JANE CASE STUDY ASSIGNMENT
Case Study Assignment #4
Najah Blassingame
Department of Counselor Education and Family Studies
CEFS 546: Psychopathology
Liberty University
Author Note
Department of Counselor Education and Family Studies, Liberty University
I have no known conflict of interest to disclose.
Correspondence concerning this article should be addressed to Najah Blassingame
Email: nblasingame@liberty.edu
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JANE CASE STUDY ASSIGNMENT 2
Jane Case Study Assignment
Key Issues
Biological
Jane is a 54-year-old married black female. She has two adult children who are 25 and
31. She has not seen either of her children outside of her home since the accident which is
unusual for her. She currently lives with her husband of 33 years in their single-family home.
Jane has a large family of origin and is the middle child of seven. Her parents live in the same
town as she does. She is open to the idea of individual counseling but expressed fear over driving
to her appointments. She stated that she would need to check with her husband and see if he
could drive her.
Jane described the car accident she was involved in 3.5 weeks ago. she was on her way
home from work driving along the four lane, 55 mile per hour road. About 10 miles from home,
she reported that she saw a car jump over the grass median and come speeding down the
highway going the wrong direction. She saw a car jump over the grass median and come
speeding down the highway going the wrong direction. the third car in front of her hit the
oncoming car head on. This caused the two cars in front of her to slam on their brakes and
resulted in a 15-car pileup on the highway. Jane hit the car in front of her, her car veered off into
the right-hand ditch that runs along the highway. When her car hit the ditch, it flipped twice, and
she landed upside down on the side of the highway.
Her fear of driving, the reoccurring memories, the lack of sleep, and the overwhelming
anxiety has kept her from her normal activities which she highly enjoyed. In the past two week,
she has had nightmares of the accident at least five nights per week. She stated these nightmares
wake her up and then she has difficulty returning to sleep due to the anxiety she feels. Jane tends
Social
Jane reported she has multiple friends at work, in the community, and at church. She
stated prior to the accident she was very involved in the community and in her church. Jane
JANE CASE STUDY ASSIGNMENT 3
to be very tense when she's in the car and looks around continually for other vehicles that are
getting too close. In the past three days, she has started to worry about this overwhelming
experience that they will become more frequent and longer. When she is in the car with her
husband she gets startled easily. If a car in front of them taps on their break she will jump, grab
the armrest, and scream. She stated this is annoys her husband and she is somewhat embarrassed
by her response. She also tends to be very tense when she's in the car and looks around
continually for other vehicles that are getting too close.
Psychological
Jane has a bachelor’s degree in business and works full time as a system analysis for a
large company. She has been at her job for 15 years. She has been promoted several times due to
her excellent job performance. During the 45 minutes, she was trapped in her car she was
strapped in her seat belt which pressed against her chest making it difficult for her to breathe.
Jane was extracted from the car and taken to the local hospital. At the hospital she was treated for
multiple broken ribs, a broken arm, a bump on her forehead that did not give her a concussion
and multiple bruises and abrasions. The released her after 24 hours. She has also been very
irritable since being released from the hospital. Jane reported no history of health problems, is on
no medication, no past mental health diagnosis, and has no history of alcohol use or other
substance use.
Spiritual
Jane reported believing in God and that her spiritual life was a central focus of her life.
She stated “I just cannot figure out why God would do this to me. She has been attempting to
pray but is struggling to focus. She also has not been able to engage in Bible study due to having
to travel to church. She has not attended church since the accident, which she feels guilty about.
Assessment
The assessment that can be used for Jane is the Clinician-Administrated PTSD Scale
because it will assess the symptoms of 17 DSM-5 symptoms of PTSD. It is a semi structured
clinical interview to assess the intensity and frequency scores of the symptoms (Bujarski et al.,
2014). This assessment uses psychometric content and very useful with diagnosing clients with
PTSD. Knowing that Jane’s primary diagnosis is PTSD this assessment will help with knowing
for sure that this is the correct diagnosis. This assessment can be used to give accurate feedback
about the results also.
JANE CASE STUDY ASSIGNMENT 4
stated that prior to the accident she spent a lot of time in her car going to work, visiting friends,
and socializing. She stated that she has not had a social life since the accident due to her
overwhelming fear up driving on the highway. If she could, she would quit her job and stay at
home where she knows she'll be safe. She reported feeling worried that her friends will break off
the relationships due to her being irritable and unavailable and that her life will never return to
the way it was before the accident. When it comes to her parents, she visits them every few days
but has not seen them since the accident. Her and her husband has a good relationship with her
husband, who she reported is being very kind and supportive.
