Psychological Disorder Analysis
Marla, a 42-year-old Hispanic female, came to the mental health clinic expressing complaints of feeling “jumpy” all the time, having trouble sleeping, and is experiencing problems with concentration. Marla states these symptoms are beginning to cause problems for her at her job. The limited information provided makes it difficult to analyze Marla’s disorder. However, the symptoms suggest that Marla may be suffering from posttraumatic stress disorder (PTSD). PTSD can be difficult to diagnose and is often unrecognized. Posttraumatic stress disorder is an anxiety disorder which can develop from having experienced a terrifying event or ordeal in which grave physical harm occurred or was threatened. A traumatic event might be military combat experience, violent personal attacks, or accidents. While Marla’s profile does not state the existence of a traumatic event in her life, it is normal for the individual to withhold this information as it may be very difficult for them to relive the event. The DSM-IV states one of the criteria of PTSD is increased levels of arousal including insomnia, irritability, and hypervigilance. “People with these disorders may feel overly alert, be easily startled, develop sleep problems, and have trouble concentrating” (Comer, 2005) (pg. 136). Marla has admitted that she is not sleeping well, is having trouble concentrating, and feels jumpy all the time which relates to being easily startled. Many times individuals are misdiagnosed because of the commonality of symptoms between disorders. Without doing a more in depth interview with Marla it would be very difficult to give an accurate diagnosis. With that in mind, the following is a mock interview with Marla to better understand her disorder. Clinician: The first thing I would like to do is learn more about you Marla. Tell me a little about yourself. Marla: Well, I am 42 years old, married, with two children. This is my second marriage. I am from a close family which I believe is common within my culture. I work full time as an accountant for a reputable firm. Clinician: You said this is your second marriage. Are the children from your second or first marriage? Marla: The girls are from my first marriage. They were very young though when my husband and I got married. He has been as much a father to them as he would be if they were his biological daughters. He has been wonderful with them. Clinician: Did your first marriage end amicably?
Marla: I guess you could say that. My first husband is deceased. Clinician: I see. You must have been very young when he passed. Marla: Yes, we were both very young and our girls were just babies. They really do not remember him at all. Clinician: What are your hopes or expectations from our visits? Marla: I am hoping you can help me figure out why I haven’t been feeling like myself lately. And more than that I am hoping you can help me find a way to get back to my old self. Clinician: What brings you here today Marla?
Marla: I have been having some issues come up that have been interfering with my work. Clinician: OK. Let’s talk about that. How do you feel most days? Marla: Like I said I am an accountant so I need to be able to concentrate and stay focused. Lately, I find my mind wandering. I am unable to concentrate on the task at hand. This is happening more and more often. It doesn’t seem to matter where I am either. At home I lose my train of thought and have been forgetting the girls’ appointments. Clinician: How have you been sleeping?
Marla: I haven’t really been sleeping very well actually. I have trouble falling asleep and once I do fall asleep most of the time I have bad dreams, nightmares really. I will sometimes wake up short of breath and with a feeling that I have just narrowly escaped some terrible ordeal....