Traumatic Event Case Study
Traumatic events can be defined as experiences or events that place an individual or someone close to them at risk of serious harm or death. The event is normally followed by a period of both shock and denial. Longer term effects including sudden flashbacks and strained relationships are also commonly observed (Carleton et al., 2019). Mr. Parker is a thirty-nine-year-old man who recently went through a traumatic event.
I was able to reach out to Mr. Parker with the assistance of a close colleague of mine. After establishing a good rapport with him, we agreed to conduct the interview via Skype. The interview was conducted on the seventh day of September, 2021, with Mr. Parker at the comfort of his home. Mr. Parker works a day job where he gets off at five providing enough time for us to begin our interview at six o’clock in the evening. The meeting lasted approximately two hours and it was very comprehensive. This essay aims at further expounding on the traumatic event that Mr. Parker underwent and highlighting some of his coping mechanisms.
From the interview, I learnt that Mr. Parker had recently lost his wife and daughter following a tragic road traffic accident. Mr. Parker paints a vivid picture of the events of that fateful night where he lost the two people that he loved the most. “We were coming from a restaurant downtown. My wife really loved the food they served there,” Mr. Parker recollects. “I had just had a few glasses of wine, to commemorate the occasion, but I was still capable of driving.
We were laughing heartily in the car, then the worst happened.” Mr. Parker then went ahead to explain to me how a truck appeared out of nowhere and he instinctively veered off the road. It was at this point that he drove straight into a tree by the roadside. At this stage of the interview, Mr. Parker is visibly sad. He is unable to look straight into the camera and wipes off a few tears trickling down his cheeks.
Mr. Parker lost consciousness and woke up to find himself in a hospital. The health care practitioners told him that he had been out for two days. Fortunate for him, he had not sustained any major injuries or significant damage to any of his organs. On inquiring about his wife and daughter, nobody was willing to give him a direct answer. “The doctors and nurses ignored me every time I asked about my family,” he tells me. This left me in a confused and desperate state.
“Finally, when I was stable, the doctor in-charge came to me. From the expression on his face, I immediately knew that all was not well. He took my hand and broke the news to me. I immediately felt my mind go blank as I stared into the doctor’s eyes. It felt like a bad dream. One that I would wake up from in a few hours. Unfortunately, it wasn’t.”
Mr. Parker further explains to me how the following days after his discharge from the hospital was the toughest time he had ever experienced. He informs me of how he constantly had nightmares almost each and every night. During these nightmares, he tells me that he often saw his wife and child screaming asking him to save them. He would then wake up gasping for air while completely drenched with sweat. He further explains to me how he nearly became an alcoholic. He spent a majority of his evenings at the bar, trying to drown the pain he felt with alcohol. He was almost suspended from his job, but his boss being a very understanding man, decided to bear with him and help him seek help.
Mr. Parker further tells me of how the accident completely altered his social life. “It was almost impossible for me to get out of the house. I spent a majority of my time indoors,” he informs me. He further goes on to tell me how it almost became completely impossible for his to continue driving his car. “Every time I saw an oncoming truck as I was driving, I became very fearful and even started trembling. Most of the time, I would park the car by the roadside, recall my late wife and child and immediately start crying,” Mr. Parker tells me. He further tells me that a friend of his introduced him to some medication sold by the roadside that was supposed to help numb his pain while also helping him sleep. The drugs did very little to change his situation.
“A religious friend of mine introduced me to the church while I was at my lowest. Previously, I had not really been a believer. I started attending church services and was often left behind to talk to the pastor and seek answers concerning several questions that I had.” Mr. Parker informs me that it was during these sessions that he was introduced to a church group that held counselling sessions to people who had experienced traumatic events similar to his. He further adds that it was during this period that he developed a sense of inner peace and acceptance that slowly helped him cope with the situation.
Mr. Parker tells me that even though he has slowly started coming to terms with the loss of his family, he still experiences certain effects. “It is almost one year now since I lost my wife and daughter. Sometimes I experience nightmares of that fateful day. However, this is not as frequent as before.” Mr. Parker tells me. He also tells me that often experiences feelings of guilt and irritability feeling quite angry with himself. He sought help from a health care practitioner who diagnosed him with post-traumatic stress disorder (PTSD).
Mr. Parker tells me that the mental health expert prescribed medication to him and also advised him to start therapy sessions. The health care practitioner prescribed fluoxetine to Mr. Parker and he informs me that he has been compliant to his medication. He also began several therapy sessions. Mr. Parker also joined a group therapy session which met once per week. He informs me that he felt safe during these sessions and would opening up about the incident and his feelings. “The medication and therapy sessions have greatly improved my situation. My social life is almost back to the way it was before the accident,” Mr. Parker tells me. He informs me that his main goal is to go back to ‘living fully’.
