This article illustrates the unique symptom presentation and outpatient treatment of posttraumatic stress disorder (PTSD) in a Hispanic female. The patient was referred to therapy to address problems with concentration and difficulties related to test-taking. A motivational interviewing-based assessment was conducted and the case was conceptualized in a cognitive— behavioral framework. After resolution of test-taking anxiety, additional anxiety symptoms emerged, including subclinical panic disorder and evidence of unresolved PTSD. Prolonged Exposure was initiated to successfully treat residual trauma-related symptoms. Recommendations for assessment and treatment of individuals with a trauma history are provided, with an emphasis on the need for sensitivity to cultural issues.
Beck, A.T., Epstein, N., Brown, G., & Steer, R.A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology , 56, 893-897.
3.
Blanco, C., Patel, S.R., Liu, L., Jiang, H., Lewis-Fernández, R., Schmidt, A.B., et al. (2007). National trends in ethnic disparities in mental health care. Medical Care, 45, 1012-1019.
4.
Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162, 214-227.
5.
Caetano, R., Cunradi, C.B., Clark, C.L., & Schafer, J. (2000). Intimate partner violence and drinking patterns among White, Black, and Hispanic couples in the U.S. Journal of Substance Abuse, 11, 123-138.
6.
Caetano, R., Schafer, J., Clark, C.I., Cunradi, C.B., & Raspberry, K. (2000). Intimate partner violence, acculturation, and alcohol consumption among Hispanic couples in the United States. Journal of Interpersonal Violence, 15, 30-45.
Dunn, C., Deroo, L., & Rivara, F.P. (2001). The use of brief interventions adapted from motivational interviewing across behavioural domains: A systematic review. Addiction, 96, 1149-1160.
9.
Eisenman, D.P.Meredith, L.S., Rhodes, H., Green, B.L., Kaltman, S., Cassells, A., et al. (2008). PTSD in Latino patients: Illness beliefs, treatment preferences, and implications for care. Journal of General Internal Medicine, 23, 1386-1392.
10.
Foa, E.B., & Rothbaum, B.O. (1998). Treating the trauma of rape: Cognitive behavioral therapy for PTSD. New York: Guilford.
11.
Galea, S., Ahern, J., Resnick, H., Kilpatrick, D., Bucuvalas, M., Gold, J. et al. (2002). Psychological sequelae of the September 11 terrorist attacks in New York City. New England Journal of Medicine, 346, 982-987.
12.
Golding, J.M. (1999). Intimate partner violence as a risk factor for mental disorders: A meta-analysis. Journal of Family Violence , 14, 99-132.
13.
Jackson, Y., & Jackson, Y.K. (2006). Encyclopedia of multicultural psychology. New York: Sage.
14.
Kessler, R.C., Chiu, W.T., Demler, O., & Walters, E.E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders on the national comorbidity survey replication. Archives of General Psychiatry, 62, 617-627.
15.
Linehan, M.M. (1993). Skills training manual for treating borderline personality disorder. New York: Guilford.
16.
Marlatt, G. A., & Gordon, J. R. (Eds.). (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York: Guilford.
17.
Miller, W.R., & Rollnick, S. (2002). Motivational interviewing (2nd ed.). New York: Guilford.
18.
Pole, N.Best, S.R., Metzler, T., & Marmar, C.R. (2005). Why are Hispanics at greater risk for PTSD?Cultural Diversity and Ethnic minority Psychology, 11, 144-161.
19.
Pole, N., Gone, J.P., & Kulkarni, M. (2008). Posttraumatic stress disorder among ethnoracial minorities in the United States. Clinical Psychology: Science and Practice, 15, 35-61.
20.
Straus, M.A., & Smith, C. (1990). Violence in Hispanic families in the United States: Incidence rates and structural interpretations. In M. A. Straus & R. J. Gelles (Eds.), Physical violence in American families: Risk factors and adaptations in violence in 8,145 families (pp. 341-363). New Brunswick, NJ: Transactions Books.
21.
Weiss, D.S., & Marmar, C.R. (1997). The Impact of Event Scale-Revised. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399-411). New York: Guilford.
