Anxiety disorder case study – Coursework Geeks

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September 17, 2021
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September 17, 2021

Anxiety disorder case study – Coursework Geeks

Please discuss the case studies you viewed this week. What did you learn about anxiety disorders? Using your critical thinking, compare and contrast at least three of these case studies. In your comments, include your observations about the person’s symptoms and how they affected their lives and also include comments about the treatment and results of the treatment, including the perspectives of the therapists. Respond thoughtfully to at least two students. As always, your post should be 250 words  by the due date, and your two responses should be 50 words each by the following day.
The cases are:
Case 1. Generalized Anxiety Disorder (GAD): LaVerne in The World of Abnormal Psychology

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Case 2. Phobias: Danny
Case 3. Social Anxiety Disorder:  Hannah
Case 4. Panic Disorder: Mary in The World of Abnormal Psychology
Case 5. Obsessive-Compulsive Disorder:  Howard Mandel
Case 6. Obsessive-Compulsive Disorder:   Stephanie
Case 1. Generalized Anxiety Disorder (GAD): LaVerne in The World of Abnormal Psychology
Case 2. Phobias: Danny
Case 3. Social Anxiety Disorder: – Hannah
Case 4. Panic Disorder: Mary in The World of Abnormal Psychology
Case 5. Obsessive-Compulsive Disorder: ​Howard Mandel
Case 6. Obsessive-Compulsive Disorder: ​Stephanie
Case 1. LaVerne in The World of Abnormal Psychology LaVerne
What is LaVerne’s disorder?
What are her symptoms?
Discuss the origins of LaVerne’s disorder from her own perspective.
Discuss LaVerne’s experience of her disorder. Apply the four D’s.
How does LaVerne’s psychiatrist describe the causes for LaVerne’sdisorder?
What is the perspective of the therapist. What kind of theory and model is she using?
Discuss and evaluate the treatment LaVerne received. Explain LaVerne’sperspective.
Do you believe that LaVerne’s treatment was effective? What is the evidence for your answer?
Other questions and issues?
Case  2 – Danny
What is Danny’s problem? Does he have an anxiety disorder?  Apply the four D’s.
Explain the formation of Danny’s phobia using classical conditioning?
Does stimulus generalization apply here? Explain.
How does Danny’s phobia interfere with his life? Or does it?
What are some of the reasons why Danny wants some help with his phobia?
How does the psychologist help Danny? What model or perspective is he using? List at least four of the techniques used by the therapist.
Other issues or questions?
Case 3 – Hannah
What is Hannah’s disorder?
What are some of her symptoms?
How do the 4 D’s apply?
How is her therapist trying to help her?
What kind of psychotherapy (and model) is she using?
Issues or questions?
Case 4. The World of Abnormal Psychology Case – Mary
What is Mary’s disorder? What are her symptoms?
Discuss the origins of Mary’s panic disorder and agoraphobia from her own perspective.
Discuss Mary’s experience of her disorder.   Apply the four D’s.
Discuss and evaluate the treatment Mary received from the psychologist’s perspective.
What is the perspective of the therapist. What kind of theory and model is he using? Describe some of the techniques he is using.
Do you believe that Mary’s treatment was effective? What is the evidence for your answer?
Other issues or questions?
Case 5. Howie Mandel
Does he have an anxiety disorder? Apply the four D’s.
How does Howie Mandel’s OCD interfere with his life? Or does it?
What kind of help does Howie Mandel get? What do you recommend?
Has his disorder, or his management of the disorder, improved?
Why or why not?
Case 6. – Stephanie
Does Stephanie have an anxiety disorder? Apply the four D’s.
Discuss the effect that the birth of her son had on Stephanie’s OCD, noting that her disorder was already evident to some degree and had already been diagnosed before he was born. Why might the birth of her child have changed the nature and severity of her disorder?
Discuss why and how Stephanie’s compulsive, ritualistic, behaviors and her avoidance behaviors relieve her extreme worries about her son’s health and safety.
Stephanie’s case is an extreme example of OCD. Discuss how her case might compare to other cases of OCD. Also discuss how common it is for a person to experience the number and range of OCD symptoms she displays.
Were Stephanie and her husband in denial to some degree when they used to laugh off her symptoms of OCD before their son’s birth? What role night humor play in coping with a psychological disorder?
