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CaptainEnergyWren8
1. Katie Smith, a 27-year old female, enters the emergency room…
1. Katie Smith, a 27-year old female, enters the emergency room after experiencing an
episode of extreme chest pain, difficulty breathing, and numbness in her arms. She states the
following to the admitting physician:
“I was walking my dog earlier when I started sweating. Since it isn’t hot outside, I couldn’t
quite understand why…then I started having trouble breathing and really got scared. My heart
was pounding so hard I thought it might explode out of my chest. My knees felt weak – it
seemed like my whole body was shaking, then my arms went numb. Apparently the whole
thing only lasted a few minutes, but it felt like each second was an hour. Did I have a heart
attack? Am I going crazy? I felt like I was going to die.”
Katie is given an EKG, but the test comes back in normal range, indicating that she did not
have a heart attack. Her physician believes she may have had a panic attack and refers her
to a clinical psychologist.
Four weeks later, Katie sees the psychologist and reports that she has experienced over two-
dozen panic attacks with similar symptoms since her time in the emergency room. At this
point, her day-to-day functioning is significantly impaired; she avoids work, time with family
and friends, and walking her dog because she thinks it might trigger another attack. There is
no concrete source of anxiety or fear in Katie’s life other than fear of the attacks themselves.
Her psychologist diagnoses her with ______________ and uses a variety of different
exercises to improve her functioning.
2. A 35-year-old married woman (Barb) seeks treatment for pelvic pain. On review of systems,
she reports several years of various symptoms, including GI problems (constipation,
abdominal pain, nausea, and vomiting); headaches; vulvodynia; fatigue; all-over body pains;
paresthesias; and several sensitivities to environmental factors and medications. She has
visited the emergency department on several occasions and has been previously admitted to
the hospital for persistent GI symptoms. Extensive GI workup, laboratory studies, and
laparoscopy to rule out endometriosis have been unrevealing. She reports a stressful
childhood, with an alcoholic father and sexual abuse by her grandfather.
3. Martha, age 43, is a personal assistant. She has been widowed for three years, lives in the
country and couldn’t stand getting wet: the mere idea of being splashed worried her intensely,
which led to her avoiding water (she never went to the beach, she couldn’t bring herself to
take her kids to the swimming-pool) that made life very complicated for her.
Her husband suddenly passed away from a heart attack while he was swimming in the sea.
On the day of his death, he phoned his wife, and told her to meet him at the beach after her
work because he felt distressed. Martha’s husband died of a heart attack while he was
swimming towards her. Following this tragic episode, Martha was off work for one month due
to a nervous breakdown. She suffered during this period from very invalidating insomnia,
continuous fatigue and depressive thoughts (she thought of death throughout the day). In the
course of the following months, while she had gone back to work, Martha fell victim to intense
anxiety, called panic attacks, which were characterized by an acceleration of breath, thoracic
oppression, palpitations, cold sweats, muscle contraction and dizziness. The fear of dying
was the strongest feeling at these times.
1. Based on Week 13 content, are Katie’s, Barb’s and Martha’s symptoms “normal” or “abnormal”? Explain your answers.
2. Which of the major psychological disorders could Katie’s, Barb’s and Martha’s symptoms potentially fall under? Explain how you came to those conclusions.
