Case Study 1

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School

University Of Arizona *

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381

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Psychology

Date

Feb 20, 2024

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Uploaded by DeanWillpowerScorpion122

PSY 381 Summer 2022 Case Study 1 Instructions : Read the following case study, then respond to the questions below. Grading : Your grade will be based on completeness (5 points), accuracy (18 points), level of detail (5 points), and mechanics (i.e., using complete sentences, minimal spelling/grammatical errors; 2 points). Total = 30 points. See the rubric on D2L for more information about these criteria. Jimothy (Jim) is a 31-year-old, White male. During the initial appointment, he was wearing a suit and tie as he met with me during his lunch break. Jim was extremely talkative during the interview and seemed to be making a point to present himself as a competent and successful person. Getting him to talk about his symptoms was somewhat difficult, as he seemed to want to avoid discussing his experiences. He stated that he only came to this appointment to make his fiancée happy. Jim does not appear to have insight regarding psychological/emotional problems. Jim reported that his symptoms first began around his birthday (August 19 th ) when he was out shopping with his fiancée at a local mall. Jim reported that he went to the mall even though he does not typically enjoy large crowds. A few minutes after they began shopping, Jim reported that he started to feel “really sick.” He stated that his hands started shaking and his vision blurred. He felt his chest start to constrict and he was having trouble breathing. Jim also described feeling “déjà vu, but like, something bad was going to happen...or already happened.” When asked if he felt afraid, Jim stated that he was “terrified” that what he was feeling meant that he was going to die. Jim reported that he ran out of the mall and sat down on the curb. His fiancée did not realize that Jim had left until approximately 10 minutes later. When he found Jim on the curb, Jim had regained his breath and was “feeling normal” again. His fiancée wanted Jim to go to the hospital or at least call a doctor, but Jim refused. A few weeks later, Jim was at work when he began feeling “really sick” in the exact same way that he had experienced at the mall. He does not think anyone at work noticed. Just like before, the experience lasted approximately 5-10 minutes. However, Jim was so shaken that he went home for the rest of the day. Jim stated he has had three more experiences like this since then, including one that occurred while talking about the previous experiences with his fiancée. Since those experiences, Jim has avoided the mall completely. He is also concerned about having another experience while at work, so he frequently calls in sick and/or attempts to work from home (which is difficult given he works in sales). At several points while describing his experiences to me, he had to stop himself as he seemed to be becoming distressed.

PSY 381 Summer 2022 Diagnosis 1. What diagnosis would you give this individual? This person, in my diagnosis, has agoraphobia as well as a panic disorder. 2. What information from the summary above supports this diagnosis? He disliked large crowds in general, so when he went to the mall, he started to feel queasy, tremble, have blurry vision, have trouble breathing, and had the sense that he was about to die. These symptoms appeared for about ten minutes, but they returned while he was at work. Due to these symptoms, Jim started to dread going to the mall and his job. He also became upset when he talked about these painful experiences. 3. What information (if any) from the summary above contradicts this diagnosis? I was unable to find any evidence to support a contradict diagnosis. Everything observed is indicative of panic disorder. 4. What other diagnoses did you consider? What made you rule those out? ( Or explain how the individual meets full criteria for another disorder). When I first read this summary, I assumed Jim had a generalized anxiety condition or social anxiety disorder. The specifics that were mentioned in the report, or the symptoms Jim was experiencing, led me to rule these out. The part near the end of the synopsis where Jim says he called in sick to avoid experiencing those ominous feelings at both work and the mall really cemented the diagnosis for me. 5. What other information would you like to have about this individual before “finalizing” your diagnosis? If you were assessing this individual, what questions would you want answered? Specifically how long Jim has been having these panic attacks, whether this is a disorder that runs in the family, and finally whether Jim is know when a panic attack is occurs/know body symptoms before a panic attack occurs. Models of Abnormality

PSY 381 Summer 2022 6. Choose two paradigms (biological, psychodynamic, cognitive-behavioral, humanistic-existential, sociocultural, or developmental psychopathology) and describe/reflect on the case study from those perspectives. Select paradigms that are particularly relevant for the diagnosis that you have given this individual. Using the biological and cognitive-behavioral paradigms made sense to use. A panic attack that is overdrive, in my opinion, is the cause of the panic episodes. In the biological stance, Jim being around a lot of people causes his brain's amygdala to become in overdrive, which in turn triggers other brain regions and causes a panic attack. A cognitive-behavioral therapist would argue that Jim's misperception of the physical symptoms of a panic attack is the cause of his attacks. Because these episodes struck Jim so unexpectedly, he was unprepared for what was about to occur and mistook his physical symptoms for a medical emergency. Treatment 7. Based on the information from the textbook, what would be your first choice of treatment for this individual? Why? Jim made a statement at the start of the session that made me think he may benefit from medication therapy after reading about him. Jim appeared to be of the opinion that there was nothing seriously wrong with his emotional and mental health for the moment. So Jim may not be interested in trying the therapy of a cognitive therapist. 8. How do you anticipate that this individual would respond to your selected treatment? Jim should benefit from this treatment, in my opinion. In addition to the fact that I believe Jim would prefer it, since I do suspect he suffers from agoraphobia. As medication works wonderfully to treat this phobia. 9. What concerns do you have about your selected treatment approach (i.e., side effects, limitations, etc.)? With the worry of prescribing medication to any patient, Jim might develop a drug dependence as a result of this treatment, which worries me. That would be my concern for this patient. .

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PSY 381 Summer 2022 10.Provide some information about an alternative treatment that might also benefit the individual. ( Note : If you selected a biological treatment as your first choice, describe a psychological treatment option here; if you selected a psychological treatment as your first choice, describe a biological treatment option here.) I would suggest psychotherapy or "talk therapy" as an alternate treatment since I believe Jim would benefit from it. Although he was a bit apprehensive, Jim assisted me in understanding what was happening. Jim would ultimately learn how to handle the attacks if he shared his experiences with others and started to comprehend what was happening, in my opinion. But time will tell as how he gets comfortable with his treatment and what he is comfortable with sharing/experiencing. 11. What additional support or activities might you recommend for this individual (e.g., exercise)? Additionally, I would advise attempting to interact with others in more compact or smaller groups. Jim would benefit from support groups since he would be surrounded by others who go through similar experiences, but as well get him to get use to the feeling being surrounded by strangers. Jim as well learn breathing exercises to help him calm down when he knows hes about to have a panic attacks.

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