Perseveration of traumatic re-experiencing in PTSD; a cautionary note regarding exposure based psychological treatments for PTSD when head injury and dysexecutive impairment are also present

Abstract

This case study describes the psychological treatment of a man with co-existing PTSD, head injury and mild dysexecutive impairment. It describes the detrimental consequences when the re-experiencing of a traumatic event appears to have become a perseverated response. In this case, the perseveration meant that the most distressing part of the traumatic event became unavoidable and lead to it being continuously re-experienced without remittance over a very prolonged period (7-10 days). This type of re-experiencing has not been reported before. It potentially has significant implications for the treatment of PTSD in such circumstances. It may also have implications for behavioural models of PTSD in general.