Abnormal Psychology Case Study - A joint diagnosis of Generalised Anxiety Disorder and Social Phobia Disorder was given which accounted for the symptoms that Isabella was presenting with in accordance to the DSM-IV and proposed DSM-V. To further analyse t

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307196704        Generalised Anxiety Disorder

A Diagnosis of GAD & the critical analysis of factors underlying meta-cognitive and uncertainty theories

307196704

University of Sydney


Abstract

On evaluation of Isabella’s symptoms, it was ruled out that she did not suffer from a panic disorder, but rather she suffered from panic attacks associated with an anxiety disorder. A joint diagnosis of Generalised Anxiety Disorder and Social Phobia Disorder was given which accounted for the symptoms that Isabella was presenting with in accordance to the DSM-IV and proposed DSM-V. To further analyse the cause and treatment of such disorders, meta-cognition theory and uncertainty theory were evaluated to determine the role that worry plays in the negative feedback system of a GAD sufferer. Both theories provide interesting insight into Isabella’s case however, as every case is unique, more research and insight is needed.


Isabella, a 29-year-old woman, first presented to her GP complaining of breathing difficulties, heart problems, sweating and faintness. Her GP found no evidence to suggest a physical problem and hence suspected that she may have a panic disorder. Upon further analysis of Isabella’s symptoms however, we find that although Isabella does seem to suffer from panic attacks, her symptoms are not entirely consistent with Panic Disorder (PD) as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Although some of Isabella’s self-reported symptoms are consistent with the DSM-IV (American Psychiatric Association, 2000) diagnostic criteria for PD, not all the criteria is appropriately satisfied. From the information we have obtained from Isabella so far, it does seem that her reports of feeling like she was suffering a heart attack is consistent with the DSM-IV PD criteria of persistent concern of the implications of the attack. Similarly, the attacks do not seem to be the result of any substance abuse, since there is no evidence that Isabella is suffering from a substance abuse problem. Furthermore, for an accurate diagnosis of PD, DSM-IV states the symptoms must not be better explained by another anxiety disorder.

A panic attack is a likely explanation of the symptoms that Isabella presented with to her GP. Her four symptoms of breathing difficulty, heart palpitations, sweating and faintness fall within the required symptoms of a panic attack. Panic attacks can occur in the context of any Anxiety Disorder. A deeper look reveals a more accurate diagnosis of General Anxiety Disorder (GAD) is more relevant to Isabella’s symptoms. According to the DSM-IV, GAD is characterized by “excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities”, Isabella’s symptoms are consistent with this criteria. Furthermore, the worry that she is feeling over everyday situations is consistent with this diagnosis. The DSM-IV for GAD requires at least three of six criteria be met for a successful diagnosis of GAD. Isabella’s reports of chronic fatigue, irritability, sleep disturbance and restlessness satisfy four of these criteria.

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It is also important to note that Isabella’s cultural variation may be a factor in regards to her expression of anxiety, however due to the severity of her described symptoms, it would seem that this shouldn’t impact on the diagnosis of GAD (Goldenberg, 1996).

Similarly, a diagnosis of Social Anxiety Disorder seems accurate under the DSM-IV due to Isabella reporting a clear avoidance of social situations at work in which she is terrified of making a fool of herself in front of others. Although Isabella only reports these feelings when at work, Specific Phobia has been ruled out due to ...

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