Discuss the impact that Stephanie’s disorder, if not treated, might have on her son over the course of his development. Do you believe that Stephanie’s husband can play a role in addressing this issue?
What is the treatment for Stephanie? How do you describe it? What model? Do you believe that after treatment Stephanie is truly free of the behaviors and rituals that were so intrusive in her life and that of her family? Do you think it is possible that she will revert to her former compulsions?
Other observations and issues:
You can’t view the videos because it’s linked to my school site but I will send the transcript 
Case study 1 video transcript
– [Announcer] Annenberg Media.
– [Narrator] Sometimes as we go through life, we master our experiences. Sometimes we don’t.
– Some people have high blood pressure. Other people have ulcers. I just happen to be one person, I don’t know why, that has anxiety disorder. When a huge amount of stress or pressure is placed upon me, it comes out in anxiety.
– I avoid being home alone. I avoid shopping alone. I avoid anything really alone. I don’t do anything by myself.
– Just watching a television show where there’s a camera angle from the top of the building, and it’s heights. Just sitting in my own living room, my hands would spring to sweat, and my heart would pound and race, and I’d probably get up and walk out of the room. It just brought back so much of that terror, and it makes it real easy to want to stay away from a situation like that when it gets reinforced over and over.
– Every day, I’d go through two or three periods of anxiety. And that’s the thing that scares you because you don’t know when it’s going to come on, and you don’t know how long it’s going to last. You just don’t know what it is. You don’t go to the hospital right away because you think, well, maybe it’ll go away. Maybe it’s just something that I’m going through right now. But my breaking point was when I reacted physically to it, and I just started crying.
– [Narrator] Anxiety. There probably isn’t a person around who hasn’t felt it. Fear, apprehension, often the expectation of an unspecified danger.
– Anxiety is a very normal, natural response that has counterparts in the animal kingdom as well. So animals have anxiety about things and so do humans. So we use this every day to decide whether or not things are truly dangerous to us or whether or not they’re not. And if they are dangerous to us, then our body continues the alarm until we know what to do about it, until we’ve had time to either run, or stand and fight, or out-think our foes, or whatever.
– [Narrator] Even though it’s perfectly normal to feel some degree of anxiety in our daily lives, for many people, anxiety reaches extreme proportions, robbing them of the smallest pleasures.
– If we understand that anxiety’s a normal, natural response, then we can also understand that it can go awry just as any of our other normal, natural body responses can go. So what helps us differentiate normal anxiety from abnormal anxiety or anxiety disorders is its intensity, whether or not the intensity of the anxiety that you feel really matches the circumstance, one, if the length of the anxiety is inappropriate to whatever is causing that anxiety, and three is whether or not we’re able to adequately respond to make a decision about what to do in that our body has alarmed us to some danger.
– [Narrator] The anxiety disorders are the most common of the mental disorders with the exception of substance abuse. Anxiety disorders affect one in every six Americans at some point in their lives. That’s over 32 million people. In this program, we’ll hear from patients who suffer from various types of anxiety disorders, and we’ll explore two of the most common in depth. Panic with agoraphobia and generalized anxiety disorder. We’ll learn what it feels like to have these disorders. We’ll learn about the biological, psychological, and environmental factors that may contribute to them, and we’ll see what treatments seem to work.
– What anxiety disorders seem to be are a very complex array of imbalances or complications in the areas of the brain that control the various aspects of this alarm system. So we’re not exactly sure of what the biology is on a one-on-one basis, but we know in general that it includes such neurotransmitters as norepinephrine, as serotonin, and there are a special number of receptors, called benzodiazepine receptors, that act along with what’s called GABA, gamma aminobutyric acid, which is inhibitory neurotransmitter in the brain. So, as far as we know, those groups of neurotransmitters somehow interact with one another and either cause or inhibit anxiety.
– I don’t trust people. I have a very hard time trusting. Even with my husband, we’d gone through the Sears store, and I was going to the ladies room. I told him to stay right there at the cash register. It was no big deal. He only went in the next aisle. I wasn’t nervous, but it made me so mad. I was yelling at him, like, “Why didn’t you stay there? “I told you to stay there.” You know what I mean? And I won’t even ask him anymore. I told him, “I don’t trust you anymore. “I’m not going to ask you anymore.”
