Substantial research has aimed to elucidate the most effective method for practitioners to formulate a patient’s diagnosis. Engel (1977) proposed a bio psychosocial model to be used by a practitioner to investigate the many dimensions of a mental disorder and arrive at a fully comprehensive approach to treat the patient. Engel proposed that in order to properly diagnose mental disorders, practitioners should consider biological, social, psychological and behavioural dysfunction of the presenting illness. Additionally, Nurcombe and Fitzhenry-Coor (1987) direct practitioners to address all facets pertaining to the patient, in order to ascertain a detailed picture of the patient and the disorder, and improve the formulation of the patient’s diagnosis. Specifically, assessment of the patient should include the patient’s health history, underlying personality constitution, collection of symptoms and perpetuating factors as well as prognostic potential. Clearly the process of correctly identifying a presenting mental health issue in a patient includes ascertaining its cause, and involves the health practitioner developing clear diagnostic and reasoning skills (Vickery, Samuels & Ropper, 2010). Nurcombe and Fitzhenry-Coor’s (1987) method incorporates the biopsychosocial elements of the patient, and can be referred to as the seven P’s; predisposition, precipitation, pattern, perpetuation, presentation, prognosis, potentials. The ideology underpinning this reasoning is a deviation from the unitary theory of placing the root of dysfunction at a single cause, and has been found to improve the accuracy in provisional diagnosis of trainee professionals in clinic (Nurcombe and Fitzhenry-Coor’s, 1987). Vickery, Samuels & Ropper (2010) use the model of heuristics to highlight some of the critical errors that many practitioners are prone to. They discuss many of the common faults that occur with the use of short cuts such as becoming attached to a provisional diagnosis despite new data that may not support it, being influenced by the ease of recalling past cases and not adjusting diagnostic probabilities with new data. They aim to reduce the bias that is intrinsic in the heuristics of diagnosing mental disorders by increasing awareness and implementing certain behavioural strategies, potentially avoiding many of the pitfalls a practitioner can fall into when making a provisional diagnosis. The objective of this paper was to apply Nurcombe and Fitzhenry-Coor’s (1987) diagnostic and reasoning skills in order to investigate the case study of patient Joan, and assess any psychopathology that may be present. As per Nurcombe & Fitzhenry-Coor’s (1987) recommendations, the case study of Joan was assessed from a behavioural, social, biological and psychological perspective, to ascertain the most accurate provisional diagnosis possible as per Axis 1 of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association [APA], 2000). A differential diagnosis was presented, including a discussion of the process taken to obtain a provisional diagnosis. This paper concludes with a discussion of Joan’s prognosis and an analysis of some treatment strategies. Joan is a 22-year-old University student presenting with panic attack symptoms of nausea, sweating and palpitations, indicating an overactivity of the autonomic nervous system (Li, Chokka and Tibbo, 2001). Joan appears uncomfortable with social interaction and requires a close companion nearby to attenuate anxiety feelings. Panic attack symptoms have occurred four times over a three month period, and have caused significant distress as Joan fears that a medical disorder may be causing them. Symptoms are causing considerable disruption to occupational and social functioning, however no depressive symptoms are noted. A full case history for Joan is provided in Appendix A. According to the DSM-IV-TR (APA,...
November 17, 2014
HPA 057, Section 001
PanicDisorder is classified as a heightened version of anxiety. With this disorder, a person will have severe episodes in which they feel a sense of being threatened and lose control of their thoughts and extreme bodily responses take over. An attack could occur at any time without a trigger and without warning. In most cases, the situation the person experiencing the attack is in does not in any way call for a response so intense. Due to lack of warning and fear of reoccurrence, panicdisorder often takes over the person’s life and effects everyday activities (Anxiety & PanicDisorders Health Center).
