Assessment of Risk Factors in Post-traumatic Stress Disorder

A 37-year-old woman, who is an intelligent computer programmer, presented with insomnia, restlessness, and anxiety. On detailed assessment, she reveals that the symptoms started after some thieves robbed their house 3 months ago. In the incident, they had killed one of her sons. She also experiences intense imagery related to the event and often wakes up after experiencing a nightmare. The woman feels uncomfortable talking about the event and requests not to talk about it. She had experienced another such incident when she was a child. She also received treatment for depression three years ago. Personality assessment revealed neurotic traits. No one else in the family developed such symptoms, even though all of them experienced the event. 

Components of CBT for PTSD

Anger is CRIME

• Anger management 


• Cognitive restructuring 


• Recall of images of the events


• Information about about stress response


• Monitoring (self) of symptoms 


• Exposure

Risk Factors for PTSD (Post-Traumatic Stress Disorder)

Risk Factors for Post-Traumatic Stress Disorder

The following description of risk factors also answers QID:919472837474

The best answer would be d) her intelligence quotient. The patient has developed symptoms of post-traumatic stress disorder, including the most specific “intrusive symptoms.” These have occurred after the life-threatening event she went through. Both the international classification of diseases and the diagnostic and statistical manual require such a precipitating factor for making the diagnosis. It is an event that is life-threatening, or according to the diagnostic and statistical manual, one that threatens body-integrity (e.g. rape). One may either be a bystander or directly threatened by the event. However, this factor interacts with other predisposing or vulnerability factors in an individual to trigger the condition. Genetic factors account for about one-third of the vulnerability, according to a study conducted on twins working in the U.S. military. Other notable predisposing factors include female gender, a history of anxiety or depression, lower levels of intelligence, neurotic traits, a history of trauma, and lower social support. Her gender, her history of depression, of experiencing a similar event, and her personality, may all have predisposed her to develop post-traumatic stress disorder. Low and not an elevated level of intelligence predisposes to post-traumatic stress disorder. Thus, her elevated level of intelligence may not have added to her risk.

FAINTS

•      Female Gender, Family History of Psychiatric Illness
•      Anxiety/mood disorder (history of)
•      Intelligence (low)
•      Neuroticism
•      Trauma, history of
•      Social support (poor)

Post-Traumatic Stress Disorder: Sample CASC

So, I have been asked by your GP to have a chat with you because you are having some difficulties in judging. So, as far as I know, you have, you were in an accident. A few months ago and since then you've been having some difficulties. But if it's okay, I'll let you explain what led you to come in here already.

Yeah, I just had an accident about six months ago. And ever since then, I just can't get out of my head.

was it was a serious accident?

Yeah, it was it could have been, you know, the car was all messed up in a way you

know to sort of concussion

to split a whiplash room in the car was really hard.

I can see where you're getting a bit anxious even talking about it. If you find questions difficult to answer It's okay, we can move on. And you can take your time, too, if you're feeling anxious. So you had this unfortunate accident you said that, although you will not seriously injure the car was quite badly damaged, and you make the most depending on how long you have to be in the hospital.

Just a couple of days.

Yeah.

And you mentioned the competition, did you suffer any kind of memory loss or any confusion? And so this happened, about six months ago. And when did you experience the problems in your programs?

In the beginning, it was normal, you know,

it was really, really horrible.

But it just keeps going on. It just seems to get worse. Get rid of it. It's just taken over my life now.

Difficult. And so, can you describe what has been happening, what sort of experiences have you been to. Have you been experiencing?

And the newest thing is a sort of the last one, really I just sort of. I'll be at work or be out with your friends or anything, I just start hearing. Like screeching tires or metal.

This off. I can hear it and then it's like it's happening all over again. I just feel completely sort of paralyzed. So you've got a couple of minutes. It just seems like a lifetime.

Sounds really scary and some people, when they experience, have this kind of experience they also sometimes have nightmares of these incidents. And is it quite frequent the nightmares?

Yeah, so most nights really seem to get worse. Okay. But now it's sort of every night and it's just sort of stuck in the same thing I'm just reliving it up to where it happens and it's often what we find is a traumatic incident like that, avoid situations that might lead to a similar thing, avoid doing the things that happen on the day of seeing that happen in your case.

And now I'm going to drive with anybody else in the car.

Right. My friend.

I just keep thinking that I could have killed her.

Are you able to drive with no kind of emotional

Avoid at all costs, but I need to keep working. If I can avoid doing anything more than I have to do. I'm late every morning because it's just such a workout to get myself in the car to go.

And are you doing anything to deal with all these problems? And when you say drinking is more than community drink after the incident. Did you use to drink before?

I sort of had a glass of wine after work, but now it's just so I just have another one and then another one. I'm just so worried about going to sleep. So I just, I just have a couple more drinks and it just helps me. It helps me get to sleep.

How much do you drink?

Probably. Probably, um, maybe a bottle of wine.

So asking this, but you won't be using any other substances, middle class, here. So, your drinking has gone up You said that you were feeling quite anxious and agitated. Do you also find that you have become a bit more snappy, irritable, with people?

He says I'm a different person now. He thinks I'm just angry all the time. I get mortgage irritated, the normal, a film just got shorter views than I did before.

And you also are quite easy to be always vigilant about what's going on around you.

You know, if I have to sit in the car with my boyfriend's driving to somewhere. I'm constantly on edge I'm looking around for other cars and any sort of hazards, constantly jumping or saying oh slow down or things like that. Yes.

I think all of this must be quite draining on you, how do you say your mood has been in the last few weeks.

I just feel so tearful all the time. On the verge of crying because I just seem so frustrated, but it's still, still going on.

Do you have any happy times in between the lives of many you're doing anything specific?

that already enjoy much,

Because you feel constantly alone and not enjoying things as well. What would you say your energy levels are like

guess just because on the edge all the time we're just taking a lot out from this what

Do you find the most interesting things that you used to enjoy? And you mentioned trying to sleep. Because you are afraid of sleeping, you have been drinking the evening. But when you go to sleep. Go to sleep.

Wake up a lot. Having these dreams gets to a point. So it's all happening again with the car, and then it gets to a point and then a shock. Wake up and then go back to sleep and it just happens.

So good focus on being able to look after yourself. Eat. Look after food and diet.

And since you've been feeling stressed, I mean, do you find that you've had any specific negative thoughts towards where you're not wanting to live anymore or felt like harming yourself or something.

Oh yeah, I don't, I don't want to live like this anymore. I don't kill myself, that's

Been asking lots of questions and you've been very patient with me Thank you very much. I need to speak to my team, and especially the psychologists in my team, because from what you're paying, what you're doing. Today, it seems like you are experiencing symptoms of post-traumatic stress disorder, commonly known as PTSD, and your concern appears below. So, I would speak to the Secretary of State and see if what the missed approach would be because we need to have. We go for psychological therapy first or try combination therapy and medication. But we have a discussion with the team and arrange another appointment for you so I can discuss more what the plan will be.