CASE STUDY: ANNA
Case Study: Anna
Andriana Hamlin
Liberty University
CEFS 546- Psychopathology
09/05/2021
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CASE STUDY: ANNA
Case Study: Anna
This case study is focused on assessing Anna's psychological issues. The goal is to find
out what key issues plague her and to identify possible solutions. The diagnostic impressions
provided are based on the information presented and the treatment options suggested.
Key Issues
Biological
Anna is currently taking Paxil for the past four weeks to manage her anxiety and physical
symptoms. A medical professional diagnosed her with anxiety. Paxil was prescribed to her to
help with the symptoms and will be re-evaluated within the next six to eight weeks. Tensions in
the body can increase over time, causing headaches and migraines. These symptoms can also
cause long-term fatigue and sleeping problems. which Anna has been experiencing for the last 24
months. She reports that she has been drinking two glasses of wine daily, which is at least five
days a week.
Psychological
Anna has had low intensity anxiety since childhood and more most of her adulthood. It
has worsened over the recent years. The intensity has stemmed from retiring from a job that was
routine for since she was 24 years old, losing her husband to cancer, and becoming the caregiver
of her 90-year-old elderly mother with the assistance of her daughter. Anna started to have
anxiety symptoms that became more frequent. She also started displaying anger when she was
confronted about her feelings.
Social
Anna's family and she as well feels as though due to the increase level of anxiety, it has
been strenuous to get along with her. After her retirement, Anna's social life has dwindled with
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CASE STUDY: ANNA
her relationship with her family and coworkers. She kept in touch with many coworkers as
possible until the last few months of 2018, when her anxiety-driven behaviors cut her contact
with them. Her anger and irritability have affected the relationships she built with her children,
her former co-workers, and her grandchildren.
While Anna is a Hindu, she has expressed a desire to integrate her religious beliefs into
her counseling. While this issue is not considered an issue to be rectified, a counselor is expected
to assist a patient in incorporating their belief system. This case study will discuss how Anna
could use her faith to help her manage her anxiety.
Assessment
Anna has multiple forms of anxiety, and she frequently reports symptoms related to
anxiety. The most appropriate assessment for her would be Overall Anxiety Severity and
Impairment Scale (OASIS). The Overall Anxiety Severity and Impairment Scale is a self-report
measure used to evaluate the severity and impairment of an individual with an anxiety disorder.
The OASIS instructions ask patients to consider a variety of symptoms, such as panic attacks and
worries (Campbell-Sills et.al, 2009). The OASIS is a tool that can be used to assess the severity
and impairment of various anxiety disorders. It can also be used to diagnose and manage anxiety
disorders. The Anxiety Scale is a useful tool for many clinical settings and research purposes. It
has been designed to be used with minimal interference (Campbell-Sills et. al, 2009).
Diagnostic Impression
Based on the symptoms and testimonials of Anna's behavior, I would strongly
recommend that she be diagnosed with Generalized Anxiety Disorders, CD-10 code 300.02,
F41.1 (American Psychological Association, 2013). The following are the main symptoms of
generalized anxiety disorder that closely resemble Anna's Symptoms. They are characterized by
excessive worry and anxiety, which can impair social functioning (APA, 2013).
Other DSM conditions that should be considered when diagnosing Anna is Separation
Anxiety Disorder (ICD-10 code 309.21, F93.0) and Substance/Medication Induced Anxiety
Spiritual:
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Disorder (291.89, F10.280) (APA, 2013). Initially, separation anxiety was triggered by Anna
losing her husband. It is also directed towards the well-being of her family and children. Anna
also reported having intrusive thoughts about herself and her financial situation. This counselor
was able to identify her alcohol-induced anxiety as a contributing factor to her issues. It was
eventually discarded due to the timeline of her symptoms, as well as her previous drinking
habits.
According to the DSM-V, women tend to suffer from Generalized Anxiety disorder than
men. This means that her thoughts are intrusive and can disrupt everyday life (APA,2013). Anna
shows signs of being negatively affected by her anxiety symptoms. However, she does not
display panic symptoms like other anxiety disorders, and she believes that Generalized Anxiety
Disorders is the most accurate diagnosis (APA, 2013).
Treatment Recommendation
The major issues that Anna has is her psychological symptoms, which include anxiety
and depression. Therefore, I believe that a holistic approach would be most beneficial for her.
The counselor can also help her overcome her anxiety by developing a social circle that she can
connect with. This would help her regain her physical health and establish a foundation for her
mental health.
Studies have shown that cognitive behavioral therapy can be effective for a variety of
mental health disorders, including anxiety disorders. In addition, including imaginal exposure, it
has been shown to improve the functioning of GAD patients after 12 months (Kaczkurkin & Foa,
2015). The effectiveness and safety of exposure therapy have been widely acknowledged for
treating anxiety disorders (Kaczkurkin & Foa, 2015). This treatment is commonly used for
treating many forms of pathological anxiety disorder (Kaczkurkin & Foa, 2015).
This client's spiritual formation will be addressed in the following sections. As an added
bonus, this counselor would suggest a reduction in alcohol consumption to avoid overlap. While
not a physician, anyone who is not a doctor can hazard a guess as to how alcohol and other
mood-altering drugs may interact with Paxil. As a result, suspending substance use may help her
avoid getting sick.
CASE STUDY: ANNA
Specific Considerations
The cultural background of Anna’s family was not significant in her symptomology. It
was mostly due to her desire to keep her mother in a nursing home and her family being
motivated by her anxiety. The counselor would most likely require assistance from Anna to
explain why assisted living an option in her culture is not. She would also require information
about her Hindu religious practices.
Counselors may face communication difficulties, misunderstanding of the culture, on the
process of counseling, misguided assumptions about cultures values and failure to understand
(Hohenshil et al., 2015). Hindus with Asian descent from lower income families, those with less
education preferred to seek help from traditional healers than professional counselors (Hohenshil
et al., 2015). These culturally diverse clients may make regular offerings or pray at the temple
while simultaneously working with a therapist, these findings suggest that for many, an element
of spirituality may be critical in helping the process (Hohenshil et al., 2015).
This counselor would manage their own religious views while helping the client
understand universal truths and commonalities. The purpose of this type of counselor is not to
convert the client, but to help them manage their mind and body.
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Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Campbell-Sills, L., Norman, S. B., Craske, M. G., Sullivan, G., Lang, A. J., Chavira, D.
A., Bystritsky, A., Sherbourne, C., Roy-Byrne, P., & Stein, M. B. (2009). Validation of a brief
measure of anxiety-related severity and impairment: the Overall Anxiety Severity and
Impairment Scale (OASIS). Journal of affective disorders, 112(1-3), 92–101.
https://doi.org/10.1016/j.jad.2008.03.014
Hohenshil, T. H., Amundson, N. E., & Niles, S. G. (2015). Counseling around the world:
An international handbook. Wiley.
Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety
disorders: an update on the empirical evidence. Dialogues in clinical neuroscience, 17(3), 337–
346. https://doi.org/10.31887/DCNS.2015.17.3/akaczkurkin
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