Clinical Case Study:
Combat PTSD
Rachel Dillon
Case Study project
Abnormal Psychology
Professor Dyszelski
24 April 2013
HISTORY OF PRESENT ILLNESS
A 30-year-old married, Caucasian female, who served three tours of duty in Iraq, presented to a Veteran’s Administration Medical Center in Madison, Wisconsin. On intake to primary care, she screened positive for PTSD and was referred for specialty services to the posttraumatic stress clinical team for experiencing traumatic symptoms over the duration of 1.5 years. The patient reported that her primary combat duties included driving fuel tankers in a convoy from base to base and performing guard duties to secure the perimeter of the base. In the context of that duty she reported being exposed to multiple life-threatening situations, witnessing dead and mutilated bodies, a near plane crash, daily mortar attacks on the base, making many split-second life-or-death decisions, and the loss of one of her soldiers. After returning to the United States she began to experience at least five distinct intrusive memories and nightmares from these combat experiences. She engaged in avoidance through attempted thought suppression, conversation redirecting, and alcohol abuse. She avoided crowds and social situations and began to fail out of college because she felt unable to focus on her academic duties as a result of her symptoms. She expressed severe nightmares/tremors and had an eradicated sleep schedule. She wakes up numerous times throughout the night and on some nights avoids sleeping completely. On presentation to the posttraumatic stress clinical team, she was diagnosed with PTSD. In addition to her other symptoms, the patient reported engaging in compulsive checking behaviors. She reported checking her front door lock 5 to 10 times a day and peering out of her windows on a constant for lurking individuals. The patient also reported engaging in checking behaviors whenever she had an