Question

Josh is a 27 year-old male who recently moved back in with his parents after his fiancée was killed by a drunk driver 3 months ago. His fiancée, a beautiful young woman he’d been dating for the past 4 years, was walking across a busy intersection to meet him for lunch one day. He still vividly remembers the horrific scene as the drunk driver ran the red light, plowing down his fiancée right before his eyes. He raced to her side, embracing her crumpled, bloody body as she died in his arms in the middle of the crosswalk. No matter how hard he tries to forget, he frequently finds himself reliving the entire incident as if it was happening all over.

Since the accident, Josh has been plagued with nightmares about the accident almost every night. He had to quit his job because his office was located in the building right next to the little café where he was meeting his fiancée for lunch the day she died. The few times he attempted to return to work were unbearable for him. He has since avoided that entire area of town.

Normally an outgoing, fun-loving guy, Josh has become increasingly withdrawn, “jumpy”, and irritable since his fiancé’s death. He’s stopped working out, playing his guitar, or playing basketball with his friends – all activities he once really enjoyed. His parents worry about how detached and emotionally flat he’s become.

What are the biological/physical symptoms? (2 pts)

What are the psychological/emotional symptoms? (2 pts)

What are the social/environmental factors or stressors? (2 pts)

What is a possible diagnosis or diagnoses? (3 pts)

What treatment options are available? Compare and contrast two different possible treatment approaches for this patient. (6 pts)

Answer 1

Biological /Physical symptoms - insomnia, nightmares, irritability, sweating , racing heartbeat

Psychological/ emotional symptoms- flashback, fear , severe anxiety, emotional detachment, flat effect

Social/environmental factors - social withdraw, , quitting job because it reminded him of that accident , loss of interest in activities

DIAGNOSIS- Josh is suffering from Post traumatic stress disorder (PTSD), it is often followed by a traumatic event like loss of a loved one due to an accident as in this case. Mr. Josh may also be suffering from depression.

Treatment- Eye movement desensitisation therapy , cognitive processing therapy can be used .