Abnormal Case Study #3

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Rutgers University *

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Psychology

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Dec 6, 2023

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1) What factors, including developmental, early life experiences, and behaviors/thoughts after the incident, contributed to Elaine’s PTSD diagnosis? Would everyone who experienced the traumatic incident develop PTSD-why or why not? Elaine's diagnosis of PTSD can be attributed to factors including prior vulnerabilities from her history of trauma and the severe train accident. The traumatic incident involved a life- threatening event, leading to heightened emotional repercussions. Her ongoing post-traumatic symptoms, avoidance behaviors, and withdrawal from social support played a role in her diagnosis. Not everyone exposed to the same trauma will develop PTSD; the development of PTSD depends on a complex interplay of individual, situational, and psychological factors, making responses to trauma highly variable. 2) What type of conditioning created Elaine’s reaction to the incident and what type of conditioning maintained the symptoms? How did the conditioning affect Elaine’s social life after the incident? How did these factors increase Elaine’s symptomatology? The type of conditioning that created Elaine's reaction was classical and the conditioning that helped maintain the symptoms was operant. After the incident, Elaine's friends were very supportive and interested in helping her. However, as time went on, they started to lose their patience. Elaine would constantly talk about her traumatic event, and her personality began to change. She became angry, cynical and nasty compared to the warm and friendly person she was before. Elaine also began distancing herself from her friends, and would blame her friends for reasons they did not understand. Eventually, Elaine's friends just gave up and stopped contacting her. The change in social life continued to maintain and increase Elaine's symptomatology in several ways. She began to avoid stimuli by refusing to go out with friends, as well as pushed away her social support. This avoidance and isolation are forms of operant conditioning, which helped to maintain symptoms. 3) What aspects of therapy helped Elaine the most and why? How did these techniques help Elaine make the trauma “part of her experience”? What other techniques could the therapist have used to help Elaine (as we discussed in class)? Did Elaine need medication (why or why not)? The aspects of therapy that helped Elaine the most were exposure therapy and in vivo therapy. They allowed her to become desensitized to her trauma and allow them to just be events that occurred throughout her life rather than huge tragedies that keep her up at night or always linger in the back of her mind. The listening to the records and the trips by train or bus allowed her to overcome the weight of the events and lessened the effects the events had on her that now just make them a part of who she is or a small part in her life. The other techniques that the

therapist could have used would have been medicine or imagery rehearsal exposure. There was re-exposure, cognitive restructuring and prolonged exposure. The listening to the recording could be said to use imagery but it was not dealing with her nightmares and her writing them down, it was her listening to the recording she made until it no longer bothered and began to help her relax. She did not need medication because medication is a last resort of the therapy techniques and the techniques worked over time and she made a full recovery from her trauma and injuries without medication. 4) Do you all think that complex PTSD should be a diagnosis in the next edition of the DSM? Why or why not? We think that complex PTSD should be a diagnosis in the next edition of the DSM. We think this is because of the self-reflection that it has on people who are diagnosed with complex PTSD. Someone who has this disorder struggles with severe and pervasive problems in affect regulation, persistent beliefs about oneself as diminished, defeated, or worthless, accompanied by deep and pervasive feelings of shame, guilt, or failure related to a traumatic event, and persistent difficulties in sustaining relationships and feeling close to others. This disorder causes significant impairment in personal, family and social areas of functioning. These affects of this disorder can give someone thoughts of hopelessness leading to a outcome that is not easily repaired by therapy types. This is why we believe this disorder needs to be apart of DSM so people suffering can be clinically helped before symptoms worsen. Group Reflection 5) Was this group process different from the other group discussions? What, if anything, improved and why? No, the overall group process was the same, the only thing that was improved was the number of in person people we had during class to discuss. 6) How has the organization of the roles, annotations and discussions changed? They haven’t really changed a whole lot, with the exception of each person having a new role and fulfilling the role slightly differently for various reasons. 7) Will you make any changes next time to work together more effectively? We can spend more time discussing the differing opinions while looking at the case for our evidence. Other than that we have a pretty effective way of working as a group.

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