– The first time I experienced it, I was in my late teens, and it was a fleeting moment. It came and it left, but I knew what I felt, I didn’t like. And then, it disappeared for several months, and all of a sudden, it came back. When it came back, it was constant. It wasn’t something that would be just coming and going.
– [Narrator] Unlike panic attacks, which are discrete episodes, generalized anxiety disorder, also known as GAD, is chronic, diffuse, excessive worry, what used to be called free-floating anxiety.
– I knew that I was not me. I knew that I was not normal. That was not the way I was supposed to be feeling. I knew that, and I knew something had to be done because I would even have dreams of men with white sheets on, knocking at my door, and I’d open the door, and when I’d see them, I would push the door and try to keep them out. You know, I was afraid. They were saying, “We’re coming to get you.” I had all kind of nightmares and sleepless nights.
– When I would wake up in the morning with a fast heartbeat and all of the other feelings that were associated with the symptoms, it escalated to the point that I felt so crazy. Anyway, just with these symptoms, it didn’t make sense. So then, I had to create something that I would fear almost to add to this problem. I don’t know if I’m making sense to you or not, but it was like these symptoms were so ridiculous, so then I, all of a sudden, focused on finding something that would scare me. So I focused on knives. Knives became a nightmare to me. I would think about knives. I would worry that I would hurt somebody with knives. I would worry that I would lose control and kill someone. And it would always be somebody that I loved.
– What really nails down the definition of generalized anxiety disorder is the worry, excessive worry. Panic disorder people worry about having a panic attack. Generalized anxiety disorder, in order to meet criteria for it, they have to worry about other things than their anxiety. And in Donna’s case, she worries about family, finances, and she has other worries and concerns too. But that’s what really captures the disorder is that they have tohave two major themes of worry outside of worrying about their anxiety.
– And then also there are financial difficulties right now. It seems like everything’s coming at one time.
– [Christina] Okay, and are you worrying as much about the finances as you are family?
– Probably about equal. It’s hard to really say for sure at this moment. If you’d asked me that probably 10 minutes from now, I’d say, “Oh, you know, the financial is terrible.” But 20 minutes from now, I’d say, “Well, it’s the family.” I’m having trouble meeting their expectations.
– [Narrator] Often the person with chronic anxiety has difficulty falling asleep and suffers from lots of aches and pains. Many drink excessively. And the risk of dependence on tranquilizers and sleeping pills is very high. About 4% of Americans suffer from generalized anxiety disorder with women outnumbering men two to one. La Verne is an administrative assistant for the United States Army in Washington. Dr. Lewis-Hall has been treating her generalized anxiety disorder for the past four years.
– Her symptoms originally, back originally, before she came to me, included such things as the muscle tension, the chronic worry, and preoccupation with difficult issues. She would have episodes that were worse than her baseline, where she would have some increase in heart rate, palpitations, some shortness of breath, and more than anything else was this feeling that doom was right around the corner, that piece that she couldn’t quite get rid of, that something was going to happen. She wasn’t quite sure what.
– [Narrator] After living with chronic anxiety for many years, La Verne finally realized she needed to get help.
– One day I was at work, and my girlfriend and I went downstairs to the cafeteria to get lunch. And as we were walking, I got very dizzy. It felt like I was just going to pass out. And I got real nervous and frightened, and I told her I didn’t want to go in there. I was just afraid that there were too many people in there. And I said, “Just wait right here, “and I’ll be all right for a minute.” And after, it passed for about two minutes, but it seems like it’s 20 minutes or longer that you’re going through this. And anyway, we went and got our lunch. But when I came back upstairs, she went back to her office, and I put my lunch on my desk. And as I put my lunch on my desk and I got ready to eat, I just burst out crying. And I threw my plate down, and I called her up, and I said, “Come take me to the hospital right now. “I just can’t take it anymore”.
– [Narrator] Many patients with chronic anxiety do go to the hospital or to their medical doctor, but most often, it’s not a psychiatrist or psychologist they end up seeing.
