rathus & Greene, 2014).

Victor had directly experienced traumatic event that exposed him to threatened death and serious injury, and he was haunted by the event for 5 years without seeing professional help and that causes major disturbance in his life. By Victor’s description on his condition, he fits in 7 out of 8 criteria of PTSD from the Diagnostic and Statistical Manual of Mental Disorder – Fifth Edition (DSM-5) (American Psychiatric Association, 2013).

1. ii.

Looking at DSM-5, diagnosis of PTSD is based on 8 criteria. First of all, Victor fits in the criteria of exposure to threatened death and serious injury, which includes the following 4 components:

1. He had directly experienced the traumatic event, where 5 years earlier he and his friend, John were physically attacked by three armed robbery.
2. Victor had also witnessed John being dragged and hit multiple times by two of the armed robbery.
3. During the traumatic event, Victor had learned that he and John might be killed by the ruthless robbery.
4. Victor was reported experiencing repeated exposure to unpleasant details of the traumatic event. Victor was suffering from panic attacks several times a week by reminders of the assault after he and John made a police report.

Second, Victor was presented with DSM-5 criteria of PTSD of intrusion symptoms related with the traumatic event, starting after the traumatic event where

1. He suffered from intense psychological distress (e.g., panic attack) at exposure to internal or external cues about the traumatic event.

Third, Victor fits in the criteria of persistent avoidance of stimuli in relation with the traumatic event, beginning after the traumatic event occurred, as supported by following components:

1. Victor made efforts to avoid external reminders (e.g., situations, activities and objects) that trigger distressing memories, feelings or thoughts that are related to the traumatic event. He was reported avoided driving or going out at night for the last 5 years after the traumatic event.
2. Victor also made efforts to avoid distressing memories, feelings and thoughts about his childhood traumatic events. He denied about childhood traumatic experience (e.g., experienced chronic physical abuse and neglected as a child), and known history of mental health problem in his family.

Fourth, Victor fits in the criteria of PTSD of negative changes in cognitions and mood in relation with the traumatic event, beginning or worsening after the traumatic event, as described by following components:

1. Victor was struggled by exaggerated negative beliefs about himself (e.g., feeling worthless)
2. Victor also have persistent negative emotional state (e.g., easily irritable, shy and anxious)
3. He had diminished interest in participating activities with friends and family, such as avoiding going out at night time.
4. Victor’s marriage was disrupted as his wife feel detached ever since Victor refused to go out at night for 5 years long.

Fifth, Victor also possess from the criteria of marked changes in arousal and reactivity in relation with the traumatic event, as supported by following components:

1. Victor has difficulty with concentration.
2. Victor also sleep disturbance (e.g., trouble falling asleep)

Sixth, Victor fits in the criteria of duration of the disturbance (Second, Third, Fourth, and Fifth criteria mentioned) which is longer than 1 month. Victor was reported suffering from PTSD for over 5 years after the traumatic event takes place.

Lastly, Victor’s disturbance is not contributed to physiological effect of a substance (such as alcohol or medication) or other medical condition.

2. i.

According to Stipancic, Renner, Schütz & Dond (2010), Neuro-Linguistic Psychotherapy (NLPt) is a specialized application of Neuro-linguistic Programming (NLP) in the area of psychotherapy. NLPt is an effective therapy method that helps people in resolving psychological difficulties, enhance perception of quality of life, and foster new learning and personal development. A total of 106 psychotherapy clients were assigned randomly to a therapy or control group. Structured Clinical Interview for DSM-4 Personality Disorder (SCID II) and Croation Scale of Quality of Life (KVZ) were used to assess the outcome. As a result, there was a significant decrease in clinical symptoms and increase in quality of life in the therapy group, as compared to the control group. Hence, the researcher also found significant findings on significant improves in the perceived quality of life with clients after therapy, as compared to the control group in waiting list.

2. ii.