Mr. Parker tells me that the incident has completely changed his life. “Previously, my spiritual life was not very well-defined. However, since the accident, I have become a staunch Christian. I found unexplainable peace at church during the most difficult time, and for that I am forever grateful to the church, to my pastor and most importantly to God.” Mr. Parker adds. He further informs me that he has since quit alcohol. He has also been able to start driving again. He however insists that he is always very careful while driving and his eyes are always fixed on the road.
Analysis and Discussion.
Mr. Parker is clearly suffering from post-traumatic stress disorder (PTSD). Post-traumatic stress disorder is a condition that is characterised by failure to fully recover after experiencing or witnessing a traumatic event or occurrence (Bisson et al., 2019). Some of the common traumatic events that trigger PTSD include accidents, physical or sexual assault, experiencing abuse or serious health care complications. As Wallace and Sweetman (2021 Traumatic Event Case Study) note, approximately one out of every three people who experience traumatic events end up with post-traumatic stress disorder. In our case, Mr. Parker loses his wife and child following a road traffic accident. The loss greatly impacts his life and general well-being.
The National Center for PTSD believe that experiencing trauma is not a rare event. They estimate that approximately six out of ten men are likely to experience a traumatic event at one stage or another. On the other hand, five out of ten women are likely to undergo a traumatic event (Simon et al., 2019). Men have an increased likelihood of experiencing accidents, war, physical assault and other disasters. Women on the other hand have a higher susceptibility to sexual assault and child sexual abuse.
According to Kashyap et al. (2019), it is estimated that approximately seven or eight people out of one hundred individuals will experience post-traumatic stress disorder at some point in their lives. Women are more predisposed to experiencing PTSD. It is estimated that approximately ten out of every one hundred women will experience post-traumatic stress disorder following a traumatic event. The occurrence in men is much lower with four out of every one hundred men who experience trauma developing post-traumatic stress disorder.
People experiencing post-traumatic stress disorder portray several symptoms. One of the commonest symptoms of PTSD is intrusive thoughts. Intrusive thoughts are experienced by individuals carrying on with their normal daily activities (Miller et al., 2019). These people suddenly experience unwelcome and distressing memories concerning the traumatic event that they just went through. Mr. Parker is constantly haunted by such thoughts during the early stages after the accident. He constantly has to stop as he is driving each time, he sees a truck that instantly triggers his memory towards that fateful day when he lost both his wife and daughter.
PTSD also commonly presents with nightmares. Research from the U.S Department of Veterans Affairs estimates that seventy one percent to ninety six percent of people with PTSD experience nightmares (Phelps et al., 2018). People with co-occurring mental conditions are at an increased risk of vivid and disturbing dreams. In our case scenario, Mr. Parker constantly experiences nightmares. In his dreams, he constantly sees his wife and child reaching out to him asking him to save them which he is unable to do.
Post-traumatic stress disorder is also characterized by avoiding events that remind the individual of the traumatic event. Boysen (2017) notes, people who survive nearly drowning may find it extremely hard to ever swim again. Their fear may be compounded to point where they may even avoid taking baths as they trigger memories of the traumatic event. Mr. Parker is quite terrified of driving following the accident that claimed the lives of both his wife and child. He is almost giving up on driving ever again and his situation is only made better following intervention.
Self-isolation, anger and irritability are other common symptoms observed in post-traumatic stress disorder. Individuals experiencing PTSD find it completely difficult to connect with other human beings. They avoid social settings as they are potential triggers and they are unable to relate well with both friends and family (Bonfils et al., 2018). PTSD also results in hyperarousal causing strong emotions such as anger and irritability. Mr. Parker spends most of his time isolated in his house following the accident. His social life is completely disrupted and he finds it difficult to leave his house. He is also constantly angry and irritable following the events that transpired and the consequent loss of his family.
Other symptoms associated with post-traumatic stress disorder include memory loss, negative thoughts towards self and the world, reduced interest in activities that one found pleasurable before, hypervigilance, difficulty in concentrating, insomnia and vivid flashbacks (Walton et al., 2017). Memory loss is commonly associated with the brain’s attempt to process and cope with the traumatic event rather than with physical injury. Individuals who have undergone traumatic events find it difficult to let their guard down resulting in hypervigilance and reduced sleep (Harnett et al., 2020 Traumatic Event Case Study). The body greatly tries to cope with the event and avoid triggers while also reducing the likelihood of experiencing such events again thus the symptoms observed.
Sequalae refers to the pathological condition resultant of a disease process or traumatic event. Kapfhammer (2018) notes that post-traumatic stress disorder greatly increases the likelihood of developing first-onset major depression and alcohol use disorder. The explanation of how these occur is not quite clear thought it is believed that it may involve the general effects of post-traumatic stress disorder or underlying vulnerabilities that are exposed by the traumatic encounter.