This disorder affects roughly six million Americans each year with women having a higher likelihood of experiencing attacks than men. In most cases, people experiencing panic attacks will not seek any form of medical intervention or turn to others for support considering the stigma that comes with any mental disorder. It’s important for these individuals to know that the attacks they are experiencing are legitimate issues that can be treated by medication and other treatment (PanicDisorder and Agoraphobia). Like many mental diseases and disorders, panicdisorder...
...given to this client?
PanicDisorder with Agoraphobia
Please outline the major symptoms of this disorder.
According to the DSM, the major symptoms of PanicDisorder with Agoraphobia are recurrent panic attacks with anxiety about experiencing another attack. Also present is anxiety being in a public place where escape will be difficult or embarrassing or where it will be difficult to receive assistance in an emergency.
Briefly outline the client’s background (age, race, occupation, etc.)
The clients name is Annie and she is a 24 year old Caucasian woman. She has held a variety of jobs but has consistently had trouble holding on to a job for any length of time. Both of her parents are still living but they do not get along. She currently lives with a group of her friends.
Please describe any factors in the client’s background that might predispose her to this disorder.
In Annie’s interview, she states that she remembers her childhood as being normal but later in the interview, reveals that she experienced abusive experiences at a young age. Also, women are 3 times more likely than men to be diagnosed with PanicDisorder with Agoraphobia. Furthermore, Annie remembers having night terrors at age 4 and of her parents trying to calm her down. Finally, Annie was also diagnosed with major depression and Obsessive...
...Psychiatric Disorders, Disease, and Drugs
January 9, 2011
Mary Jane Dugan
Psychiatric Disorders, Disease, and Drugs
A psychiatric disorder is defined as disorder of psychological function so severe that it requires treatment usually by psychiatrist or clinical psychologist. The abnormal behavior expressed by people suffering from psychiatric disorders prevent them from living normal lives some of these disorder include schizophrenia, depression, mania, anxiety disorder, and Tourette Syndrome (Pinel, 2007)
Schizophrenia a term brought up in the early 20th century is defined as the splitting of psychic functions because symptoms it presented, which was the interruption of the connection between emotion, thought, and action. Schizophrenia is believed to begin in adolescence and early adulthood many times viewed as the insanity disorder. Treatment and study of this disorder has shown great difficulty because of the inconsistency of the symptoms that continuously change during the development of the disorder. Some symptoms include odd behavior such as lack of personal hygiene, speaking in rhymes, maintain still in a certain position for a long period of time and lack of social interaction. Bizarre delusions such feeling of being controlled or prosecuted is another symptoms often viewed severe paranoia. The most common...
Spectrum of symtpoms:
GAD: excessive anxiety occurring more days than not for >6mo with 3+ of (felling on edge, fatigue, irritability, muscle tension, difficulty concentrating, sleep problems). Symptoms have significant overlap with depression. F:M = 2:1; highly comorbid with MDD (62); patients complaining of anxiety may have depression or comorbid depression.
8% (40% are exposed to trauma)
Comordbid with substance use and somatization d/o’s
Specific phobia: excessive persistent fear of a specific object or situation with avoidance and interference with functioning.
In social phobia, “scrutiny by others” and the discovery of anxiety by others is most feared (more than fear of appearing incompetent, weak, etc). Social phobia has younger average age of onset – mid-teens. Social phobia is a primary specific phobia, must be distinguished from secondary social anxiety which may be a consequence of panicdisorder.
Beta-blockers is a good choice for performance anxiety. Pindolol is the only beta-blocker with serotonergic activity, less likely to contribute to depression.
Panicdisorder: >=4 of symptoms, most of which are somatic; high co-morbidity with somatization...