– Usually, it’s the primary care physician or the emergency room physician that’ll see anxiety disorders and especially generalized anxiety disorders. These are people who will come in, becausemost of the symptoms of this illness are symptoms of the body. They’ll come in with dizziness. We’ll work them up for dizziness. They’ll come in with palpitations. We work them up for that. So the person that they see, first and foremost, is their general practitioner, or their family practitioner, or the person in the emergency room.
– [Narrator] St. Paul, Minnesota, General Practitioner Teresa Quinn sees many patients with generalized anxiety disorder who come in complaining of physical symptoms.
– I saw a person who was very focused on neck pain. That was her primary complaint was neck pain. And she did have some reasons for having the neck pain. But every time I saw her, the time would go by very quickly. She’d have a lot of things to talk about and would speak in a pressured manner, and would talk about other symptoms eventually too that were bothering her, and eventually it became clear to me that she had an anxiety disorder, and it turned out to be GAD.
– It was very disappointing because for 28 years, I have run from one doctor to another. And it also hurt me when I had physical ailments. There were times that I would go to a doctor with physical problems, and they’d look at me, and they’d say, “Donna, “are you sure it isn’t just in your head?”
– I think the most important thing for the physician is to be aware that anxiety disorders are very common and not to miss those disorders. I think in the past, we were almost trained that if we ruled out a physical disease, our job was done. And I think it’s very important that we be aware of what the symptoms are of anxiety disorders so that we can either treat that patient or refer them, and also so we can educate the patient.
– So in each case, there was a current life stress that also has to be figured in. And I think it would be too parochial to think in terms of any one of these factors as being the reason for an anxiety disorder to occur. One has to consider the complex interplay of all of those forces.
– [Narrator] For La Verne, it was a series of life events, beginning with the death of her mother, that contributed to the onset of her chronic anxiety.
– I was close to my mother. To me, a lot of people might think it sounds funny, but that was my God on Earth. You know, losing her, I didn’t really have anybody else that really mattered because she always talked to me about everything. You know, I was angry. I was angry at God. I couldn’t understand why he didn’t take my father, or somebody that I didn’t love, or something that wouldn’t hurt me. And I cried a lot. I cried for about two years every day. And that’s when I first started getting the anxiety and thinking that I was going crazy.
– [Narrator] For the past four years, Dr. Lewis-Hall has been treating La Verne’s chronic anxiety with a variety of techniques. While cognitive behavioral psychotherapy has brought positive results, it’s through medication that La Verne has found the most relief.
– She’s on Xanax and has done extremely well. The question you always have to ask yourself about someone who is on one of these medications is, is now enough? Have they been on it long enough? And usually, what we do is to follow to ensure that they stay on an adequate dosage but are not overdosing themselves. And most people do stay on stable doses. If you start on X amount, you stay on X amount for the many years that you’re on it. But periodically, you have to review the case and know whether or not it’s still warranted that a person would have to stay on medication.
– I’m not frightened of anything. I can ride an elevator. I can ride the subway. I don’t think of any of those things anymore. And it just keeps me calm. I don’t get anxious or anything. But if I do, then I’ll take the medication, or I’ll talk to myself and tell myself that this is something that happens to me and to let it pass because at one time, I was trying to stop the feeling, and then it gets worse when you try to stop it, so it’s best to let the feeling come on and go away. I wouldn’t do without it. Right now, I would be afraid to not take it. Yeah, I would be very afraid to not take it.
– [Narrator] We returned to the agoraphobia clinic in week two of their program to see how the participants were progressing with their treatment. They had made great strides in only two weeks. Mary was now driving alone, Roger had crossed numerous bridges, and Patrick drove alone to Atlantic city. Although they have not become panic attack free, there clearly was improvement.
– In addition to that, it’s very clear that some of the medications, the ones called minor tranquilizers, the benzodiazepines in particular, Xanax, the most commonly used these days, actually interfere with one of the processes necessary for getting over, that is permanent change, of the fear. And there is data to support that. We certainly see it clinically all the time.
– Once you’ve made a diagnosis, and the person is prepared for treatment, you discuss the options. When you think that it’s legitimate is the same as you would think that medication was legitimate in non-anxiety-related illnesses. So if you find that the intensity of the person’s behaviors, feelings, and thoughts are so great that they interfere with their day-to-day life and they can’t wait, so that if they’re suicidal or feel that they might hurt themselves or somebody else, then you start medication right away, if possible.