In a study conducted, the risk of developing major depression secondary to post-traumatic stress disorder was similar to the risk observed following other anxiety disorders (Hoppen and Morina, 2019 Traumatic Event Case Study). Female individuals who had pre-existing anxiety and PTSD were at a significantly increased risk of first-onset major depression. Further research demonstrated that pre-existing major depression greatly increased the vulnerability of women to post-traumatic stress disorder inducing effects of traumatic experiences and also the likelihood of being exposed to traumatic events.
Research estimates that approximately eighty percent of people with post-traumatic stress disorder have a comorbid disorder. The most common comorbidities include depression, anxiety, alcohol use, drug and substance use (Tripp et al., 2019). Post-traumatic stress disorder is a condition on itself, with very limited pharmacological treatment options. The reliance of psychotherapy as the sole treatment option may prove not sufficient enough in a majority of patients with the condition.
Individuals with post-traumatic stress disorder in most instances present with other disorders as well. This state makes it extremely challenging for health care professionals to diagnose the actual underlying symptoms resulting from the post-traumatic stress disorder (Nichter et al., 2019). Major depression and drug and substance use are the commonest conditions observed in people with post-traumatic stress disorder.
According to Peeters et al. (2021), individuals with post-traumatic stress disorder can also commonly present with an increased likelihood of panic disorder, agoraphobia, obsessive-compulsive disorder, social phobia and somatization disorder. Research has not yet well established the extent to which these conditions present before developing post-traumatic stress disorder, or whether the develop much later after the traumatic event and development of the PTSD.
Data derived from the National Comorbidity Survey has indicated that there is an additional psychiatric disorder in approximately eighty eight percent of male patients who have presented with a history of post-traumatic stress disorder (Thomlinson et al., 2017). This percentage is slightly lower in females with approximately seventy nine percent of women presenting with post-traumatic stress disorder manifesting and additional psychiatric disorder.
Further research indicates that about fifty nine percent of males with a history of post-traumatic stress disorder often meet the criteria for diagnosis of three or more psychiatric disorders (Giourou et al., 2018). The figure is lower in females with approximately forty four percent of women displaying similar data. Women with a definitive diagnosis of post-traumatic stress disorder are four times more likely to develop major depression and four and a half times more likely to develop mania when compared to women without the condition (Copeland et al., 2018). For their male counterparts, the likelihood of developing depression and mania in post-traumatic stress disorder is seven times and ten times more respectively when compared to men with no prior history of post-traumatic stress disorder.
Post-traumatic stress disorder is a condition often characterised by failure to recover after witnessing or experiencing a traumatic event such as a fatal accident or any form of assault. People with this condition will often present with nightmares, increased reactivity to stimuli, insomnia, self-isolation and irritability, depressed mood and avoidance of situations or activities that remind and individual of the trauma experienced. The condition often requires a medical diagnosis. Treatment options available often include various types of psychotherapy combined with pharmacotherapy to aid in the management of the patient’s symptoms.
Traumatic Event Case Study References.
Bisson, J. I., Berliner, L., Cloitre, M., Forbes, D., Jensen, T. K., Lewis, C., Monson, C. M., Olff, M., Pilling, S., Riggs, D. S., Roberts, N. P. & Shapiro, F. (2019). The International Society for Traumatic Stress Studies New Guidelines for the Prevention and Treatment of Posttraumatic Stress Disorder: Methodology and Development Process. Journal of Traumatic Stress, 32(4), 475-483. https://doi.org/10.1002/jts.22421
Bonfils, K. A., Lysaker, P. H., Yanos, P. T., Siegel, A., Leonhardt, B. L., James, A. V., Brustuen, B., Luedtke, B., & Davis, L. W. (2018). Self-stigma in PTSD: Prevalence and correlates. Psychiatry Research, 265, 7–12. https://doi.org/10.1016/j.psychres.2018.04.004
