Running Head: EFFECTS ON PTSD ON A SOLDIERS SOUL

Effects of PTSD On a Soldiers Soul

Abnormal Psychology MW; 1:00 2:25 PM
Los Angeles Valley College
Kathryn Respicio

EFFECTS OF PTSD ON A SOLDIERS SOUL

Abstract
The character of Lt. Dan Taylor, from the film Forrest Gump, was examined as a case study for
Posttraumatic Stress Disorder. From thorough research and utilization of class knowledge, a
mental health assessment was made for the characters diagnosis. A comprehensive diagnosis for
this character will be explained through particular film scenes and psychopathological symptoms
that meet the criteria for PTSD. The cognitive-behavioral perspective will be used to treat this
characters disorder. The use of this perspective will be justified by a proposed intervention for
the character.

EFFECTS OF PTSD ON A SOLDIERS SOUL

Effects of PTSD on a Soldiers Soul

Multi-Axial Diagnosis
Axis I. Post-Traumatic Stress Disorder (Principle Diagnosis), Substance Dependence
Axis II. Borderline Personality Disorder (Differential Diagnosis)
Axis III. Double amputee above the knee
Axis IV. Limited support system, lives in poverty
Axis V. GAF score 50
Demographic Info
Lieutenant Dan Taylor is a Caucasian male is his mid-thirties. He is a legal citizen of the
United States. He is being assessed on April 28, 2015. He has voluntarily admitted himself to the
hospital following an incident in which he displayed reckless and self-destructive behavior while
fishing with a colleague.
Mental Health / Substance Abuse History
Presenting Problem
Lt. Dan admitted himself to the hospital for experiencing intense psychological distress at
exposure to an external cue that symbolizes a traumatic event he experienced during the Vietnam
War. He has persistent, negative distorted cognitions about himself and consequences of the
traumatic event. He also experiences high arousal reactivity towards others. This is particularly
expressed at those he believes are responsible for the cause of the traumatic event and the
consequences of his current life. All of the cognitions he holds about himself and the world
around him resulted in a display of reckless and self-destructive behavior.
Relevant History
Relevant history is not available.

EFFECTS OF PTSD ON A SOLDIERS SOUL

Family History
In every generation of Lt. Dans lineage, there was a member of his family who fought
and died in every American war. This serves as Lt. Dans justification for joining the army. This
also serves as the onset for Lt. Dans belief in that he is destined to die in the war he fights in. It
is unknown if Lt. Dan has any surviving family members.
Educational / Occupational / Social History
Dan Taylor served as a Lieutenant during the Vietnam War. After being discharged due
to an injury, he lived in poverty in New York. Several years after living in New York, he became
first command on the first Bubba Gump shrimp boat in Bayou La Batre. No history prior to Lt.
Dans tour is given.
Medical Status / History
Lt. Dan sustained an injury during his tour in Vietnam. Following a grenade explosion
during guerilla warfare, he lost both his legs. He is a double amputee above the knee and is
confined to a wheelchair.
Mental Status Exam
Diagnostic Features
Lt. Dan displays several symptoms that meet the criteria for a diagnosis of Posttraumatic
Stress Disorder. The onset of characteristic symptoms is preceded by his direct experience of a
traumatic event. His experience during the Vietnam War provided direct exposure to actual or
threatened death and serious injury (APA, 2013 p. 271). After giving strict orders to Forrest
Gump, a soldier in his platoon, to leave him behind, Forrest makes the decision to save Lt. Dan.
While running through the Vietnam jungle amidst guerilla warfare, a grenade explodes near

