the basis for your diagnostic formulation and evidence-based treatments research paper). Materials: DSM-5-TR: Trauma Disorders DSM 5-TR Made Easy: Chapter 6 – Trauma and Stressor-Related Disorders (begins on p. 216)
instructions for what content to use in completing your Case Conceptualization Papers (e.g. which Cases, ancillary materials, etc.). Using Appendix A as a model to help you organize your sections, write a paper with diagnostic formulation including DSM 5-TR alphanumeric code and name and any specifiers, other considerations (Z-codes), and evidence-based treatments (both pharmacological and psychosocial). You will submit the APA-formatted paper in the Weekly Learning Guide for the module. The case conceptualization papers should be written in APA 7 Student edition
Presenting Concern
Emily is a 23-year-old woman who seeks therapy after struggling with symptoms of trauma for the past two years. She reports persistent feelings of detachment from her surroundings and herself, including sensations of being outside her body and a distorted sense of the world around her. She recalls a traumatic car accident that occurred two years ago as the precipitating event, though she notes that the flashbacks and intrusive thoughts related to the accident have persisted and worsened over time.
In addition, Emily experiences anxiety, hypervigilance, and a pervasive sense of disconnection from herself and others. She feels as though she is constantly on edge, unable to fully engage in life, work, or relationships. The dissociative symptoms have left her feeling numb and disconnected from her emotions and daily experiences, causing significant distress and impairment.
History of Presenting Issue
The traumatic event occurred two years ago, during a severe car accident. Emily was a passenger in her friend’s vehicle when they were struck head-on by another car on a rainy highway. She recalls the terror she felt as the vehicle spun out of control and collided with a tree, leaving her briefly unconscious. Upon regaining consciousness, Emily was disoriented and shaken, experiencing immediate physical pain and emotional distress. She was hospitalized for several days with a broken arm, bruises, and a concussion, but it was the emotional and psychological impact of the crash that persisted long after the physical injuries healed.
Following the accident, Emily began experiencing vivid flashbacks of the crash, accompanied by intense feelings of fear and helplessness. She would suddenly find herself transported back to the scene, her heart racing, her breath shallow, and her body trembling. These flashbacks often occurred without warning, sometimes triggered by the sound of screeching tires or rain hitting the windows, which reminded her of the day of the accident. She also began avoiding anything related to cars or driving, leading to a decrease in her social activities and independence. Her previously routine tasks—driving to work, grocery shopping, and visiting friends—became sources of extreme anxiety, and she often relied on others to drive her places.
Emily’s dissociative symptoms emerged shortly after the accident and have persisted in varying degrees since then. She reports feeling as if she is “outside of herself,” like she is watching her life from a distance. This sense of depersonalization is accompanied by feelings of derealization, where the world around her seems surreal, dream-like, or distorted. She describes walking through her day-to-day life as though she’s in a fog, disconnected from the people and events around her. At times, she feels like she is going through the motions of life without truly living it.
Her emotional numbness has contributed to difficulties in maintaining relationships. Emily has distanced herself from close friends and family, unable to experience the joy and connection she once felt. She isolates herself for long periods of time, unable to reach out for support, as her dissociative symptoms make it feel as though no one could truly understand her internal experience. Although Emily continues to function in her job as a graphic designer, she struggles with concentration and attention to detail, as her dissociative states often cause her to feel “checked out” during the workday.
Testimony from Emily’s Friend
Emily’s best friend, Sarah, has known her for several years and offers a corroborative account of Emily’s experiences:
"I’ve known Emily since college, and I’ve never seen her like this before. Ever since the accident, she’s been a completely different person. At first, I thought she was just going through a rough time, but it’s been over two years, and she hasn’t bounced back. She doesn’t drive anymore, which is crazy because she used to love going on road trips with me. Now, she gets anxious whenever it rains, and sometimes, she’ll just zone out during a conversation like she’s not even there. She seems really distant—like she’s not really ‘Emily’ anymore, but a shell of her old self. We used to talk about everything, but now it’s like she’s not even aware of what’s going on in her life. I miss her, and I can tell she’s struggling, but when I try to talk to her, she either shuts me out or says she’s ‘fine.’ I just don’t know how to help her anymore."