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Diagnostic Impressions
I came up with the two following disorders because of matching criteria to Jane’s
symptoms. Jane has been exposed to actual death by witnessing an individual been pulled from a
vehicle to be exported to the hospital. She directly experienced the traumatic event by being in a
severe motor vehicle accident. This incident cause Jane to have emotional distress about driving.
She also had the presences of recurring memories of the event. She has negative thoughts feeling
that she is unlucky, and her life will never be the same. This evidence led me to the diagnosis of
Posttraumatic Disorder due to her experiencing and reexperiencing her traumatic experience
about her severe motor vehicle accident. The other disorder is chosen because of the same
symptoms including Avoidance Symptoms and Arousal Symptoms. The Avoidance Symptoms
Jane has been experiencing is the efforts to avoid memories, thoughts, and feeling about her
accident. The Arousal Symptoms Jane has been experiencing sleep disturbances, problems with
concentrating and her exaggerated starling response. This evidence helped me to choose Acute
Stress Disorder as the secondary diagnosis.
Primary Diagnosis – Posttraumatic Disorder (F43.10)
Jane showed many symptoms of the Posttraumatic Disorder because she directly
experienced traumatic experiences and they are associated within Criteria A, B, D and E. Jane
has two symptoms from Criteria A listed as directly experiencing a traumatic experience and
witnessing people dying in an accident. She has three symptoms from Criteria B such as having
memories, distressing dreams and flashbacks about the accident. Jane has negative thoughts that
she is unlucky about what happened because she feels scared knowing that it may happen again.
She has trouble socializing with her friends and family. Jane experiences problems with
JANE CASE STUDY ASSIGNMENT
concentration, difficulty sleeping, and she is easily startled when her husband drives. She also
avoids the idea of driving and socializing.
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Secondary Diagnosis – Acute Stress Disorder (F43.0)
Jane showed many symptoms of the Acute Stress Disorder because she directly
experienced the traumatic event by being in a severe motor vehicle accident. She has some of the
similar symptoms from the Posttraumatic Disorder. Jane has symptoms from Criteria A and B.
Jane experienced a traumatic experience by being involved in a car accident. Jane has been
irritable about the situation. She is constantly looking around and worried about being in another
accident.
Treatment Recommendations
Witnessing Death
Jane has experienced about three people dying from an accident she was involved in. She
was having memories about its multiple times of the day and could experience the whole event
all over again as if it was happing again. This accident has affected Jane mentality and she feels
that memory of the crash has affected her in a negative way. I believe the best treatment that Jane
could use to overcome her situation of death could be meditating and finding peace about the
situation knowing it is not her fault. Since she believes in God I can help her with praying
exercises by praying for her, guiding her in prayers and helping her to be comfortable with
praying again.
JANE CASE STUDY ASSIGNMENT 7
Being Afraid to Drive
Jane is afraid to drive, and she feels that another accident will happen. Jane will feel the
experience of being constricted in a car, her heart racing and the feeling of being overwhelmed
will affect her anytime she tries to drive. She gives her husband a hard time by getting startled
easily in the car by jumping, grabbing the arm rest, and screaming. She feels that she annoys
him, but she feels embarrassed about it. She is very tense about the road, and she even avoids
driving. I believe to treat Jane’s fear is by helping her to ease into driving and getting back out on
the road. The way she could ease her fear is by identifying her fears and talking them out with
someone. She can also bring positivity over herself by using positive affirmations.
Specific Considerations
This triggering event can affect how I prioritize treatment interventions by her fear of not
wanting to try to drive again. Jane’s fear has affected her by disturbing her daily routines of life.
This fear will make Jane back away from trying to overcome her fear and trauma. It is important
to collaborate with this client with treatment planning because Jane needs someone to encourage
her to try. When I help Jane, I would have to gain a trusting relationship with her. This idea will
help her to be open about trying to overcome her fears of driving. Some the barriers I might
encounter with this client is her way of transportation, stubborn attitude and how she is on edge
about things at the moment.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). American Psychiatric Association.
Bujarski, S. J., Craig, J. T., Zielinski, M. J., Badour, C. L., & Feldner, M. T. (2014). A
Multimodal Examination of Emotional Responding to a Trauma-Relevant Film Among
Traumatic Motor Vehicle Accident Survivors. Assessment, 22(2), 216–223.
https://doi.org/10.1177/1073191114548030
Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2017). Abnormal psychology. John
Wiley & Sons, Inc.