– The future, it looks good. It’s going to be good. Can’t get any worse, I know that, because those days were the darkest days that I’ve ever had. So I can see the green trees now, and I can hear the birds sing, and I’m not just going through the motions anymore, and then I’ll know how to handle things from now on. So I know the future is real good. No problems there.
– [Announcer] Annenberg Media. For information about this and other Annenberg Media programs, call 1-800-LEARNER and visit us at
case study 2 video transcript 
– [Narrator] Danny Mathionas is 10 years old. His phobia makes his walk to school a daily horror. Danny believes his fear of dogs stems from a single moment when he was a toddler.
– When I was 18 months old, I was in a buggy and this dog jumped up at me. It didn’t bite me, but I think that it scared me. When it jumps up, I like, think it’s like going to bite me, and hurt me, and attack me. People say, “Oh no, you’ll be alright.” But,I’ve tried to think to myself, “It’s not going to hurt me.” But I just can’t help thinking it is!
– [Narrator] Much to his embarrassment, Danny often asks his mom to take him to school. Oh my God. Mom!
– It’s all right, it’s okay. It’s okay, It’s okay.
– Mom look!
– It’s all right. It’s okay.
– It’s coming up out of that place, can we cross over?
– It all right, It’s all right. Okay? Just keep walking, it’s all right.
– Oh, I don’t know.
– Okay? She’s taking him in.
– Good.
– Okay. Okay?
– Yeah.
– It’s all right. All right, you can drop hands now. Okay?
– Yeah. I want to say I cope with dogs because I want to go to school on my own. I want to go ’round my mate’s house. Want to go ’round my granddad’s house. That seems to stop me, wanting to go ’round my mate’s house and my granddad’s house and things like that.
– [Granddad] Come on, Daniel!
– [Narrator] Danny’s grandfather has a small dog and finds it hard to understand why Danny is so afraid of it.
– Hannah! Don’t bring the dog inside.
– [Hannah] I won’t!
– Well make sure you don’t!
– It doesn’t matter whatever size it is. You don’t say to somebody who’s scared of flying “Yes, but it’s only a helicopter.” Do you? If they’re scared of flying, they’re scared of flying.
– Yeah.
– Whether it’s a great big airplane or a light aircraft.
– Yeah.
– Danny’s father has been hoping his phobia is just a phase.
– I hoped really that he grow out of it. And as he got a bit older, I thought he’d would, he’d learn that all dogs are not bad dogs. But he’s, he’s got worse over the years. He has got worse.
– [Narrator] Phobias provoke intense physical responses. Danny agreed to have his heart rate monitored by behavioral therapist, Colin Blowers, before and after seeing a dog.
– [Danny] Okay.
– [Narrator] First, the dog was hidden behind a screen. And at this point, Danny’s heart rate was 86 beats per minute.
– [Dr. Blowers] Look in that direction.
– It’s not on a lead.
– [Dr. Blowers] It is on a lead. It is on a lead, Danny.
– [Narrator] But when he saw the dog, Danny’s heart rate almost doubled. His blood pumped to his muscles, and his body prepared to either run or attack. The “fight or flight” response. Once the screen went back down,
– [Dr. Blowers] That was very brave of you. Well done.
– Danny’s heart rate was back to normal in moments. Danny’s mother worries that his fear, may in part, have come from her.
– I didn’t know whether I made him anxious about dogs. Big dogs worry me to a degree because of their size. Being a mother, the guilt trip syndrome, really. I kept thinking, “It must be something that I had done, to make him so scared and so petrified.”
– [Narrator] Danny is also having behavioral therapy, and today is his first session. Danny will be gradually exposed to dogs, but any exposure is frightening.
– Now don’t be nervous, will you? We’ll take everything at your own pace, okay.
– Okay. Yeah.
– [Mom] There’s none about the car park at all. You want to wait out, or you want to get back in?
– I want to get back in.
– You can sit back in til, til everybody gets here. Yeah?
– All right.
– Okay.
– For Danny, today is the equivalent of looking down the barrel of a gun, and not knowing whether it’s going to fire or not. He’s, he could feel that terrified. Hi Ruth.
– Hello. Nice to see you again.
