PSY 100 Introduction to Psychology

QUESTION

PSY 100Introduction to PsychologyProfessor Natalie KempSpring 2014Case Study 2Client #2 Tara is an 18-year-old freshman who is in her first year at a large state University. She was homeschooled for her entire education, and comes from a strong Christian background. She has had a tough time adjustingto her new life, but she really enjoys her new friends and classes. The problem is last week she has a big test in herbiology class. She had been studying all week and felt confident that she would do well. When she went to leave thedorm, she sort of lost her breath and started trembling and thought she was going to faint. She started sweating andar stued dvi y reaC souou rcrs eeH wer aso.comfelt her heart racing. It only lasted a few minutes, but she was so scared that she called 911 to come get her. Shethought she was having a heart attack, but when the ambulance got there, she felt physically fine. Mentally, she wasmortified about what happened and could not explain why.The diagnosis of this case study is a Panic Disorder, an anxiety disorder marked byunpredictable minutes-long episodes of intense dread in which a person experiences terror andaccompanying chest pain, choking or other frightening sensations. The criteria used to determinethis was by using the DSM-IV-TR, The Diagnostic and Statistical Manual of Mental Disorders.According to the DSM-IV-TR, a panic attack is characterised by four or more of a range of symptoms.In this case study, Tara suffered ‘loss of breath,’ ‘started trembling,’ ‘thought she was going tofaint,’ ‘started sweating’ and ‘felt her heart racing’. These symptoms all meet the DSM-IV-TR criteriafor panic disorder and attacks; therefore I believe the diagnosis must be a panic disorder.The additional information which is required in order to rule out a different diagnosis is thatthe panic attack was an acute attack triggered suddenly and unexpectedly. Also, as the duration isshort and the symptoms were intense, it clarifies that the symptoms are caused by a panic disorder.Whereas, if Tara had a general anxiety disorder, it would be due to chronic stressors which build upto cause only moderate intensity reactions that last a series of days, weeks or months.shThisFrom a biological perspective, the cause of Tara’s panic disorder may be due to genes.Following the stress-diathesis model, studies have shown that some individuals seem predisposedto anxiety, and by experiencing a traumatic situation or event, it causes a certain anxiety to occur.The greater the genetic predisposition to anxiety, the less traumatic of a situation needed in order tocause the anxiety to occur. Twin studies also support the perspective that our genes may be partlyresponsible for developing fears and anxiety. Twins are more likely to share phobias, and a studycompleted by Carey in 1990, discovered that Identical twins developed similar phobias even whenraised separately. Another cause of Tara’s panic disorder from a biological perspective could bedue to the brain, the biological development of panic disorder is caused by an over arousal of brainareas involved in impulse control and habitual behaviors. Gehring et al conducted a study and foundthat the disordered brain detects that something is amiss, it generates a mental hiccup of repeatingthoughts or actions, leading to anxiety.Tests which could be used in order to diagnose panic disorder may be a complete physicalexam, a blood test to check thyroids in order to rule out any other conditions which may causehttps://www.coursehero.com/file/10443161/Psychology-Case-Study-ldocx/similar symptoms and an evaluation by a mental health specialist in order to discuss symptoms,fears, stress and other life issues. A questionnaire, the Panic Disorder Severity Scale, may also beused to diagnose panic disorder as it measures the severity of the disorder and successfully monitorsthe treatment of the disorder.ar stued dvi y reaC souou rcrs eeH wer aso.comThere are several options for the treatment of a panic disorder according to the biologicalperspective; the chosen option is based on a decision between the patient and psychiatrist. Oneoption is medication. Antidepressants reduce the severity of panic symptoms and eliminate panicattacks, whilst Benzodiazepines are also effective in reducing panic symptoms, the frequency ofattacks and have a short onset of action. However, medication for the treatment of this disorderhas side effects, such as the development of depression and addiction, and this medication onlycures the symptoms, not the direct cause of the panic disorder. Another option for the treatment ofTara’s panic disorder is cognitive behavior therapy, which includes many techniques, such as appliedrelaxation, panic management, breathing retraining and cognitive restructuring, in order to decreasesymptoms of the panic disorder. These two choices of treatments can be combined in order forsuccessful treatment to occur.isFrom a psychodynamic perspective, the cause of Tara’s panic disorder is due to unconsciousdrives and inner conflicts. It suggests