Acute Stress Disorder – Kiki Dover

Client:  Kiki Dover     
Age:   44
Dr.:  Trevor Valdez
Differential Diagnosis:
·      Acute Stress Disorder
·      Post-traumatic Stress Disorder 
Primary Diagnostic Features:
·      Experienced traumatic event that results in activation of the sympathetic nervous system symptoms,
·     Development of dissociative symptoms
·      Disruption of cognitive experience
·      Duration is 4 weeks or less

Multi-Axial Diagnosis
Axis I: Acute Stress Disorder
Axis II: None
Axis III: None
Axis IV: Witnessing of an execution
Axis V: GAF = 72   

Theoretical Perspectives
Biological Perspective:
·      After the client experienced the traumatic event, her immune system became primed to potential similar stressors. She may also have had a greater magnitude of the pretrauma skin conductance response to startle stimuli which makes her more likely to exhibit posttraumatic stress symptoms in the acute trauma phase. This means there is a genetic predisposition. Low levels of GABA and an increased level of norepinephrine may also be causing these symptoms and the sympathetic nervous system being overactive. Her serotonin pathways may also have abnormalities. Finally, there may be atrophy of the hippocampus.
Behavioral Perspective:
·      This client’s symptoms may be mainly due to the faulty learning experience of classical conditioning. She may have acquired a conditioned fear to the stimulus that was present during the traumatic event (witnessing the execution). The response is the numerous symptoms related to the trauma. The symptoms may also be an outcome of operant conditioning because the client is choosing to avoid triggering stimuli (turning down assignments she wouldn’t usually), which would result in a decrease in her anxiety, which is a form of negative reinforcement.
Sociocultural Perspective:

·   This client’s symptoms may be due to her occupation. The trauma happened after she witnessed the execution at her work, so it is a work-related trauma. She is granted the ability to watch the execution unlike most others, and this lead to her numerous symptoms.

Source: Youtube