According to Birocco, Guillam, Storto Ritorto,Catino,Gir, … & Ciuffreda, L. (2012), Reiki is a natural healing treatment which is performed by laying of hands and transferring energy from the Reiki giver to the receiver. In the pilot study of Birocco, et.al (2012), the use of Reiki were investigated on 118 cancer patients on their management of anxiety, pain and global wellness. A numerical rating scale conducted by the Reiki practitioners, Visual Analog Scare (VAS) and description of physical feelings of patient were recorded during each session of Reiki treatment. As a result, it was reported that the Reiki sessions are helpful in improving relaxation, pain relief, sleep qualities, well-being and reducing anxiety level. Hence, Reiki therapy is able to respond to patients’ emotional and physical needs when they are undergoing chemotherapy.

b) iii.

Mindfulness-based Cognitive therapy (MBCT) is a systematic training program in combining mindfulness meditation with cognitive-behavioral methods. According to Piet & Hougaard (2011), MBCT is designated to help major depressive disorder (MDD) patients to reduce symptoms of relapse or reoccurring. The meta-analysis study is measured by electronic databases and 593 participants from six randomized controlled trials were examined. As a result, MBCT were reported significantly decreasing the risk of relapse of MDD patients with 34% in compared to the control group. In general, the therapy was also proved as effective as maintenance antidepressant medication.

b) iv.

According to Brien, Lachance, Prescott, McDermott & Lewith (2011), homeopathic consultation process has clinical benefits in patients that are rather more effective than the homeopathic remedy. In the study, they examined 83 arthritis patients in randomized treatment and control group and placed them in either homeopathic consultation or non-homeopathic consultation. Result shows that patients receiving a homeopathic consultation significantly improved swollen joint count, current pain, weekly pain and negative mood. Hence, homeopathic consultation is in relation with clinically relevant benefits for patients.

b) v.

b) vi.

According to Zhang, Chen, Yip, Ng & Wong (2010), acupuncture therapy is usely as an alternative way of treating depressive disorder, particularly major depressive disorder (MDD) and post-stroke depression (PSD). In the research, the efficacy of acupuncture was compared to antidepressants by retrieving 207 clinical studies of acupuncture for depression. Result shows that acupuncture therapy is superior to antidepressants as compared to control group in significant improving of symptom severity and response of PSD. Hence, acupuncture therapy is rather a safe approach in treating both MDD and PSD patients.

b) vii.

In year 2011, a study conducted by Scheeringa, Weems, Cohen, Amaya‐Jackson & Guthrie (2011) claimed that trauma-focused cognitive behavioral therapy (TF-CBT) is useful for treating children with posttraumatic stress disorder (PTSD). In the study, 64 children were randomly assigned in TF-CBT treatment group or 12-weeks wait list control group. As a result, the treatment group improved significantly more on symptoms of PTSD. Hence, the study suggested that TF-CBT is an effective approach for reducing PTSD symptoms and benefits from certain comorbid disorders.

b) viii.

A study conducted by Youssef, S. (2013) examined the effect of hypnotherapy as a treatment for depression. The study includes two randomized controlled trials and a case study and was measured by Beck Depression Inventory (BDI- II), Beck Anxiety Inventory(BAI), and Beck Hopelessness Scale (BHS). As a result, hypnotherapy shows significant improvement in depression, anxiety, and hopelessness scores in the controlled group. Meanwhile, the study also shows that the therapy is more effective than antidepressant treatment on depression. Hence, the study proved that hypnotherapy is an effective treatment for depression.

b) ix.

According to Raboni, Alonso, Tufik & Suchecki (2014), Eye Movement Desensitization Reprocessing (EMDR) is an effective approach in treating Posttraumatic Stress Disorder (PTSD) patient. In Raboni, et.al (2014) study, out-patients with PTSD were assigned randomly to brief eclectic psychotherapy or EMDR and the study was measured by clinician-rated PTSD, anxiety and depression as well. Result shows that EMDR significantly reduced PTSD symptoms more than brief eclectic psychotherapy and hence result in faster recovery compared to the brief psychotherapy.

b) x.

According to Abbass, A. A., Rabung, S., Leichsenring, F., Refseth, J. S., & Midgley, N. (2013), Short-Term Psychodynamic Psychotherapy (STPP) is a successful approach in treating common mental disorder on children and adolescents. In the study, Abbass, et.al (2013) meta-analyzed controlled outcome studies of STPP sessions. As a result, they found that the outcome were suggesting that the treatment may be effective, as there is an effect increased in follow up compared to post treatment.