EFFECTS OF PTSD ON A SOLDIERS SOUL

Forrest and Lt. Dan causing Lt. Dan to lose his legs from the knee up. He also witnessed
members of his platoon killed in action.
The essential feature of PTSD is the development of characteristic symptoms following
exposure to one or more traumatic events (APA, 2013, p. 274). In the case of Lt. Dan, this is
prominent in several features. According to the American Psychological Association (2013), one
of the characteristic symptoms that develops is dysphoric mood states and negative cognitions
that can be distressing (p. 274). While staying at the army hospital, Lt. Dan confronts Forrest in
the middle of the night. He pulls Forrest off his bed and claims that he had a destiny. He angrily
yells at Forrest saying that he should have died out there with [his] men. Instead of completing
his destiny and dying with honor, now he must live his life as a legless cripple. After
expressing his anger, he begins to cry and wonder what he will do with his life now. Intrusive
symptoms are present in this scene. Lt. Dan feels intense psychological distress at exposure to
internal or external cues that symbolize has aspect of the traumatic event (APA, 2013, p. 271).
For him, the loss of his legs symbolizes how he did not complete his destiny. Instead of dying in
the field, a long-held military tradition in his family, he is left to live as a cripple with no set path
to follow.
Another scene that demonstrates his negative mood and cognitions occurs when Lt. Dan
meets Forrest months after the Vietnam War. Forrest runs into him after his television
appearance in New York. Lt. Dans appearance is disheveled and unclean. He has long, greasy
hair and wears dirty clothes. He informs Forrest that he lives off of welfare and currently resides
in a motel. He rants to Forrest about how it is pointless to believe in God. He reminisces that a
priest once told him that even though God is always listening, [Lt. Dan] still needs to help
himself. During this entire conversation, Lt. Dan is looking for liquor bottles to drink out of. He

EFFECTS OF PTSD ON A SOLDIERS SOUL

displays negative alterations in cognitions and moods associated with the traumatic event
(APA, 2013, p. 271). He meets the criteria for holding persistent and exaggerated negative
beliefs about himself and his current predicament. Lt. Dan is told that he must help himself in
order to live a happier life. However, Lt. Dan refutes the belief that he could live a better life
because he believes that God and Forrest cheated him out of destiny he was supposed to fulfill.
This belief is further supported by his reiteration of Forrest rescuing him during the war. Had
Forrest allowed him to complete his destiny and die with honor, he would not be living as a
homeless cripple living off of welfare. Lt. Dans beliefs illustrate the criterion of persistent,
distorted beliefs about the consequences of the traumatic event that leads the individual to blame
others (APA, 2013, p. 272).
Lt. Dans case also demonstrates the prominence of arousal and reactive-externalizing
symptoms (APA, 2013, p. 274). Some years after their first encounter in New York, Lt. Dan
joins Forrest as he ventures out to become a shrimp boat captain. Amidst a hurricane out at sea,
Lt. Dan sits on top of the sails of the boat. As Forrest fights to keep the boat afloat, Lt. Dan
screams, This is a showdown between you and me! Lt. Dan recklessly and fearlessly sits on
the railings of the boat, laughing maniacally as he challenges God to sink the boat. During this
scene, he demonstrates marked alterations in arousal and reactivity associated with the
traumatic event (APA, 2013, p. 272). Lt. Dans display of reckless or self-destructive behavior
is especially evident in this scene. He puts himself at high risk by placing himself on the rails of
the boat, knowing that the force of the storm could kill him. However, he uses this storm as an
opportunity to challenge God and see if his current life holds equivalent value to his destiny.
Evidence of Lt. Dans reactive-externalizing symptoms is also present with all of the
interactions he has with Forrest. Marked alterations in arousal and reactivity are denoted by