that our childhood shapes our personality and ways ofbecoming attached to others, so for Tara being home schooled for her entire education andtherefore meeting less peers, she will lack in her attachment to others. The psychodynamicperspective suggests a pleasure principle, when individuals unconsciously avoid unpleasure. InTara’s situation, it appears she unconsciously avoids the biology test by having a panic attack. Italso suggests a compromise formation, where panic attacks represent an attempt for an individualto compromise between angry feelings and fears of abandonment. This is significant in this casestudy as Tara is struggling to compromise between have a tough time adjusting to her new life,and attempting to study for her biology test. The psychodynamic perspective suggests individualshave an inborn neurophysiological irritability which predisposes them to early fear. This is thencombined with an exposure to parental behaviors, leading to a persistence of fear, conflicts betweendependence and independence and predisposed uncertainties of anxiety and isolation. Through lifesituations, stress occurs, resulting in the individual’s loss of security and control, which thereforeleading to a panic episode.shThIn order to treat Tara’s panic disorder psychodynamically, Psychodynamic therapy could beused. This therapy interprets a patient’s conflict, and could help Tara to explore and gain perspectiveon recurring unconscious thoughts and feelings. Free association, the method of exploring theunconscious in which the person relaxes and says whatever comes to mind, no matter how trivialor embarrassing, could also be used for the psychodynamic treatment of Tara’s disorder. This couldbe used as it can discover underlying unconscious causes of Tara’s panic disorder, determine painfulunconscious memories, retrieve them and release them, preventing the anxiety which causes herpanic attacks. Tara should definitely engage in the treatment of Psychoanalysis, which aims to bringher repressed feeling into her own conscious awareness. By gaining insight into the roots of herdisorder, it will allow her to work through suppressed feelings and take responsibility for her ownsuccessful independent development.https://www.coursehero.com/file/10443161/Psychology-Case-Study-ldocx/The behavioral perspective suggests that Tara’s panic disorder is how we learn observableresponses, due to conditioning and reinforcement. Classical conditioning in disorders is a reactionthat is learned through the pairing of stimuli. In Tara’s case, the initial panic of the attack isan unconditioned response to stressful stimuli, this causes hyperventilation, and strong panicsymptoms such as fainting, trembling and loss of breathing. Panic disorder is therefore the resultof attached stressful stimuli becoming conditioned to enthused anxiety. Operant conditioning,when a specific conditioned response to a certain conditioned response is controlled by a processof reinforcement. This also explains Tara’s case as her fear goes when she is away from the certainsituation that causes her fear and anxiety, explaining negative reinforcement as Tara learns to avoidthe stimulus that causes her anxiety, and therefore feels better when she escapes from it.ar stued dvi y reaC souou rcrs eeH wer aso.comFor the treatment of the behavioral perspective of Tara’s panic disorder, it is believedbehaviors are the problems, and the application of learning principles can eliminate them.Psychologists believe that the treatment of the panic disorder can be due to maladaptive symptoms,learned behaviors that can be replaced by constructive behaviors. Using classical conditioning as anexplanation for Tara’s panic disorder, it can be treated in three different ways: Counter conditioning,which pairs the trigger stimulus within a new response that is incompatible with fear, ExposureTherapy, using behavior techniques that treat anxieties by exposing an individual to somethingthey fear and avoid, and also Aversive Conditioning, a method of substituting a negative responseto a harmful stimulus, in Tara’s case the biology test, a positive response. Treatment for usingoperant conditioning as an explanation for Tara’s panic disorder suggests voluntary behaviors arestrongly influenced by their consequences. Behavior modification, reinforcing desired behaviorsand withholding reinforcement for undesired behaviors or punishing them, could be used as atreatment. It is believed positive reinforcers shape behavior in a step by step process, rewardingcloser and closer approximations of a desired behavior. Token economy could also be used atreatment for Tara’s panic disorder, as an operant conditioning procedure it enables individuals toearn a specific token for exhibiting a desired behavior, which they can later exchange for specificprivileges.shThisThe cognitive perspective proposes that individuals have invalid beliefs or thoughts that leadto anxiety. These invalid thoughts and beliefs are developed as a result of an individual’s previousexperiences. It’s believed that once these are established, these thoughts