Abnormal Psychology Case Study Assignment
DSM-5 Diagnosis
Based on Heather’s case study (case study 7), the best diagnostic match according to the DSM-5
criteria is social anxiety disorder (SAD). Heather's symptoms align closely with SAD for the
following reasons:
1. Intense fear of social situations: In this case, Heather continues to have an “intense fear of
speaking with people she does not know very well,” a characteristic of SAD.
2. Avoidance behaviours: To further illustrate her social phobia, she selected huge lecture
courses in which she could sit in the back with the objective of not talking to other students or
responding to any questions. This is in agreement with the pattern that is typical of SAD.
3. Fear of negative evaluation: Heather is confident about the fact that she will do something
embarrassing' and a negative review will be given by others.'' This fear of the perception of
others is at the core of SAD.
4. Impairment in functioning: h er fear has impacted her education as she can no
longer take large lecture classes with the participation being optional. She has stated she is
thinking about quitting school, which raises questions of severe harm.
5. Anticipatory anxiety: One of the typical symptoms that Heather exhibits is difficulty in
sleeping at night and this can be as a result of worries about the next social events.
6. Disproportionate fear: Finally, although Heather succeeds in her academic performance
(high marks, list of deans), her phobia of interpersonal communication appears to be overgrown,
which is another essential sign of SAD.
7. Duration: More, she has endured her specified symptoms for at least two years making her
endure the SAD symptoms meeting the seventh criterion of the disorder.
Although Heather's phobic fear of vomiting might be indicative of emetophobia, it is the overall
hierarchy of social phobias and avoidance behaviors that predominate and reasonably define
SAD as a primary diagnosis in Heather's case. Symptoms that are severe enough to be disruptive
and lead to problems in daily functioning disrupt her life. This is not better accounted for by
another mental disorder or medical condition, but Social Anxiety Disorder because the signs and
features are never merely shyness or normal social unease.
The Treatment I would Recommend
Cognitive-Behavioral Therapy (CBT) and gradual exposure therapy are the most effective
treatments given that Heather has been diagnosed with SAD.
CBT is highly effective for SAD and would help Heather:
1. Restructure her cognition because her assumptions are unrealistic, envision a healthier picture
of what might actually happen.
2. Create ways and means to help people cope with anxiety symptoms (Neufeld et al., 2020).
3. Try to understand the signs of anxiety and try to get techniques through which such signs can
be lessened.
Exposure therapy, implemented gradually, would involve:
1. Developing a hierarchy of the social phobic situations is an important step in the provided
model.
2. Gradually increasing the level of anxiety provoking positions whereby constantly exposing
Heather to such positions (Hunger et al., 2020).
3. The need to learn how to 'sit' through such situations until the anxiety levels are reduced while
at the same time boosting Annabelle's confidence.
This treatment recommendation is based on the cognitive-behavioral theory of etiology for
SAD, which posits that the disorder develops and is maintained through:
1. Distorted schemas of thinking (negative attitudes toward self, over-estimation of threat in
social situations)
2. It deals with behavioral avoidance to disconfirm fears that can be termed as negative behavior.
3. Attention to self and personal impact in dealing with social context
CBT and exposure therapy directly address these maintaining factors by:
1. Restructuring negative cognitions
2. Exposure of the client to the maladaptive thoughts in a way that is more controlled and
ultimately an attempt at 'corrective experiences’(Neufeld et al., 2020).
3. This finding suggests that directing attention outward is useful in social settings.
Moreover, this approach has considerable research evidence as a direct treatment of SAD as well
as a range of other psychological disorders. This makes it possible to organize the therapy in a
specific way that will help Heather achieve definite objectives in her academic process that will
be aimed at her phobias. Since the patient, Heather, has excellent scores in her academic
performance, then it implies that she understands herself in the right manner and has good
thinking abilities that will enhance her commitment to cognitive-behavioral therapy. The
exposure therapy would be a gradual one, which would, in turn, assist is managing her anxiety as
she progresses towards her goal of being a participant in small classes.
3. At What Point Do These Things Become Maladaptive and What is the Prognosis?
Heather’s symptoms are considered severe when they cause significant impairment in the
development or maintenance of daily living, activities and preventing her from reaching normal
developmental goals. Specifically:
1. Academic impact: Due to fear, her participation in required smaller classes is affected, hence
instabilities in her progress.
2. Social development: She is denied a chance to interface with other students, which is a
critical component of college social network development.
3. Quality of life: She described her anxiety which has impaired her sleep and makes her to have
considerable distress.
4. Future implications: If left uncompensated, this might affect her employment opportunities
in the future since organizational positions often involve socializing with others and even
presenting before others.
5. Considering dropping out: Simple acts such as thinking of leaving school are quite
expressive of just how much of an impact it has on her life.
The prognosis for Heather's case is generally positive, given several factors:
1. Early intervention: That she is only 19 years old means she is getting treatment for the
problem before it gets fully developed.
2. Academic success: This is particularly true for patients like her who present with favorable
prognostic markers such as high levels of cognitive functioning and motivation.
3. Treatment efficacy: The two therapies said to have high success rates include Cognitive-
Behavioral Therapy (CBT) and exposure therapy for Social Anxiety Disorder.
4. Gradual exposure opportunities: Because college life presents many well-ordinated, gradual
opportunities for exposure to social settings, this study’s recommendations are well aligned with
this environment.
5. Potential support system: It is also important that she should already know the places to look
for the services of an academic advisor and mental health services if she is in school.
Timely intervention meant that Heather had hopes of seeing her symptoms improve to normalcy
within a period of 12-16weeks of consistent therapy. As for the long-term outcome, variables in
this regard are also quite promising, and most patients report significant symptom alleviation and
overall life quality improvement. The major qualification is that the extent of improvement is
related to Heather’s motivation and effort in treatment and homework completion, as well as the
competence of her therapist. There may be some level of residual anxiety in social settings that
may still be present, but as long as she has enough tools in her toolbox to manage them, her
functioning is not going to be that impaired.
References
Neufeld, C. B., Palma, P. C., Caetano, K. A., Brust-Renck, P. G., Curtiss, J., & Hofmann, S. G.
(2020). A randomized clinical trial of group and individual cognitive-behavioral therapy
approaches for social anxiety disorder.AInternational Journal of Clinical and Health
Psychology,A20(1), 29-37. https://doi.org/10.1016/j.ijchp.2019.11.004
Hunger, C., Hilzinger, R., Klewinghaus, L., Deusser, L., Sander, A., Mander, J., ... & Schweitzer,
J. (2020). Comparing cognitive behavioral therapy and systemic therapy for social anxiety
disorder: Randomized controlled pilot trial (SOPHO‐CBT/ST).AFamily process,A59(4), 1389-
1406. https://doi.org/10.1111/famp.12492