EFFECTS OF PTSD ON A SOLDIERS SOUL

irritability and angry outbursts (with little or no provocation) typically expressed as verbal or
physical aggression toward people or objects (APA, 2013, p. 272). Even though Forrest does
not provoke reactions from Lt. Dan, he consistently shows verbal aggression toward Forrest. His
interactions with Forrest are characterized by anger, bitterness and resentment often provoked
by the presence of Forrest and Forrests persistence at a friendship.
Duration for each of the criteria must last for more than one month. The duration of Lt.
Dans symptoms have persisted for years. This is measured in the time following the traumatic
event during the Vietnam War to the time he serves as Forrests first command on the Bubba
Gump shrimp boat.
The final criteria states that present symptoms must cause clinically significant distress
or impairment in social and occupational functioning (APA, 2013, p. 272). Following the
Vietnam War, Lt. Dan is unwilling to look for another line of work. He is content with living in a
motel. He is also content with using welfare to support himself. Prior to him meeting Forrest in
New York, his only other social contact was with prostitutes. He has no known surviving family
members or friends he associates with.
Diagnostic Specifier: With Delayed Expression. Full diagnostic criteria for Lt. Dan has
been made within the first six months of the event. His negative cognitions, angry outbursts,
arousal activity and dysphoric mood states are present immediately after exposure to the
traumatic event.
Prevalence
In the United States, lifetime prevalence risk for PTSD is 8.7% for individuals at age 75
years old. According to the American Psychological Association (2013), rates of PTSD are
higher among veterans and others whose vocation increases the risk of traumatic exposure (p.

EFFECTS OF PTSD ON A SOLDIERS SOUL

276). The highest rates of PTSD are found among survivors of military combat and rape. Lt. Dan
would fit amongst the first category since he is a surviving veteran of the Vietnam War.
Development and Onset
The American Psychological Association (2013) states that PTSD symptoms usually
begin within the first three months after the trauma (p. 276). While some cases showcase a
delayed expression, Lt. Dans symptoms are immediately prominent. This is evident in the first
interaction he has with Forrest following the traumatic event. Lt. Dan reiterates his anger about
how he was cheated out of fulfilling his destiny. He expresses resentment that Forrest disobeyed
his orders to leave him behind. He also expresses regret at the life he lives.
Differential Diagnosis
Several of the symptoms exhibited for PTSD diagnosis overlap with the diagnosis for
Borderline Personality Disorder. Lt. Dan meets five of the nine criterions to qualify for this
diagnosis. For the first criterion, he displays impulsivity that is potentially self-damaging
(APA, 2013, p. 663). This is exhibited in his sexual activity with prostitutes and his alcohol
dependence. Recurrent suicidal behavior, gestures or threats (APA, 2013, p. 663) are evident
in his death-defying showdown with God during a hurricane. His interactions with Forrest
exemplify affective instability due to a marked reactivity of mood (APA, 2013, p. 663). These
interactions are marked by irritability and angry outbursts on behalf of Lt. Dan. Even though
Forrest does not provoke these affects, they occur because of Lt. Dans belief that Forrest
interfered with his destiny. He also displays chronic feelings of emptiness (APA, 2013 p. 663).
This is demonstrated by his belief that he was cheated out of his destiny. Because he no longer
has a set path to follow, he does not feel the need to help himself live a happier and more
fulfilling life. He blames Forrest for taking away the part of his life that had meaning and legacy.

EFFECTS OF PTSD ON A SOLDIERS SOUL

The last criterion for BPD is difficulty in controlling anger. This is characterized by displays of
extreme sarcasm, enduring bitterness or verbal outbursts (APA, 2013, p. 663). This is evident in
the encounter Lt. Dan has with Forrest after the Vietnam War. He expresses bitterness at Forrest
for being awarded the Congressional Medal of Honor. He also expresses mocking sarcasm at
Forrests ambition to become a shrimp boat captain.
Risks
Lt. demonstrates two types of risks that are associated with PTSD. According to the
American Psychological Association (2013), PTSD is associated with suicidal ideation and
suicide attempts (p. 278). Although the hurricane scene is more implicate of reckless and
impulsive behavior, Lt. Dan still knowingly puts himself at a high-risk of death. Because there is
only one known incident of reckless behavior, the severity would be rated as moderate. The
second risk that Lt. Dan exhibits is substance abuse with alcohol. Comorbid substance abuse
disorder is more common among males (APA, 2013, p. 280). The severity for this risk would be
graded as high. If Lt. Dan is not drinking from a liquor bottle, he is looking for another bottle to
polish off. This is evident in his interaction with Forrest in New York.
Prognosis and Prognosis
Lt. Dan meets seven of the nine diagnostic criterions for PTSD. It is interesting to note
that he does not persistently avoid stimuli associated with the traumatic event. This is evident in
that he does not avoid interactions with Forrest the person he feels is directly responsible for
changing his destiny. Nonetheless, presence of intrusive symptoms, negative alterations in
cognitions and mood and marked alterations in arousal and reactivity were preceded by the
traumatic event he experienced during the Vietnam War. These symptoms have lasted for several
years, causing a serious impairment in his social and occupational functioning.

