224 Unit 3 CURRENTSOCIAL ANDEMOTIONALCONCERNS
ity of the person to the event are the most important
factors affecting the likelihood of developing PTSD
(American Psychiatric Association [APA], 2000).
Woods (2000) found PTSD symptoms in groups of
women who were being abused as well as women who
had been out of abusive relationships for an average
of 9 years. De Vries et al. (1999) found that PTSD was
a common result in childhood traffic injuries for both
the children and their parents with 25% of the chil-
dren and 15% of parents developing PTSD symptoms.
Interestingly only 46% of the parents of affected chil-
dren sought help of any kind for their child and only
20% sought help for themselves.Dissociative Disorders
Dissociationis a subconscious defense mechanism
that helps a person protect his or her emotional self
from recognizing the full effects of some horrific or
traumatic event by allowing the mind to forget or re-
move itself from the painful situation or memory. Dis-
sociation can occur both during and after the event.
As with any other protective coping mechanism, dis-
sociating becomes easier with repeated use.
Dissociative disordershave the essential fea-
ture of a disruption in the usually integrated functions
of consciousness, memory, identity, or environmental
perception. This often interferes with the person’s re-
lationships, ability to function in daily life, and ability
to cope with the realities of the abusive or traumatic
event. This disturbance varies greatly in intensity in
different people, and the onset may be sudden or grad-
ual, transient or chronic. Dissociative symptoms are
seen in clients with PTSD.
The DSM-IV-TR describes different types of dis-
sociative disorders:- Dissociative amnesia:The client cannot
remember important personal information
usually of a traumatic or stressful nature. - Dissociative fugue:The client has episodes of
suddenly leaving the home or place of work
Posttraumatic stress disorderJulie sat up in bed. She felt her heart pounding, she was
perspiring, and she felt like she couldn’t breathe. She was
gasping for breath and felt the pressure on her throat!
The picture of that dark figure knocking her to the ground
and his hands around her throat was vivid in her mind.
Her heart was pounding and she was reliving it all over
again, the pain and the terror of that night! It had been
2 years since she was attacked and raped in the park
while jogging, but sometimes it felt like just yesterday.
She had nightmares of panic almost every night. She
would never be rid of that night.
Lately the dread of reliving the nightmare made Julie
afraid to fall asleep, and she wasn’t getting much sleep.
She felt exhausted. She didn’t feel much like eating and
was losing weight. This ordeal had ruined her life. She
was missing work more and more. Even while at work,
she often felt an overwhelming sense of dread. Some-CLINICALVIGNETTE: POSTTRAUMATICSTRESSDISORDER
times even in the daytime, the memories of that night
and flashbacks would come.
Her friends didn’t seem to want to be around her
anymore because she was often moody and couldn’t
seem to enjoy herself. Sure, they were supportive and lis-
tened to her for the first 6 months, but now it was 2 years
since the rape. Before the rape, she was always ready to
go to a party or out to dinner and a movie with friends.
Now she just felt like staying home. She was tired of her
mother and friends telling her she needed to go out and
have some fun. Nobody could understand what she had
gone through and how she felt. Julie had had several
boyfriends since then, but the relationships just never
seemed to work out. She was moody and would often be-
come anxious and depressed for no reason and cancel
dates at the last minute. Everyone was getting tired of her
moods, but she felt she had no control over them.