– And you. Hi Danny.
– Hi.
– How are you feeling?
– A bit worried.
– A bit worried. Yeah. How would you feel about standing outside of the car? Not too happy.
– I’ll be all right.
– [Dr. Blowers] Okay.
– [Narrator] Colin has arranged for a colleague to bring a dog on a leash to a nearby clearing.
– [Dr. Blowers] Just through the trees there.
– He’s just, what is he on a lead?
– Oh, definitely on a lead. No problem at all.
– [Danny] This is about as close as I can come I think.
– Take a couple of deep breaths.
– Think I could stay here for a little bit longer.
– [Dr. Blowers] Yeah, sure. That’s no problem at all. How long has it been since you’ve been this close to, to a dog?
– [Danny] I want to go to this side of you.
– You can go to this side of me. What? Just in case some onecomes down the path? How would you feel about moving a little bit closer? That’s great!
– This is as close as I can come.
– That’s fine.
– Oh no!
– It’s all right.
– [Danny] Oh da da, da da. Over here.
– Because there are so many other dogs around and that’s worrying you, what we’ll do, we’ll end the session here. All right?
– Yeah.
– You’ve done really well to get this close to, to Daisy. And, we’ll arrange to get together next week.
– Okay.
– And we’ll find somewhere where there won’t be other dogs to worry about.
– [Narrator] It’s Danny’s second treatment session. Today, there’s a lively Labrador at the end of the garden.
– All right? How’s that?
– Okay.
– How anxious?
– About five.
– About five on that scale. So it’s gone up a bit. You still want to keep moving forward? Well done. That’s brilliant.
– [Narrator] Danny has never touched a dog. His goal is to stroke the Labrador.
– [Danny] That’s as close as I think I want to go.
– [Dr. Blowers] That’s fine. So that’s about as close as we got with the dog last time, wasn’t it? He looks quite lively, doesn’t he? Can you give me a score as to how anxious you are?
– [Danny] Four.
– [Dr. Blowers] Okay. So even just in the few minutes we’ve been standing here, your anxiety has come down a little. A little bit closer? That’s good. Well done. Can you tell me what level of anxiety you’ve got now Danny? On that scale?
– About three.
– About three. Want to try to move in a bit closer?
– I’m going to touch him.
– You’re going to touch him?
– I think I am, I think I am.
– Brilliant. That’s good. Don’t forget to breathe while you’re doing it.
– I don’t want to.
– Bit too playful, innit he?
– So how’d you feel while you were doing that? While you were stroking the dog?
– Felt a little bit worrying, but I was all right.
– I thought it was unbelievable.
– [Danny] Yeah. I was totally shocked. I’ve never-
– What did you expect me to go and stroke its head and stroke its back and pick up it’s tail?
– I never expected you to get that close. Not so soon. And to feel, you looked as if you felt comfortable what you were doing.
– [Danny] Yeah. I thought you did really, really well. Very proud of you, I was. Did really well. Okay?
– Yeah.
– [Dad] Hello?
– [Danny] Hi, Dad!
– [Dad] Hello!
– Yeah, look. I had my treatment today.
– [Dad] Oh yeah. How’d you go on?
– Yeah, I got on really well!
– [Dad] Did ya?
– Yeah. I picked up its tail.
– [Dad] Yeah?
– Yeah, I stroked his head.
– Yeah.
– Tickled its tummy.
– [Dad] Oh, that’s all right!
– Mm-hmm.
– [Dad] All right, do how did you feel about it all?
– I was a bit worried, but I was all right. Reckon I could do it on my own.
– [Dr. Blowers] You do? Off you go then. All yours!
– Oscar! Come on, Oscar. That’s a good boy, now. No, not this way. This way!
– I think it will take a lot, lot, lot longer.
– It can do sometimes. Remember we’ve had working in our favor, is that Danny’s just aching to play with dogs.
– Yeah.
– Yeah. You know what the next question he’s going to ask is, don’t you?
– I think I might. Yes.
– Yes, quite. Can I have one as a pet?
– Yeah, come on. Run! Running! You like running! So do I.
– [Narrator] After four sessions of behavioral therapy, Danny is no longer afraid of dogs and is even able to enjoy them.
– Naughty boy.
Case study 3 link 

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