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However, his prognosis looks promising. This is evident in a scene that occurs some time
after the storm. While on the boat, Lt. Dan pulls Forrest aside and finally thanks him for saving
his life. Then he lifts himself out of his chair, onto the ledge of the boat and jumps into the
ocean. He looks up at the sky with hope as he takes a swim on the clear ocean. This scene is
indicative of the beginning of a healing process. Lt. Dan has made his peace with the new path
ahead of him. This in turn symbolizes that he is ready to accept the help and guidance needed for
him to live his life. As long as he is provided with the proper treatment and tools, Lt. Dan will be
able to integrate himself back into society and live his life with purpose.
Treatment Plan
Specific goals with treatment. Reduce psychological distress by changing the negative
cognitions Lt. Dan holds about his destiny and his current living situation. Aaron Beck, a pioneer
in cognitive-behavioral therapy, believed in the importance of identifying underlying cognitions
assumed to be producing the maladaptive emotions and behavior (Butcher, Mineka, & Hooley,
2011, p. 57). The central idea to this perspective is that the way humans interpret their
experiences will determine their emotional reactions to them. By identifying and modifying Lt.
Dans negative and distorted cognitions, this will reduce maladaptive emotions and behavior.
This includes reducing the anger and resentment he expresses to those he feels are responsible
for cheating him out of his destiny. This also includes reducing the reckless behavior he displays
in challenging God who he also feels is responsible for denying him the chance to complete his
destiny.
Cognitive Therapy for PTSD. This is therapy that combines elements of cognitive
therapy and exposure therapy. This treatment is designed to modify excessively negative
appraisals of the trauma or its consequences (Butcher et al., 2011, p.135). The therapy will last

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for twelve sessions, with the client attending one session per week. The client is responsible for
attending each session. He will be asked to write about his traumatic event. Thoughts and
feelings should also be included in this narrative. The client will be asked to read this narrative
inside and outside of session. During session, the therapist will utilize cognitive restructuring
to help the client identify maladaptive and distorted cognitions. After these cognitives are
identified, the client is tasked with challenging them with logical reasoning. With this effort, this
should decrease the threat that patients experience when they have memories of the traumatic
event and remove problematic cognitive and behavioral strategies (Butcher et al., 2011, p. 137).
An empirical study conducted by Kar (2011) concludes cognitive therapy is an effective
treatment for both acute and chronic PTSD, with both short- and long-term benefits following
the traumatic event (p. 93). This proposed treatment for Lt. Dan will allow him to restructure
his thoughts and interpretation about the change in his destiny. By challenging maladaptive and
distorted cognitions he holds, he will be able to fully accept the consequences of what happened
in Vietnam. He will be able to forgive Forrest for saving him and ultimately changing his
destiny. Lastly, he could begin to accept the life he has now and live it to the fullest. This in turn
should reduce the negative social interactions and social behavior he has displayed.

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References
American Psychological Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
Butcher, N. B., Mineka, S., & Hooley, J. M. (2011). Abnormal psychology: core concepts (2nd
ed.). Boston, M.A.: Pearson Education, Inc.
Kar, N. (2011). Cognitive behavioral therapy for the treatment of post-traumatic stress disorder:
a review. Neuropsychiatric Disease and Treatment, 7, 161-181.
http://ncbi.nlm.gov/pmc/articles/PMC3083990/pdf/ndt-7-167.pdf.