Introduction
The narrative presented in Victor’s case shows that he meets the DSM-5 criteria for Posttraumatic Stress Disorder (PTSD). PTSD refers to the consistent maladaptive response that lasts for more than a month after undergoing disturbing events (Lehavot et al., 2018). The condition may develop after months, years, or decades, although in certain circumstances, patients might only begin showing it after many months of experiencing traumatic actions. The case demonstrates that Victor had rightly experienced distressing events that not only exposed him to serious calamitous sights but haunted him in many ways. The situation is further deteriorated by the fact that he took too long to receive professional assistance, making him encounter major turbulences in his life. Based on his explanation of the situation, he fits Criterion B trauma. The inference is backed by the fact that Victor’s traumatic situation is persistently manifesting intrusion symptoms such as nightmares, flashbacks, unwanted upsetting memories, and a lack of willingness to share previous hurtful events.
Victor depicts the criteria of avoidance in connection with upsetting events as supported by these indications. First, he made efforts to avert external reminders (objects, activities, people, or situations) that prompt distressing memories, thoughts, and feelings related to the past traumatic experience. For example, he avoids seeing colleagues from his infantry unit because such acts will remind him of the experiences he wishes not to reminisce about. Moreover, Victor experiences trauma-related feelings when he illustrates having disturbing memories regarding his shocking experiences every day, though he fails to share any of such particulars.
Victor displays symptoms of alterations in mood and cognition by the following evidence in the case. He shows reduced interest in some activities such as the job. For example, he reports that he finds it hard to execute his role as a security officer since it had turned boring coupled with too much time for thinking. He shows persistent negative emotional states such as becoming easily irritable. Victor’s marriage appears disrupted since his wife feels disconnected as things are not right coupled with the feeling of isolation. The patient has symptoms of alterations in reactivity and arousal concerning the shocking event. The situation is supported by evidence of difficulty with concentration combined with sleep disturbance. For example, he reports considerable challenges in sleeping where he “sleeps with one eye open” while on some instances when he falls into a deeper sleep, he experiences nightmares. However, the provided case shows that Victor does not meet the symptoms of stressors. For example, it does not document whether he was exposed to death, threatened, or actual injury, or threatened death.
In attempts to unravel missing information to establish whether Victor meets the criteria outlined in the PTSD assessment, it is prudent to ask fundamental missing questions that will go a long way in providing a detailed response to his case. For example, it will be important to know the duration that the symptoms have lasted and whether he has experienced indications that create distress or functional weakening. It will be essential to know whether Victor has used medication or abused substances that might result in exclusion conditions.
Differential Diagnoses
Within the realms of differential diagnoses of PSTD, it is essential to contemplate aspects such as depression, panic disorder, anxiety, phobia, and malingering. Other symptoms include the psychiatric display of health conditions, substance abuse, and dissociative disorders. Victor demonstrates symptoms characteristics of depression such as dysphoric mood coupled with disturbances in sleep. Moreover, he has trouble concentrating, thinking, making decisions, and memorizing things. The patient also shows symptoms of loss of interest as well as pleasure in certain activities. For example, Victor finds the duties of a security guard boring. He is also feeling irritated and struggles to get sleep and if at all he falls asleep, he experiences serious nightmares.
In another instance, Victor demonstrates symptoms and characteristics of a specific phobia such as avoidance and fear. In the course of battling the traumatic events experienced as an infantryman, he practices avoidance behavior to help him forget the hurtful events he previously encountered. For example, he also evades seeing his friends from his Reserve group since it will remind him of previous involvements. The symptoms of substance abuse and malingering do not fulfill the DSM-5 diagnostic criteria since Victor neither demonstrates a medical history of abuse of substances nor an overemphasis on the functional state before the traumatic state.
Conclusion
As Victor’s therapist, using Cognitive Processing Therapy (CPT) would be the most recommended treatment plan for this case. The CPT model helps in understanding that it is usual for individuals to experience psychological responses to traumatic actions. In the model, PTSD is explained to be occurring when something creeps into the channel of natural recovery from trauma. In most instances, it is an individual’s belief regarding why the upsetting event occurred that makes them have difficulties. The CPT model is an effective treatment plan for Victor since it concentrates on how he will comprehend the traumatic events and the aftermath experiences while helping him to establish more structured and helpful thoughts about the trauma (Roberge et al., 2021). The model helps in the patient’s recovery process by reducing distress associated with recollections of the trauma.
References
Lehavot, K., Katon, J. G., Chen, J. A., Fortney, J. C., & Simpson, T. L. (2018). Post-traumatic stress disorder by gender and veteran status.American Journal of Preventive Medicine, 54(1), 1-9.
Roberge, E. M., Harris, J. A., Weinstein, H. R., & Rozek, D. C. (2021). Treating veterans at risk for suicide: An examination of the safety, tolerability, and outcomes of cognitive processing therapy.Journal of traumatic stress, 34(6), 1228-1237.