PSY 275 Week 2 Anxiety, Trauma and Related Disorders Example

After the Call She Cannot Forget: Anxiety and Trauma-Related Disorders in a Paramedic

[Student Name]

University of Phoenix

PSY/275: Introduction to Abnormal Psychology

Week 2 Assignment

[Instructor Name]

[Date]

The paramedic and the events described are composites written for a model paper; research findings come from the sources listed.

Anxiety is a normal response to threat, preparing the body and mind for action. Anxiety disorders arise when fear or worry becomes excessive, persistent and impairing. Trauma-related disorders follow exposure to events involving death, serious injury or violence. This paper analyzes one composite case to show how these disorders are recognized, why they develop in some people and not others and how they are treated.

The Case

Jess is twenty-seven and has worked as a paramedic in Flagstaff, Arizona, for five busy years. Four months ago she responded to a highway crash in which a young child died despite her efforts. Since then she has had vivid nightmares about the scene several nights a week, avoids driving on that stretch of highway even when it adds twenty minutes, jumps at sirens she once ignored and feels numb with her partner. She now snaps at coworkers and has started drinking more on her days off to fall asleep. She privately blames herself for the child's death, though the medical examiner found the injuries could not have been survived.

Matching Symptoms to Criteria

Posttraumatic stress disorder requires exposure to a traumatic event and symptoms in four clusters lasting more than a month: intrusion, such as nightmares and flashbacks; avoidance of reminders; negative changes in thoughts and mood, such as self-blame and detachment; and changes in arousal and reactivity, such as startle and irritability. Jess shows symptoms in every cluster, they have lasted four months and they affect her work and relationship.

Acute stress disorder involves similar symptoms but applies only from three days to one month after trauma. Had Jess been assessed in the first weeks, that diagnosis might have fit; at four months, PTSD fits better.

Other anxiety disorders should be considered. Her startle and tension resemble generalized anxiety, but her symptoms are tied to one event rather than many everyday worries. She does not report sudden, unexpected panic attacks typical of panic disorder. Her increased drinking also needs attention, since substance use often accompanies PTSD.

Why Some People Develop PTSD

Most people exposed to trauma, including most first responders, do not develop PTSD. Brewin et al. (2000) combined studies of trauma-exposed adults in a meta-analysis and found that factors operating during and after the trauma, such as trauma severity, lack of social support and additional life stress afterward, had stronger associations with PTSD than most pre-trauma factors such as education or prior trauma. Jess's case includes severe trauma, a sense of responsibility and, until now, little opportunity to talk about it at work, which fit these findings.

Biological factors also play a role. Trauma activates the body's stress response, and in PTSD the fear system may remain overly sensitive, so that reminders trigger alarm long after the danger has passed.

Learning and Avoidance

Behavioral models explain how avoidance keeps fear alive. The highway became linked with terror through classical conditioning. Each time Jess avoids it, her anxiety drops, which reinforces avoidance and prevents her from learning that the road is now safe. Cognitive models add that beliefs such as "it was my fault" maintain guilt and distress.

Treatment Evidence

Hofmann et al. (2012) reviewed meta-analyses of cognitive behavioral therapy and reported strong support for its effectiveness across anxiety disorders and for posttraumatic stress, though effects varied across conditions. Trauma-focused forms of cognitive behavioral therapy help people process memories and challenge beliefs such as self-blame.

Craske et al. (2014) described exposure therapy as inhibitory learning: rather than erasing the original fear, exposure creates new learning that competes with it, so that the reminder comes to signal safety. They suggested ways to strengthen this learning, such as varying exposure situations and testing expectations directly. For Jess, gradually driving the avoided highway and safely revisiting the memory with a therapist would create that new learning.

Avoiding the highway feels like protection, but each detour teaches Jess's fear system that the danger is still there.

Other Anxiety-Related Patterns to Know

Although Jess's case centers on trauma, the course covers related conditions that differ in important ways. In specific phobia, the fear centers on one trigger, such as heights or needles, and avoidance follows. In panic disorder, sudden surges of fear arrive without warning, and people come to fear the attacks themselves. Obsessive-compulsive disorder involves intrusive thoughts and repetitive behaviors performed to reduce distress, such as checking or washing. Each shares the theme of fear and avoidance, but the trigger, the focus of fear and the typical treatment target differ.

Protective Factors

Several factors may protect Jess. She has a supportive partner, a stable job with a union that offers counseling and five years of experience handling hard calls. Research on trauma suggests that support after an event, a sense of meaning and the ability to talk about what happened are among the strongest protective influences, which is why early peer support matters.

Medication and Other Support

Some antidepressants are also used for PTSD and anxiety disorders, and they can be combined with therapy. For first responders, peer support programs and supervisors trained to recognize distress can make it easier to seek help early. Addressing her increased drinking is part of treatment, since alcohol can worsen sleep and mood.

Treatment Plan

A reasonable plan would include an assessment with a clinician who specializes in trauma, a course of trauma-focused cognitive behavioral therapy that includes gradual exposure and work on self-blame, screening and support for alcohol use and coordination with her employer's peer support program. Her partner might join a session to understand PTSD, learn what helps and what does not and plan how to respond to nightmares.

Conclusion

Jess's nightmares, avoidance, numbness and startle fit PTSD rather than acute stress or another anxiety disorder, given their duration and pattern. Research on risk factors highlights the importance of support after trauma, and treatment research supports cognitive behavioral approaches that include exposure as new learning. With effective treatment, most people with PTSD improve substantially.

References

Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748-766. https://doi.org/10.1037/0022-006X.68.5.748

Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23. https://doi.org/10.1016/j.brat.2014.04.006

Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427-440. https://doi.org/10.1007/s10608-012-9476-1