Psychology Trauma – A4

Assignment 4


Vignette Analysis I:
This  assignment focuses on vignette analysis and direct application of  course concepts to the persons and situations presented in the  vignette.   All discussions must take into account the legal and ethical  considerations, as well as cross-cultural issues that pertain to the  situations presented below.

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Use  the reading assignments thoroughly in an integrative discussion. All  assignments MUST be typed, double-spaced, in APA style, and written at  graduate level English. Be sure to cite your work according to APA  format. Please keep your responses focused on what is presented in the  vignette. Do not add information but use your creativity to support what  you see in the vignette as written. Avoid elaboration and assumptions.

The  course text is the primary resource for this assignment. You should be  citing the text often to support your discussion (along with the DSM-5).  Outside references should be minimal, except for culture.

Note:  Cultural  information can be found in the DSM-5. You are also encouraged to use  outside Cross Cultural sources as needed, but please reference if doing  so.  

Discussion must be 6-7 pages plus a title and reference page. 

Vignette Analysis I

Vignette Analysis I will be covering Chapters 1 through 3 in the course text and the relevant DSM-5 disorders.

Your discussion must include at least five (5)  of the following areas covered in the text that you see relevant,  directly and specifically to the persons and situations presented in the  vignette:

(Please identify which areas you are choosing)

· Type I, II, III Trauma

· Developmental and lifespan trauma

· Anxiety, depression and anger Reactions

· Physical and somatic problems

· Emotional dysregulation

· Loss of self-integrity

· Compromised relationships with others

· Safety and the therapeutic relationship
Vignette One
Roni is a 25-year-old female of Asian descent who has been diagnosed with Post Traumatic Stress Disorder (PTSD). Roni  and her family came to the United States when she was 17 years old  after her paternal uncle was killed.  She does not remember the details,  but she has fleeting memories of “gunshots, people screaming and all  the children being pushed into a car and taken to some strange  place”.  No one in the family was allowed to mention her uncle’s death  once they arrived in the U.S.  Roni also tells you, “I hate July 4th in this country. The only way I can cope with that horrific noise, is by taking medicine my doctor gives me”. Roni  also reports that she has overwhelming fears of abandonment and is  terrified of being alone. During the history taking, Roni tells you that  when she thinks of her uncle’s death, she has great relief and,  “sometimes I am glad he is dead. I feel so guilty for admitting that,  but he was creepy and I hated being alone with him.”

Roni  is now married for 4 years to a wonderful man she met in junior  college. The couple has a 2 year old daughter whom she loves dearly. At  times when Roni and her daughter are in the neighborhood playground,  Roni has the sensation that she is being stalked and fears that someone  is going to hurt her daughter. She knows this is irrational, but these  terrifying thoughts come over her and, “I must run home to protect my  daughter from bad people.” She claims that her life is fulfilling and  meaningful but that sometimes she finds herself numb for no reason and  feels like her life is a movie.  


Courtois, C.A. & Ford, J.D.    (2015).   Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach.   The Guilford Press.      ISBN 978-1462524600







Psychology of Trauma-Vignette Analysis I

Laura Kay Utgard

Cal Southern University

PSY: 87519

Dr. Barbara Lackey

August 1, 2018











Vignette Analysis I

Anxiety, depression and anger Reactions

The present post-traumatic stress diagnostic is applying to one event which lasts for a short duration, nevertheless, there is an increase in the number of professionals who are pushing for a new diagnosis in describing the long-lasting psychological events after the long term trauma. Even though it is unofficial diagnosis in the DSM-5, the complex post-traumatic stress disorder is affecting people who have undergone through chronic unpreventable traumas it is slightly possible to control over the ongoing months or years (Jonathan, Sarah, Catrin, & Neil, 2015). Relate to Roni

People with post-traumatic stress disorder usually struggle with occasional and intense symptoms of anxiety. The stronger symptoms of anxiety make these individuals depend on unhealthy ways of coping like the use of the drugs and alcohol thus making their situation to be worse as they risk having more complications such as cancers. The anxiety disorder caused by the post-traumatic stress disorder sometimes gets worse over time and this is likely to contribute to the development of other psychological disorder known as the anxiety disorder. Anxiety is a worry and an issue of concern because it may also result in physical symptoms such as fast heart rate and shakiness. Other disorders that might be experienced by the post-traumatic stress disorder patients include phobia, social anxiety disorder, separation anxiety disorder, panic disorder, and the selective mutism (Abigail, Negar, Sierra, Dorthie, Marylene, & Bekh, 2017).Relate to Roni

