PSYC 430 : Anxiety - Case Study Example

Case Study: Anxiety Answer Sheet Diagnosing Tina Diagnosing Generalized Anxiety Disorder: 1a. Refer to the DSM-IV checklist for generalized anxiety disorder. Which of Tinas symptoms meet any of the criteria? (Be sure to match specific symptoms with specific criteria.)1. Excessive or ongoing anxiety and worry for atleast six months regarding numerous events or activities. After Tina’s husband died, she was always miserable and worried that something bad would happen to her 14 year old twins.

She worried that one may kidnap them on their way to school or the bus would crush with the twins inside. She was also worried that the bridge would collapse while she was passing.2. Difficulty controlling worrying habitTina constantly worried about the well-being of her children.3. Atleast three of the following symptoms; restiveness, easy fatigue, tetchiness, muscle tension, sleep interruptions.Tina has all the above symptoms. She was always restless as she appeared troubled besides being nervous whereby he resulted to drinking to calm her nerves.

She was always fatigued due to lack of sleep and constant worrying. She was very irritable and a small thing set her off. Things that she was able to tolerate before were her twins’ loud music, talking on the phone for too long and squabbling among themselves, they now irritated her. She had muscle tension and felt like her body was tied up in knots. She also experienced sleep disturbance as she asked the doctor for medicine to help her sleep. 4.significant stress or impairementThe previous week, Tina had to stop her car because she was gasping for breath and her heart was beating at a very fast rate.

She even thought that she was having a heart attack. 1b. Based upon your review of Tinas symptoms and the diagnostic criteria, could Tina be diagnosed with generalized anxiety disorder or not (and if not, why not)? Based on the symptoms, Tina can be diagnosed with generalized anxiety disorder. This is because symptoms so far analyzed and confiormed meet all the criteria for the generalized anxiety disorder person. Diagnosing Specific Phobia:2a. Refer to the DSM-IV checklist for specific phobia.

Which of Tina’s symptoms meet any of the criteria? (Be sure to match specific symptoms with specific criteria.)1. Marked and specific fear of a specific object or situation which is excessive or unreasonable, lasting atleast six months Tina dreaded crossing bridges. She found herself wondering how safe the bridges were while trying to cross them. She wondered if they would collapse the minute she reached the top. The normal tension worsened when she was crossing bigger bridges which made her panic.2. Immediate anxiety usually produced by exposure to the objectTina always felt a sense of panic as she approached the dreaded bridges.3. Recognition that the fear is excessive or unreasonablePart of Tina saw the fear of bridges as ridiculous.2b. Does Tina have a specific phobia and if yes, what is the feared object? Yes. Tina has a phobia of bridges.

Diagnosing Panic Disorder:3a. Refer to the DSM-IV checklist for panic disorder with agoraphobia and the checklist for panic disorder without agoraphobia. Which of Tina’s symptoms meet any of the criteria? (Be sure to match any specific symptoms with specific criteria.) panic disorder with agoraphobia1. Symptoms of panic disorderShe gasped for breath as she was driving, sweaty palms and her heart beats increased2. Anxiety about being in place or situations from which escape might be difficult or which help might not be availableTina felt that the bridge might collapse and they would all fall into the river where they cannit be rescued.3. Situations either avoided or endured withmarked distress or manageable only with the presence of a companionShe crossed had to cross bridges with great difficulty only because bridges in coastal Florida cannot be avoided.3b. Does Tina meet the diagnostic criteria for panic disorder with agoraphobia or panic disorder without agoraphobia or neither?

Explain why you believe your choice is the most appropriate diagnosis. Tina’s symptoms meet all the diagnostic criteria for panic disorder with agoraphobia. This is because she was not concerned or worried about the implications of her attacks.Understanding Tina’s Disorders:1. How would the Socio-Cultural Perspective explain Tinas GAD? Tina was used to doing everything knowing that she had a husband by her side. Now that she is alone, she is finding it hard to do the simple things she used to do before.2. Explain Tinas GAD from the Existential Perspective.

Tina’s problems started after her husband died. She is therefore having a hard time adjusting to the changes in her life.3. Explain Tina’s GAD from the Cognitive Perspective (please identify any basic irrational assumptions that Tina is making, even if they may be unspoken). Tina has the irrational assumption that she needs someone stronger than herself to be dependent on as she came straight from her parents’ home to her husband’s home. Most of her interactions and behavior are affected by this assumption.4. Explain Tina’s Phobia from a Behavioral Perspective (please use classical conditioning as a possible example).

Tina’s phobia of bridges did not exist before as she has been using bridges all her life. The fact that she had never heard of bridges in coastal Florida collapsing, made her think that a bridge would collapse once she reached the top.5. Explain Tina’s Phobia from a Psychodynamic Perspective.Tina’s interpersonal relationship with her children had been affected by her husband’s demise. She felt that they were all grown up and did not need her anymore. In addition, she was used to doing stuff for her husband who was not there anymore.

This added to her feeling of not being needed. 6. Considering the biological correlates or causes of Tinas panic disorder, what role does the neurotransmitter norepinephrine play in her panic disorder? The norepinephrine neurotransmitter is what made Tina to think that she was having a heart attack the previous week when she was gasping for breath and her heart rate had increased. 7. What does Tinas locus ceruleus have to do with her panic disorder?Tina’s locus ceruleus has branches of axons of noradrenergic neurons which are associated with panic disorders.8. What role might GABA play in her symptoms?

Tina’s gamma-aminobutyric might not be sufficient to aid in relaxation, sleep and regulation of anxiety. Treating Tina1. Which Psychodynamic technique has been found to be the most useful in the treatment of GAD? Long-term psychodynamic therapy is most useful as it focuses on changing the aspects of one’s personality or identity.2. Explain why a humanistic approach would be helpful in treating Tinas GAD. Self-actualization is important in treating GAD. Human beings are driven to change, develop personal potential and grow.

This will go a long way in helping Tina move past her husband’s death and adjust to the changes.3. How might you use Rational-Emotive Therapy to treat Tina’s GAD?First, I would identify her underlying irrational thoughts which is that she needs someone stronger than herself to be dependent on as she came straight from her parents’ home to her husband’s home. Second, I would challenge these thoughts by disputing these beliefs using direct and confrontational methods. Third, is to help Tina change her thoughts after realizing she was being irrational.4. How would Systematic Desensitization be used to treat Tina’s phobia of bridges?

Systematic desensitization can help Tina reduce anxiety by desensitizing the triggers that are causing her distress. She can imagine herself crossing a bridge and use relaxation strategies. Once successful, she can then apply it when crossing a real bridge.5. What medications have proven useful for treatment with panic disorder? Xanax, klonopin, valium, ativan and serax. 6. What role could cognitive therapy play in Tinas treatment for panic disorder? Cognitive therapy can be used to challenge Tina’s negative thoughts of losing her children after she lost her husband.7. Considering that Tina may be treated for comorbid disorders, how do you see the treatments for the various disorders complementing each other?

Some medications used to treat her nicotine dependence will also treat her depression and help her relax.8. Is there any reason to think that any of the treatments would be contraindicated when utilized together? Explain why/how or why/how not.Treatment using medication contradicts all the other treatments. This is because all the other treatments involve solving the underlying problems causing the attacks.