Boysen, G. A. (2017). Evidence-based answers to questions about trigger warnings for clinically-based distress: A review for teachers. Scholarship of Teaching and Learning in Psychology, 3(2), 163-177. https://psycnet.apa.org/doi/10.1037/stl0000084
Carleton, R. N., Afifi, T. O., Taillieu, T., Turner, S., Krakauer, R., Anderson, G. S., MacPhee, R. S., Ricciardelli, R., Cram, H. A., Groll, D. & McCreary, D. R. (2019). Exposures to potentially traumatic events among public safety personnel in Canada. Canadian Journal of Behavioural Science, 51(1), 37-52. http://dx.doi.org/10.1037/cbs0000115
Copeland, W. E., Shanahan, L., Hinesley, J., Chan, R. F., Aberg, K. A., Fairbank, J. A., van den Oord, E. J. C. G., & Costello, E. J. (2018). Association of Childhood Trauma Exposure With Adult Psychiatric Disorders and Functional Outcomes. JAMA Network Open, 1(7), e184493-e184493. doi:10.1001/jamanetworkopen.2018.4493
Giourou, E., Skokou, M., Andrew, S. P., Alexopoulou, K., Gourzis, P., & Jelastopulu, E. (2018). Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma?. World Journal Of Psychiatry, 8(1), 12. https://dx.doi.org/10.5498%2Fwjp.v8.i1.12
Harnett, N. G., Goodman, A. M., & Knight, D. C. (2020). PTSD-related neuroimaging abnormalities in brain function, structure, and biochemistry. Experimental Neurology, 330, 113331. https://doi.org/10.1016/j.expneurol.2020.113331
Hoppen, T. H., & Morina, N. (2019). The prevalence of PTSD and major depression in the global population of adult war survivors: a meta-analytically informed estimate in absolute numbers. European Journal Of Psychotraumatology, 10(1), 1578637. https://dx.doi.org/10.1080%2F20008198.2019.1578637
Kapfhammer, H. P. (2018). Acute and long-term mental and physical sequelae in the aftermath of traumatic exposure–some remarks on “the body keeps the score”. Psychiatria Danubina, 30(3), 254-272. https://psycnet.apa.org/doi/10.24869/psyd.2018.254
Kashyap, S., Page, A. C., & Joscelyne, A. (2019). Post-migration treatment targets associated with reductions in depression and PTSD among survivors of torture seeking asylum in the USA. Psychiatry Research, 271, 565-572. https://doi.org/10.1016/j.psychres.2018.12.047
Miller, M. B., Metrik, J., Borsari, B., & Jackson, K. M. (2019). Longitudinal associations between sleep, intrusive thoughts, and alcohol problems among veterans. Alcoholism: Clinical And Experimental Research, 43(11), 2438-2445. https://doi.org/10.1111/acer.14191
Nichter, B., Norman, S., Haller, M., & Pietrzak, R. H. (2019). Psychological burden of PTSD, depression, and their comorbidity in the US veteran population: suicidality, functioning, and service utilization. Journal Of Affective Disorders, 256, 633-640. https://doi.org/10.1016/j.jad.2019.06.072
Peeters, N., van Passel, B., & Krans, J. (2021). The effectiveness of schema therapy for patients with anxiety disorders, OCD, or PTSD: A systematic review and research agenda. The British Journal Of Clinical Psychology, 10.1111/bjc.12324. Advance online publication. https://doi.org/10.1111/bjc.12324
Phelps, A. J., Kanaan, R. A., Worsnop, C., Redston, S., Ralph, N., & Forbes, D. (2018). An ambulatory polysomnography study of the post-traumatic nightmares of post-traumatic stress disorder. Sleep, 41(1). https://doi.org/10.1093/sleep/zsx188
Simon, N., Roberts, N. P., Lewis, C. E., van Gelderen, M. J., & Bisson, J. I. (2019). Associations between perceived social support, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD): Implications for treatment. European Journal Of Psychotraumatology, 10(1), 1573129. https://dx.doi.org/10.1080%2F20008198.2019.1573129.
Thomlinson, R., Muncer, S., & Dent, H. (2017). Comorbidity between PTSD and anxiety and depression: implications for IAPT services. Archives of Depression and Anxiety, 3(1), 14-17. https://doi.org/10.17352/2455-5460.000017
Tripp, J. C., Jones, J. L., Back, S. E., & Norman, S. B. (2019). Dealing With complexity and comorbidity: Comorbid PTSD and substance use disorders. Current Treatment Options in Psychiatry, 6(3), 188-197. http://dx.doi.org/10.1007%2Fs40501-019-00176-w
Wallace, D. M., & Sweetman, A. (2021). Comorbid sleep apnea, post-traumatic stress disorder, and insomnia: underlying mechanisms and treatment implications—a commentary on El Solh et al.’s Impact of low arousal threshold on treatment of obstructive sleep apnea in patients with post-traumatic stress disorder. Sleep and Breathing, 25(2), 605-607. https://doi.org/10.1007/s11325-020-02107-z
Walton, J. L., Cuccurullo, L. A. J., Raines, A. M., Vidaurri, D. N., Allan, N. P., Maieritsch, K. P., & Franklin, C. L. (2017). Sometimes less is more: Establishing the core symptoms of PTSD. Journal Of Traumatic Stress, 30(3), 254-258. https://doi.org/10.1002/jts.22185