and beliefs are maintainedand lead to a distorted interpretation of others and events that occur on a daily basis. The cognitiveperspective suggests Tara’s panic disorder is caused by a problem with her selective attention, shefocuses excessive amounts of attention on perceived threats in her life, in this case her biology test,making her more aware of these threats than normal individuals, preventing her from taking thebiology test. From a cognitive perspective, a panic attack occurs due to the misinterpretation ofbodily sensations as a sign of impending disaster, in Tara’s case, a heart attack. The persistence ofthese panic attacks and misinterpretations leads to the tendency of an individual to avoid thesituation where the panic occurs, developing into a panic disorder.The cognitive perspective of panic disorder suggests two main treatments will be successfulin treating Tara’s disorder. One of these treatments is Cognitive Behavioral Therapy, which focuseson the thinking patterns and behaviors that are triggering panic attacks, allowing individuals toidentify and change their faulty cognitions that maintain anxiety. Cognitive Behavioral therapy thenproceeds to show the individual that their cognitions are incorrect, for example in Tara’s case thetherapy would prove to Tara that her biology test was not as hard as she thought it would be,therefore reducing her anxiety. This therapy then allows the therapist and client to set goals to thinkhttps://www.coursehero.com/file/10443161/Psychology-Case-Study-ldocx/more positively, enabling them to see their negative thoughts are mistaken, and prevent anxietyoccurring. The other treatment that could be used is Rational Emotive Behavior Therapy, whichfocuses on resolving emotional and behavioral cognitive conflicts, enabling people to live with lessanxiety. Rational Emotive Behavior Therapy involves three steps: Identifying the underlying irrationalthought patterns and beliefs which lead to psychological distress, challenging these irrational beliefs,and then gaining insight and recognizing irrational thought patterns which cause anxiety. Once thesesteps had occurred, the anxiety of an individual is then reduced. Rational Emotive Behavior Therapyinvolves an ABC model of behavior. The A stands for an activating event, when something happensin the environment around an individual, The B in the model stands for the belief an individual willhold about the certain event and the C stands for Consequence, the emotional response to theindividuals belief, in this case the biology test causing anxiety.ar stued dvi y reaC souou rcrs eeH wer aso.comFrom a humanistic perspective, the cause of Tara’s panic disorder is due to her selfactualization becoming inhibited, forcing her to make decisions or choices that lead to anxiety. Tarauses human reasoning to assess her upcoming biology test, causing her to feel anxious of things thataren’t there, and therefore Tara does not want to handle these anxieties, causing her to have a panicattack. Psychologists also believe from a humanistic perspective that anxious individuals, such asTara, build up unrealistic mental images of themselves, leaving them vulnerable to informationwhich proves otherwise, causing them to have panic attacks, as they have increased anxiety. Thisprocess then continues, causing frequent panic attacks and eventually the diagnosis of a panicdisorder.Humanistic Therapy focuses on a non-judgmental approach to therapy, with questionsaimed to enable an individual to explore their thoughts, emotions and feelings, with the purposeof reducing anxiety. It’s heavily based on a positive, constructive view of human beings and theircapacity to be self-determining. Humanistic therapy is very ‘client-centered’ and aims to focuson creating an accepting positive environment through therapy, where clients can be honest andexperience themselves. Unconditional positive regard would be used, showing complete supportand acceptance of an individual, whatever they say or do. This would help Tara because it wouldenable her to reduce her anxieties about her biology test, a stimulus that caused her panic attack,it would also encourage her to increase her self-awareness and mindfulness enough to prevent anincrease in anxiety, which caused her panic disorder initially. During humanistic therapy, Tara wouldbe encouraged to act in a consistent way in various situations, increasing her ability to adapt tostressful situations without experiencing increased anxiety.shThisAlthough Panic disorder can be explained and treated in many different ways, every singleperspective is reductionist, and fails to take into consideration other perspectives which may alsocontribute to the disorder. Overall, all perspectives contribute to the development of a panicdisorder. Tara’s panic disorder will never be completely cured; medication and therapy will allowTara to resume a normal lifestyle, where relapse is always possible.https://www.coursehero.com/file/10443161/Psychology-Case-Study-ldocx/Powered by TCPDF (www.tcpdf.org)

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