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Psychopathology- The Case of John & PTSD

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My mark for this case study was 80% overall. Instructions: John is a 27-year-old man who comes to you for help at the urging of his fiancée. He reports that he used to work as a paramedic for 2 years, until 2 months ago, when he resigned. His fiancé has told him he has “not been the same” for the last 3 months and it is impacting their relationship. Although he offers few details, upon questioning, he reports that he has significant difficulty sleeping because he has vivid nightmares. He endorses experiencing several “horrible” events during his time as a paramedic, but is unwilling to provide specific details – he tells you he has never spoken with anyone about them and he is not sure he ever will. He is only willing to share that he has been in situations where he either felt personally threatened or saw others in threatening situations. He spends much of his time alone because he feels irritable and doesn’t want to snap at people, and so rarely goes out (except to go to work) and reports he isn’t interested in doing things that he usually derived pleasure from and feels disconnected from his fiancée and friends. He reports to you that he finds it difficult to perform his duties in his current administrative job because it is boring and gives him too much time to think. At the same time, he is easily startled by noise and motion and spends excessive time searching for threats that are never confirmed both when at work and home. He describes having intrusive memories about his “horrible” experiences daily, but he declines to share any details. He also avoids seeing friends from his old job because seeing them reminds him of experiences that he does not want to remember. Finally, he reports that in the last 3 months he has increased his alcohol intake and now drinks excessively to help him cope with his intrusive thoughts and difficulty sleeping (i.e. six or more drinks per sitting, but not feeling “too drunk”). Due to the heaviness and frequency of his . drinking in recent weeks, John has called in sick a few times from work to recover from drinking the night before. He reports he has tried to cut down his drinking because of the interpersonal problems it causes with work and his fiancée but has struggled to do so. Please write an essay in which you’ve fully considered the following issues and applied them directly to the case study above: 1. What is the primary diagnosis that you would assign to John and justify your answer using the DSM-5 and ICD-10 criteria (please don’t use point form)? 2. Discuss any comorbid disorder(s) according to DSM-5 and ICD-10 that may or may not exist in this case study 3. Explore the disorder(s) identified in relation to etiological factors, especially that of gender. 4. Provide a critical review of the particular challenges of working with the disorder(s) identified from a South African perspective..

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Psychopathology Evaluation of John




Kelsey Nairn

Bachelors of Applied Social Science

South African College of Applied Psychology




Psychopathology

Fred Schouwink

8th October 2020

, 2


Table of Contents

Psychopathology........................................................................................................................3

Defining Psychopathology.....................................................................................................3

Statistical Deviance............................................................................................................3

Maladaptiveness.................................................................................................................4

Personal Distress................................................................................................................4

Classification of Mental Disorders.........................................................................................5

The Case of John........................................................................................................................5

DSM-5 Diagnostic Criteria for PTSD ...................................................................................6

Criterion A: Exposure to traumatic event..........................................................................6

Criterion B: Intrusion Symptoms.......................................................................................6

Criterion C: Avoidance Behaviors.....................................................................................7

Criterion D: Alterations in cognitions and mood...............................................................7

E. Alterations in arousal and reactivity..............................................................................8

ICD-10 Criteria for PTSD......................................................................................................8

Comorbidities.........................................................................................................................9

Substance Use Disorders‌(SUD)........................................................................................9

DSM-5 Criteria for Substance Use Disorders (SUD)........................................................9

Aetiological Factors.............................................................................................................10

Critical‌‌Review‌‌of‌P
‌ TSD‌‌in‌‌the‌‌South‌‌African‌‌Context‌.‌........................................................11

Conclusion................................................................................................................................12

Works Cited..............................................................................................................................13

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