According to the DSM-5, depression is described as having depressed moods on a daily basis, losing the interest or pleasure of engaging in other activities, loss in the weight or gaining of the weight, finding it hard to fall asleep or having too much sleeps, feeling restless and worthless, finding it hard to concentrate, and suicidal thoughts. Depression is making the traumatic experiences to worsen and this reduces the chances of healing the post-traumatic stress disorder. The signs of the post-traumatic stress disorder can be distressing and debilitating and this leads to the development of the depression. This makes the affected individuals feel detached from the families or friends. It is also becoming hard for the affected victim to experience positive emotions such as joy and happiness and when not addressed immediately, people with the post-traumatic disorder will forever be sad, lonely, and depressed (Abigail, Negar, Sierra, Dorthie, Marylene, & Bekh, 2017). Same

Various ranges of negative internal states increase the possibility of an angry response. People with post-traumatic stress disorder develop anger to assists them in coping with life stresses by providing them with the energy to carry on in the face of problem. Even though it might be of help to them, anger creates major problems in the personal lives of the individuals experiencing post-traumatic stress disorder. When these patients are faced with a threat, they respond with anger. Anger helps them survive by shifting their focus. However, anger leads to an outburst of extreme emotions (Jonathan, Sarah, Catrin, & Neil, 2015). Same

In this case study (Vignette one), Roni has developed a sensation that she is being stalked and is having the fear that her child might be hurt. She is having terrifying and this makes to be worried about the safety of her daughter. Roni is having depression and this makes her have negative thoughts which make her be worried that a similar situation might occur to her 2-year-old daughter. Expand and relato to course conepts

Physical and Somatic Problems

Phased based approaches are important for a more complex presentation of the post-traumatic stress disorder. The phase-based approaches involve targeting problems dysregulation, dissociation, and the somatic symptoms to help in the promotion of the adaptive coping, sense of wellbeing, and the stabilization prior to undertaking traumatic focused intervention (Grupta, 2013). Somatic problems are issues which are related to the physical sensation and movements. Individuals with post-traumatic stress disorder always suffer from the physical issues. The post-traumatic stress disorder’s persistent emotional arousal contributes to the dysregulation of the biological systems and this increases the risks of having a biological abnormality which could result in numerous somatic complaints. The somatic complaints include fatigue, pain, tension, and the related biological adaptation which is promoted by the never-ending states of the stress (Jonathan, Sarah, Catrin, & Neil, 2015). Same

The tension within Roni makes her not to forget the incidence of which occurred when she was 17 years old. Due to the tension which makes her have fleeting memories of the gunshots, screaming of the people and incidence when the children were being pushed into a car into an unknown place makes her be fearful. She cannot be alone and when she remembers the incidence, she becomes tense thus feels insecure to the extent that she cannot leave her daughter alone to play in the neighborhood playground. See Syllabus – ?Type 1,2,3 Trauma

Emotional Dysregulation

Emotional dysregulation involves the process of being unable to control or regulate the emotional responses to the proactive stimuli. Each individual is exposed to events such as conflict or the perceived abandonment. Individuals with post-traumatic stress disorder usually experience emotional dysregulation and they tend to react in an emotionally exaggerated manner to the interpersonal challenges by overreacting such as the burst of anger, intense effort to avoid the perceived abandonment. Emotional dysregulation tends to be rational and this implies that it is triggered by a close personal contact such as family, child or the loved one who is having the power to control over that person.

The symptoms of the post-traumatic stress disorder such as the emotional dysregulation act as a risk factor and it leads to the development of difficulty or the interference with the daily functions. Therefore, in the process of treatment, it is always important to target this symptom because it will help in promoting the greater treatment success. Through teaching the act of accepting the situation or the forbearance of the adverse emotions is crucial in the treatment of the people with the emotion dysregulation (Abigail, Negar, Sierra, Dorthie, Marylene, & Bekh, 2017). Sane as above Some theory does not seem to app

In this case study, Roni who is suffering from the post-traumatic disorder is having emotional dysregulation. She is having excessive fear as she tries to react to the past severe and the life-threatening traumatic event by running to take her child from the neighbors’ playground. She has been exposed to events of conflict or the perceived abandonment and she is having an intense effort to avoid the perceived abandonment. According to her situation, she complains of being overwhelmingly fearful of abandonment and is terrified of being alone. This fear is also making her lose trust in her neighbors and she fears to leave them alone with her 2-year-old child due to fear of being hurt by people. All these behaviors are reactions to the previous severe and often life-threatening traumatic event which happened to her when she was 17 years old and they are being reinitiated by the memories she is having and this makes her not to be able to control these emotional responses. Due to her love for her daughter and the fear of being hurt, she is powerfully being controlled by her daughter. Better analysis according to course theory, Laura

