Agoraphobia Case Study Essay

In case one the Subject Ann has a disproportionate fear of being away from home unaccompanied, as well as various open spaces, events, and even while driving the car. A result of this fear is that Ann rarely leaves her home, and when she does, she seeks escape or needs an immediate relative to accompany her. These symptoms have developed over a period of three years, and could be used to diagnose agoraphobia in Ann.
Like most phobias Behaviorist believe agoraphobia is learned. In this case, Ann would have encountered a scenario that triggered a fear response of being outside. Since Ann’s main excuse for not leaving the house is that there might be an emergency. This could possibly shed some light on what triggered her agoraphobia. However,

she cannot remember any event in her lifetime when there was such an emergency. Ann further states that her initial fears were far less debilitating than in her current state. It is for that reason that it is very unlikely that her agoraphobia was because of classical conditioning. Another possible way phobias are created is through modeling. However, this seems equally unlikely, as most people do not typically demonstrate any form of agoraphobia in their everyday life. The most unlikely cause of Ann’s agoraphobia would be some form of substance abuse. This is unlikely because even though Ann might not have reported this to her doctor the people close to Ann like her husband would probably have noticed. Since none of these appears to be the cause, Ann probably had some form of genetic predisposition to develop agoraphobia beforehand.
Treatment for agoraphobia can include a wide range of anti-depressant and anti-anxiety medication; however, the most important treatment lies in psychotherapy. It is very unlikely that without any form of treatment Ann will get better, in fact without any sort of treatment, her conditions would probably get worse. Most doctors would recommend exposure therapy to their agoraphobic patients. It is the most successful therapy for agoraphobia, with 60-80% of saying that they find it easier to go into public places. There is no reason why treatment could not work for Ann. Exposure therapy also includes on number of motivating components in order to help patients get better. These include support groups, which would probably be of great help to Ann.
Even if treatment is successful, it is possible that Ann could relapse. With further treatment, she could undoubtedly regain all the work she has put in but the fear of relapse may always be present. Ann is very much aware of her own problems, and she appears to want help, as she knows it is interrupting her life. In many extreme cases of agoraphobia, patients are incapable of leaving their houses. This is a good sign for Ann, as it clearly has not developed to that point. However if left unchecked Ann’s symptoms could have gotten progressively worse. Even to the extent of being unable to leave the home.

Case 3, Diagnosis Schizophrenia
In case three Bob is catatonic, when he does talk he is completely incoherent and keeps coming back to the word “Gilgamesh”. Bob is socially withdrawn and is intent on only wearing a pajama top as clothing. These symptoms, which have lasted over a month, have gotten to the point where they have completely halted both his professional and social life. His sister Sharon brought Bob to an inpatient unit after he was arrested. From these symptoms, a diagnosis of schizophrenia can be made.
It is very likely in this case, that Bob had either schizoid or schizotypal personality disorder when he was younger which then developed into schizophrenia after being left untreated. A young bob was described as a loner, he hardly ever laughed and seemed emotionally distant. A year and a half prior to being brought to the inpatient unit. Bob stopped going out and even started ignoring attempts to contact him. Sharon and her husband would often times hear him giggling seemingly for no reason. Eventually Bob stopped being productive at work and finally stopped going to work entirely.
One could argue that if Bob’s schizophrenia developed from a cluster A disorder than it is likely that the cause of his schizophrenia was genetic. However, developmental factors probably had a play in this too. If Bob had not been allowed to remain a loner or socially withdrawn. Things may have turned out different. Although that is speculation at best. Before his schizophrenia manifested he probably would have been distrustful of the doctor and not participated in therapy or even taken his meds. Which also would have led to schizophrenia.
As for treatment Bob should immediately go on antipsychotics, medication would not be a choice for Bob while he is in inpatient care, and when the doctor feels he is ready he could take part in some form of psychosocial treatment. The drugs would most likely consist of second generation or atypical antipsychotics. Long-term inpatient care is rather uncommon as treatment for schizophrenia; there are instead a number for therapies including Social, family, and Cognitive behavioral therapies, which are used. Family therapy is one of the most common therapies for schizophrenia and other mental disorders. However, it is rather dependent on having a supportive family. In this case, it would be reliant on Sharon and her family. Even without a supportive family, there are other options. Many schizophrenics live independently with members of community supporting them.
Bob will have schizophrenia for the rest of his life. However, it is possible that with the right treatment, he could show significant signs of improvement even to the point of being a contributing member of society. Bob probably does not have much of choice when it comes to treatment, and should remain and antipsychotics for the rest of his life. It is hard to say how well bob will do with his treatment. Positive symptoms are treated effectively with antipsychotics. However, Bob has a number of negative symptoms, which may affect his life just as much. In any case, bob will have a tough life.

Case 4, Diagnosis Avoidant Personality disorder
In case four, Adrian a single 42 year old mother, has low self-esteem, poor decision making, constant anxiety, as well as more physical symptoms such as migraines and high blood pressure.

These symptoms have gotten to the point that they affect both her work and social life. Her boss has noted her difficulties; and she has not been on a date in over a year. Even her children leave her out of the loop so that she can avoid unnecessary anxiety. The symptoms all seem to point to avoidant personality disorder, which is a cluster C personality disorder.
The causes of Avoidant personality disorder very greatly. However most psychologists believe in the biopsychosocial model. This states that there is no single cause of Avoidant personality disorder. Adrian’s development of Avoidant Personality Disorder could have been in response to social or psychological factors or even have been genetic.
It is said that people with avoidant personality disorder to not develop proper social skills. However, considering Adrian’s age and late onset, that is very unlikely. Instead, Adrian views on the world seemed to have been negatively shifted towards her fear of disapproval. Her avoidance seems to be almost like a preemptive measure to avoid being disappointed. Interestingly the results of her actions are rather like a self-fulfilling prophecy. Where she is treated coldly because she acts coldly because she fears she will be treated

coldly.
Drugs are not necessary in the treatment for avoidant personality disorder. The most important thing will be therapy. However, in the case of therapy, having them stay in treatment is a real problem. Adrian is distrustful of other people and therapists or other members of a therapy group would be no exception. It is important that someone earn her trust, as people with avoidant personality disorder come to therapy looking for acceptance. If they do not get that trust and acceptance, it is unlikely that therapy will continue. Treatment therapy for Avoidant personality disorder is very similar to other anxiety disorders. As for medication, anti-anxiety pills may yield a more immediate success, but lack the sticking power of therapy. All problems may return if the medication is removed.
While the personality disorder may have slowed her down a little bit, it has by no means stopped Adrian. Most treatments for Avoidant personality disorder have at least a moderate degree of success. Which means that with luck Adrian may enjoy a better work and social life. However, Adrian’s improvement is almost entirely hinging on her doctor and whether or not they can earn her trust. From there Adrian must improve her own self-image and beliefs. This will allow her to participate more freely with the world. A little change could be of great benefit in her life. As positive social interactions could steadily change her view of the world to the point of Adrian actually seeking them out instead of avoiding them.