...Psychiatric Disorders, Diseases, and Drugs
Psychiatric Disorders, Diseases, and Drugs
In the time span of only one year, roughly seven percent of Americans suffer from some form of a mood disorder (Mood Disorders, n.d.). The typical person is able to experience moods on all levels but those that suffer from mood disorders get “stuck” into a certain mood (Mood Disorders, n.d.). There are different mood disorders and each one can have differing levels of how much one suffers from it. Anxiety disorders are when anxiety is the predominant feature or the avoidance of the anxiety causes abnormal behavior (Morris, 2010). Anxiety disorders are the most common mental disorder. There are many categories, or subdivisions, of anxiety disorders including specific phobias and panicdisorders (Morris, 2010). Schizophrenic disorders are very serious disorders in which the individual experiences a disturbance in thoughts, emotions, communications, and can also experience hallucinations and delusions (Morris, 2010). Bulimia nervosa and tourettes syndrome are also psychological disorders that can be helped through medication.
Bipolar disorder is a mood disorder in which the individual is experiencing bouts of both mania and...
Aug. 6, 2012
Jose J. Juarez
A psychological disorder, also referred to as a mental disorder, is an ongoing behavioral pattern, thoughts, feelings or actions that are deviant, distressful, and dysfunctional. It impacts multiple life areas which create hardships for the person experiencing these symptoms that can seriously affect your day-to-day function in life and interfere with your ability to interact in society (Unknown, Psychological Disorders-Symptoms, Causes, Treatments). While the causes of psychological disorders are unknown, and some are varied, assessments and evaluations are done by psychiatrists and therapists. Afterwards, treatments are often done depending on the cause. Treatments usually involve psychotherapy to work on behaviors, skill development, and thought process. For some patients that have severe problems, such as substance abuse or serious complications, are hospitalized. To acquire a diagnosis, clinicians use the DMV-IV-TR guidelines and answer a serious of questions about observation behaviors, such as: “Is the person afraid to leave home?” (Myers). Common known disorders are anxiety disorder, panicdisorder, general anxiety disorder, phobias, obsessive-compulsive disorder, also known as OCD, and post-traumatic stress...
...anxiety in many situations throughout the day, they may be detrimental to a normal lifestyle. An anxiety disorder is a disorder where feelings of fear, apprehension, or anxiety are disruptive or cause distortions in behavior, (Coon, 526); they are psychiatric illnesses that are not useful for normal functioning. At times, an underlying illness or disease can cause persistent anxiety. Treatment of the illness or disease will stop the anxiety. Anxiety illnesses affect more than 23 million Americans with about 10 million Americans suffering from the most common, general anxiety disorder . (Harvard, 1). Common anxiety disorders are panic attacks (panicdisorder), phobias, and general anxiety disorder (GAD). Panic attacks Panic attacks can begin with a feeling of intense terror followed by physical symptoms of anxiety. A panic attack is characterized by unpredictable attacks of severe anxiety with symptoms not related to any particular situation. (Hale, 1886). The person experiencing the attack may not be aware of the cause. Symptoms include four or more of the following: pounding heart, difficulty breathing, dizziness, chest pain, shaking, sweating, choking, nausea, depersonalization, numbness, fear of dying, flushes, fear of going crazy. Heredity, metabolic factors, hyperventilation, and psychological factors may contribute...
Although phobic disorder is certainly common, it has been more difficult to establish the extent to which it should be considered a "serious" mental disorder from a public health perspective.
Recent studies in understanding the behavioral, molecular, and anatomical bases of fear extinction in animals and humans are leading to new knowledge about the nature of fear and new treatments for anxiety disorders that affect millions of Americans (news release from SFN). In those people who suffer from phobic disorders (specific phobia, social phobia and agoraphobia) excessive and inappropriate fear and anxiety comprise the core symptoms of the disorder. Collectively, these disorders are the most common forms of psychiatric illness, surpassing rates of mood disorders and substance abuse
A study by Michael Davis, PhD, at Emory University (SFN News Release) that determined how human brain can used to treat such disorders. He found that a receptor for a particular protein called the N-methyl-D-aspartate (NMDA) receptor in a brain region called the amygdala is critical for the extinction of conditioned fear. Many medical professional believe and it also has been proved true in many cases that combination of drugs therapy and behavioral therapy has the most successful results.
2. Phobia - Definition
The term Phobia' was not used on its own until...