To overcome this situation, it is always important to include the safety of the patient, education, and the engagement. These treatment mechanisms require the involvement of the relational psychotherapy accompanied with the mentalization-based therapies, dialectical behavioral therapy, and the somatic experiencing therapy. The management of the anger sleep; psychoeducation, and the neuro-feedback are important in improving the client experience. Relate to Roni

Loss of Self-Integrity

Exposure to the extreme interpersonal stress caused by the mental illnesses such as the post-traumatic stress disorder which is exemplified by the experience of torture is causing a threat to the psychological integrity of the affected individual. Such experiences lead to the mental death due to the loss of the pre-trauma identity of the victim. The mental death results in the loss of the key beliefs and values, distrust, and alienation from other people, sham or guilt or having a sense of being permanently damaged. The events of the post-traumatic stress disorder are a threat to the life or to the physical integrity of oneself. The results of these threats are the intense fear, helplessness, and horror.

DSM-5 is highlighting that the traumatic stressors caused by the post-traumatic stress disorder involved the perceived threat to the life of the individual or the physical integrity. These stressors affect the physical condition of the victim because they interfere with the integrity of the victim’s social network of the broad system of the social support (Abigail, Negar, Sierra, Dorthie, Marylene, & Bekh, 2017). In this case study (Vignette One), Roni is no longer believing or trusting her neighbors due to the event which she experienced and this interfered with the self-integrity thus she can no longer trust people around her. This situation has made her be helpless and is having intense fear. She cannot concentrate on whatever she is doing and is worried that the same experience might re-occur again. She fears to leave her 2-year-old daughter in the neighbor’s playground due to the development of the distrust. This is not her wish but the situation or her condition as forced her to behave this way. She does not have any feeling or connection with her neighbors and feels like she is alone. According to her, life is fulfilling and meaningful but sometimes she is finding herself numb for no reason and feels like her life in a movie. How does this relate to self integrity

Safety and Therapeutic Relationship

There are several well-known and evidence-based categories of the psychological therapies for the post-traumatic stress disorder. Most treatment forms are focused on the cognitive behavioral therapy which has been proven to be suitable in treating the post-traumatic stress disorder. It is always important to address the key intrapersonal and the interpersonal factors which are occasionally disrupting the responses to the exposure to the trauma. Most of the evidenced-based therapies involve the use of the prolonged exposure, cognitive processing therapy, brief eclectic psychotherapy, and the cognitive therapy.

These trauma-focused therapies involve the inclusion of a number of types of the guided exposition to traumatic memory. A good case is that which involve requesting the affected victim to relieve the trauma imaginable. This is carried out through developing exhaustive present-tense description of precisely what occurred throughout the traumatic incidence while creating an audio record of the narration and asking the victim to frequently pay attention to that video (Roberts, Roberts, Jones, & Bisson, 2016).

In this case study, it is important to optimize treatment for the clients by addressing the complicated issues of the trauma through the sound utilization of the multi-theoretical strategies. For Roni to benefit from the therapeutic approach applied, it is important to consider her safety, educating her, and engaging her in every aspect and process of the treatment. Education, in this case, involve providing Roni with the necessary skills which are important the management of the stress, depression and the conflict which makes her to distrust her close friends such as the neighbors (Courtois & Ford, 2015).Yes, I would recommend that you do this, Laura




References Abigail, P., Negar, F., Sierra, C., Dorthie, C., Marylene, C., & Bekh, B. (2017). Differential predictors of DSM-5 PTSD and ICD-11 complex PTSD among African American women. European Journal of Psychotraumatology, 8 (1). Courtois, C. A., & Ford, J. D. (2015). Treatment of complex trauma: a sequenced, relationship-based approach. The Guildford Express. Grupta, M. (2013). Review of somatic symptoms in post-traumatic stress disorder. International Review Psychiatry, 25, 86-99. Jonathan, I. B., Sarah, C., Catrin, L., & Neil, P. R. (2015). Post-traumatic stress disorder. BMJ, 351. Roberts, N. P., Roberts, P. A., Jones, N., & Bisson, J. I. (2016). Psychological therapies for post-traumatic stress disorder and comorbid substance use disorder (Review). Cochrane Database of Systematic Reviews (4), 1-125.

Laura, please review my welcome letter to you – I can send you another copy ; Also please review syllabus directions and Sample vignette Please take each experience, symptoms and relate to those relevant areas

One area where you began to analyze and apply. Well referenced. +15