Case Study Report: Panic Disorder with Agoraphobia

Case Study Report: Agitation Ataxia with Agoraphobia             In the case of Dennis Holt, a thirty one year old man presenting with casual occurrences of agitation attacks, the closing analysis was Agitation Ataxia with Agoraphobia. The analysis of the ataxia can be advised to aftereffect from a botheration with cognition. Holt beheld the apple with acute negativity. He accepted bodies not to like him, and accepted the affliction to appear in every situation. He feared that he was abhorrent at his allowance sales job, but there was no absolute affirmation to abutment that feeling. After his aboriginal agitation attack, he additionally became actual aflutter of aback the abutting one ability occur, and this beatific him into situations that he already begin afflictive with the abstraction that he would accept a agitation attack, and conceivably bodies would anticipate beneath of him. He became aggressive acute about signs that he accustomed from his body, such as agitation or a quickened affection beat, and formed himself into a agitation while aggravating to abstain a agitation attack. In addition, he was a actual anxious, aerial strung person, as able-bodied as actuality cocky conscious. These factors can be traced aback to his abrogating accord with his father, whom he could never assume to please. Holt additionally suffered from gastrointestinal problems, some of which could be attributed to his anxiety. These problems fabricated him alike added cocky acquainted and nervous. He eventually developed a abhorrence of active on the larboard ancillary of the alley due to a agitation advance while driving. A agitation advance during a banquet fabricated him aflutter to eat with ample groups. Finally, a agitation advance during a arcade cruise fabricated him clumsy to face actuality in the bound borders of a mall. However, he could participate in activities that accustomed him to be in accessible spaces or complex aloof a few people. His annulment from his aboriginal wife allegedly contributed to his animosity of low cocky worth, and his alienation to “rush into anything” with his new fiancée added displayed his abrogating cerebral angle on the world.             Looking at the DSM-IV belief for agitation attacks, Holt fit the belief in several ways. He accomplished palpitations, sweating, trembling, conciseness of animation and a baking sensation, a asthmatic sensation, chest affliction and discomfort, belly distress, dizziness, numbness, and tingling, accompanied by a activity of acute panic, and all these affection had lasted at atomic ten minutes. For a analysis of Agitation Disorder, one charge accept had a agitation advance that acquired the actuality to change his or her behavior for at atomic one month, as able-bodied as recurrent, abrupt agitation attacks, and Holt additionally fit this criteria. Holt had fears of actuality trapped in afflictive places and situations, and the abhorrence that actuality in those situations would accompany on a agitation attack. His gastrointestinal problems additionally fabricated him aflutter of actuality in a bearings that he could not abolish himself from. These affection able him for a analysis of Agoraphobia. Finally, Holt’s connected anxiety, beef tension, disability to relax, astriction headaches, connected fatigue, disability to beddy-bye well, and gastrointestinal problems additionally able him for a analysis of Generalized All-overs Disorder. While Holt did not acquaintance abounding agitation attacks, and he did not accept the affection of derealization, depersonalization, abhorrence of accident ascendancy or dying, or chills and hot flushes, he had able-bodied added than four of the thirteen affection bare to analyze a agitation attack. Also, while his fears had not rendered him housebound, he abhorred abundant amusing situations to be advised agoraphobic. Overall, Holt’s diagnoses appeared to be actually correct, and he was a abreast absolute fit for the all-embracing diagnosis.             The diathesis-stress perspective, as activated to Holt, seemed to comedy a analytic cogent role in his cerebral disorders. The  two diathesis that could possibly be activated to Holt’s activity were the actuality that he had accessory abdomen problems and was rather shy as a boyish and an adolescent. This aftermost actuality could appear into comedy because the accent put aloft him by his ancestor from an aboriginal age onward. The ancestor capital Holt to excel and be the best in aggregate he encountered, including academy assignment and sports, but Holt was abandoned boilerplate in these areas. His job as an allowance salesman was not adequate to his father, who had capital Holt to be an aeriform engineer, and Holt’s aboriginal bootless alliance was a connected disappointment to his father. The ancestor consistently brought up these perceived shortcomings, and this activity led to arguments at about every visit. Holt was able to participate in academy functions and activities admitting his shyness, and he did not booty his father’s criticism quietly. However, Holt’s achievement in academy may announce that his backwardness and the connected accent of his father’s acrimonious did, in fact, accept an appulse on his brainy state. He became captivated with “test anxiety” in college, and afraid over tests to the point that he was about clumsy to booty them. While some of his advisers accustomed him added acclaim assignment because of his growing problem, his grades still fell. About the time that he developed deepening gastrointestinal problems, he appear to the therapist that he had faced connected burden from both of his parents to accomplish bigger grades and acceleration out of bookish probation. The gastrointestinal problems had been a baby allotment of his activity before, but the accent he was beneath beatific them out of control. Holt was diagnosed with Irritable Bowel Syndrome, but still suffered from problems admitting the anesthetic he was given. One could altercate that the affectionate accent activated to the diathesis of backwardness and abdomen issues pushed Holt into the cerebral problems he suffered after in life. Cocky alertness and abhorrence of affair and embarrassment could accept arisen from his predisposition for backwardness and abdomen problems.             Holt’s case was acutely handled from a cerebral viewpoint. He was accomplished absolute cerebration techniques in adjustment to overcome, or at atomic control, his fears and advance his cocky esteem. He was additionally accomplished adapted cocky talk, and abstruse to not put himself bottomward as much. Behavioral analysis was additionally used. For example, Holt was accomplished alleviation techniques and was affected to accost some of his fears, such as arcade at the mall, arch on. Holt was not apparent to breath restructuring or acknowledgment to actual sensations, however. This is rather hasty seeing as how these are two important genitalia of cerebral behavioral therapy. Conceivably the therapist acquainted that retraining Holt’s cerebration and behavior were the best all-important apparatus to his able-bodied being. Holt was additionally not accustomed medication to still his nerves. He did not appetite it, so his therapist formed about that request. However, with medication Holt may accept bigger abundant added bound than with cerebral behavioral analysis alone. One is told that Holt was in analysis for six months. With medication, that time could accept been shortened, and he could accept acquainted abundant bigger sooner.             Axis I - Agitation Ataxia with Agoraphobia             Axis II - Generalized All-overs Disorder             Axis III - Gastrointestinal Disease             Axis IV - Problems with primary abutment group: father             Axis V -  45 The GAF called was based on the actuality that Holt suffers from austere agitation symptoms, forth with the actuality that he is axis bottomward invitations from accompany and attached his accomplishments due to the abhorrence of accepting a agitation advance while active or while in a ample group. His relationships may be adversity due to his aberrant fears.

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