Case Vignette: Which Trauma based disorder(Posttramatic stress disorder (PTSD), Acute stres disorder (ASD) oradjusment disorder is Bethany and Charles each suffering from andwhy? Dignosis Bethany and Charles and use symptoms from the casevignette (story below) to supportthe dignosis.
Bethany Pinsky, age 23, has gone to a theater to see the localpremiere of a big-budget movie. As she settles into her seat,waiting for the show to begin, a young man in a ski mask suddenlyappeared in front of the screen. Brandishing an assault rifle, hefired directly into the audience. She saw many people get shot,including the woman sitting next to her. People all around beganscreening, and there was a confused stampede for the exit door.Terrified, she somehow fought her way to the exit and escaped,uninjured, to the parking lot, where police cars were justarriving.
Charles Quigley, age 25, went to the same movie theater at thesame time. He too feared for his life. Hiding behind a row ofseats, he was able to crawl to the aisle and quickly sprint to theexit.  Although covered in blood, he escaped withoutphysical injury.
Bethany, Two Weeks Later
Bethany comes to see you. She has not recovered 2 weeks later.She feels emotionally constricted, and unable to experiencepleasant or positive feelings. She jumps at the slightest sound,she is unable to focus on her work and her sleep has been fitfuland marked by traumatic nightmares. She has tried to avoid anyreminders of the shooting but nevertheless relentlessly recalls thesounds of gunfire, the screams, and the sticky feel of the bloodpouring out of her neighbor's chest in the movie theater. She feelsthe experience has changed her life forever.
Charles, Two Months Later
Charles comes to see you as he has been having a difficult timesleeping and concentrating. He feels like he wasn't impacted asmuch as others by the event but continues to think about theshooting. He finds himself sad at times and easily cries. He feelshis heart rate increase and becomes slightly nervous at a loudsound. He feels anger towards others who tell him that theyunderstand how he feels. When asked about his job and personalrelationships, he states that he has been able to keep his job.However, he is afraid he may get fired soon as his performance atwork has been poor due to his inability to concentrate. Hisgirlfriend tries to help him but he feels she can't understand hispain since she wasn't there. She has noticed his low energy andfeeling of hopelessness lately and suggested that he seesomeone.
