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Specialist Leonard adamantly wants to return to combat and kill as many "Hadjis," (unkind slang for enemy combatants), in Afghanistan as possible. He suffers from nightmares but denies nightmares are a problem for him. He reports that he can sometimes smell and taste the blood of his friends as he did when his friends were blown up beside him. He reports that experience motivates him. Leonard insists he is more than ready to go back to Afghanis... Specialist Leonard adamantly wants to return to combat and kill as many "Hadjis," (unkind slang for enemy combatants), in Afghanistan as possible. He suffers from nightmares but denies nightmares are a problem for him. He reports that he can sometimes smell and taste the blood of his friends as he did when his friends were blown up beside him. He reports that experience motivates him. Leonard insists he is more than ready to go back to Afghanistan but that his commanders refuse to let him return. He reports his commanders believe that he is overly eager to fight and that judgment from his commanders makes him furious.This training title shows F43.10 Posttraumatic Stress Disorder. The symptoms of Posttraumatic Stress Disorder demonstrated in this vignette include: nightmares, anxiety, sweating, irritability, and exaggerated startle response. This man demonstrates immature coping mechanisms including: severe anger, wishes to reverse events (the defense of undoing), and seeking and plotting violent revenge (the immature defense of acting out). Show more Show less

After being admitted to the hospital for an alcohol-related injury, Parker admits that he may have issues with anger. He describes that when he experiences anger, he has a sensation of feeling hot throughout his body. His answers reflect a calm and intelligent assessment of his emotions. In recounting memories, he describes moments during which he lost control and tried to physically harm others. He reports that during other outbursts he damaged... After being admitted to the hospital for an alcohol-related injury, Parker admits that he may have issues with anger. He describes that when he experiences anger, he has a sensation of feeling hot throughout his body. His answers reflect a calm and intelligent assessment of his emotions. In recounting memories, he describes moments during which he lost control and tried to physically harm others. He reports that during other outbursts he damaged property such as punching a car window. He states that he believes his anger is due to the way he’s wired and due to his problems with drinking alcohol. Show more Show less

Sam has issues with rage. His arms are crossed, his eyes gaze downward, and he sometimes mumbles his answers. He reports that preceding his outbursts he feels tension in his stomach that spreads throughout his body. Sam’s anger often stems from disagreements with his father, whom he considers to be demanding. At times Sam’s anger is redirected towards his friends.

Jessie appears calm and attempts to thoughtfully answer the clinician’s questions. She describes several physical changes in her body that lead up to her outbursts of anger. When Jessie expresses her anger, she becomes violent and sometimes throws and breaks objects. Her outbursts often follow times she feels a loss of control or feels ignored and hurt by others. Her violent outbursts appear to stem from a family in which frequent shouting is... Jessie appears calm and attempts to thoughtfully answer the clinician’s questions. She describes several physical changes in her body that lead up to her outbursts of anger. When Jessie expresses her anger, she becomes violent and sometimes throws and breaks objects. Her outbursts often follow times she feels a loss of control or feels ignored and hurt by others. Her violent outbursts appear to stem from a family in which frequent shouting is accepted as normal. Show more Show less