4/30/14
PS272 C
Case Study Jennifer is 25 years old she is single, unemployed, and currently living with her mother and two younger sisters. Jennifer reports having a rough childhood her mother would often lock her in her bedroom when she was upset and turn on an outdoor radio to drown out her screams. Jennifer often felt neglected and things only got worse when her mothers brother moved in with them. Jennifer’s mother picked up a job where she had to work the third shift and it was around this time that Jennifer reports being sexually assaulted by her uncle. The abuse continued, often times when her uncle was drunk. She felt frightened because when her uncle would attack her he would tell her if she told anyone he would hurt her and her family. Afterwards her heart would race when thoughts of the abuse arouse she experienced nightmares and even avoided large crowds she felt hopeless, ashamed and sad all the time. She jumped at the slightest noise at nighttime in fear that it was her uncle entering the bedroom. When Jennifer told her mother about the abuse she accused her of making it up which resulted in Jennifer believing that her emotions were unwanted and extreme. As she got older she began to hide her emotions and cope by stealing and drinking her mothers alcohol. She noticed that the anxiety dissipated after a few drinks. Jennifer became an alcoholic; she needed a drink to start her day. Even though the alcohol helped push away the emotional pain it often left her feeling depressed. This led Jennifer to participating in binge drinking, fighting, and unprotected sex. She had often mood shifts going from intense anger to depression. Due to Jennifer’s experience and symptoms I believe that she has PTSD. “Post Traumatic Stress Disorder entails an extreme response to a severe stressor, including increased anxiety, avoidance of stimuli associated with the trauma, and symptoms of increased arousal.” In order to have PTSD the person must have experienced or witnessed actual or threatened death. Sexual assault is one of the main reasons a woman may experience PTSD. For women, rape is the most common type of trauma preceding PTSD. “At least one one-third of women meet criteria for PTSD after rape.” Jennifer experiences multiple symptoms related to PTSD including recurrent distressing thoughts and nightmares, avoiding external reminders of the trauma, persistent negative beliefs about herself, others and the world, reckless self-destructive behavior after the incident and exaggerated startle response. PTSD symptoms last for at least one month, Jennifer’s symptoms last way longer she was assaulted as a young girl and is still experiencing negative symptoms at 25 years old Along with PTSD I also believe that Jennifer is suffering from Substance Use
Disorder. She is continuously stealing alcohol from her mother’s liquor cabinet. She found herself drinking up to three pints of alcohol a day and she needed it first thing in the morning to rid herself of sickness. She experienced repeated relationship problems; she would get close to a man but just end up pushing him away in fear that he would one day abandon her. Jennifer tried to control her drinking but she couldn’t and spent all her free time getting drunk. These symptoms have been occurring for more than a year, which qualifies Jennifer as having Substance Use Disorder. The last disorder I would diagnose Jennifer with is Borderline Personality Disorder due to her frantic efforts to avoid abandonment, self-damaging impulsive behaviors, recurrent suicidal behavior, chronic feelings of emptiness, and recurrent bouts of poorly controlled anger. These symptoms started before early adulthood and continued into her adult years. Although Acute Stress Disorder is very closely related to PTSD it can be ruled out as a diagnosis for Jennifer. Symptoms for Acute Stress Disorder are very similar to those of PTSD but the time associated with the symptoms