Psychological disorders (mental disorders) are health conditions characterized by alterations in one’s behavior, or mood, and thinking, or a combination thereof. Which can be associated with the distress and impairment of one’s daily functioning, therefore, affecting one’s daily life. Psychological disorders can be debilitating for one who suffers from them. In the United States, surveys suggest that almost 1 of every 5 adults receives treatment for psychological disorders in the course of a year (Comer, 2011).
Marla, a 42-year-old Hispanic female who is an accountant, came into the mental health clinic, seems to exhibit symptoms that she suffers from an anxiety disorder. Marla has complaints of sleeping problems, experiencing a jumpy feeling all of the time, an inability to concentrate, and her symptoms are causing problems with her job performance, which, all points to generalized anxiety disorder (GAD). To determine if Marla does indeed suffer from an anxiety disorder or type of anxiety disorder, a clinical assessment needs to be performed, and the given information from the clinical assessment needs to be compared to the criteria set in the DSM-IV.
Clinical assessments are used be clinicians in determining why and how one behaves abnormally and are a means for how one might seek help (Comer, 2011). Clinicians use clinical assessments also in evaluating one’s progress after one has been in treatment for a while and to decide whether the treatment should be changed (Comer, 2011). The developed techniques and tools of clinical assessments fall into three categories, which are clinical interviews, tests, and observations (Comer, 2011). The purpose of clinical interviews is to collect detailed information about the one’s problems and feelings, lifestyle and relationships, other personal history, and to ask about the one’s expectations of therapy and the motives one has for seeking therapy (Comer, 2011).
Clinical tests are used as a means of gathering informational aspects of one’s psychological functioning, therefore, broader information can be inferred (Comer, 2011). Personality and response inventories, projective, psychophysiological, neurological, neuropsychological, and intelligence tests are the six test commonly used by clinicians. Clinical observations are used by clinicians to systematically observe a patient’s behavior (Comer, 2011). Three types of technique are used in observing patient, which are naturalistic observation, analog observation, and self-monitoring. For accuracy and usefulness clinical interviews, tests, and observations have to be standardized, as well as have clear reliability and validity (Comer, 2011). To standardize a technique it has to be to set in a way where similar steps can be followed whenever it is administered, reliability refers to the consistency of assessment measures, and validity refers to how a technique must accurately measure what it is supposed to measure (Comer, 2011).
During intake it is explained to Marla that the symptoms she is experiencing require further analysis, because her symptoms are apparent in the criteria of several psychological disorders, such as post traumatic stress disorder (PTSD), stress disorders, and anxiety disorders. Therefore, to reach the proper diagnosis Marla needs to participate in a clinical assessment. In this assessment, Marla will participate in a clinical interview, will be tested, and observed to determine the proper diagnoses. Once the proper diagnoses is determine there will be an effective treatment plan established.
The first step in diagnosis of Marla is a clinical interview. Depending on how Marla answers the questions reflects directly on the persistent issues that are affecting her daily life. Therefore Marla’s answers assist in the analysis and diagnosis of her issues. In conducting the clinical interview with Marla I considered asking the following questions:
• Why are you seeking therapy and do you think it can be a means of help for you?
• What do you think you want or need from therapy and what are your expectations regarding therapy?
• What type of person do you think you are as far as your behaviors, traits, and personality?
• What was your childhood like and what was your home environment like?
• What is your life like now and what is your home and work environment like?
• Do you have a relationship with a significant other, and if so how is the relationship going?
• What are your interactions like others, such as family and friends, and coworkers?
• Do you suffer from any mental illness and have you experienced any feelings of depression, anxiousness, or thoughts of suicide? If so, how long have you been experiencing these feelings?
• As far as you know is there a history of mental illness, depression, or anxiety in your family?
• Are you currently taking any medications, if so which ones, and do you drink alcohol, or use any recreational drugs?
Through the given information of Marla’s clinical assessment, where she participated in clinical interviews, tests, and observations and following the given information provided by the DSM-IV’s criteria, Marla likely is suffering from an anxiety disorder, the specific type of is generalized anxiety disorder (GAD).
In the United States anxiety disorders are the most common mental disorders, and in any given year around 18 percent of the adult population suffer from one or another of the six anxiety disorders identified by DSM-IV-TR, while close to 29 percent of all people develop one of the disorders at some point in their lives (Comer, 2011). Anxiety by itself is not a disorder, although it does become a disorder when one experiences chronic symptoms that interfere with one’s daily life and ability to function. Anxiety disorders fall into a set of separate diagnoses, depending upon the symptoms and severity of the anxiety the person experiences, therefore Marla’s symptoms point to generalized anxiety disorder (Hauser, 2005).
Excessive worry is the key feature of generalized anxiety disorder (GAD). According to the DSM checklist one with generalized anxiety disorder (GAD) will experience excessive or ongoing anxiety and worry, for at least six months, about numerous events or activities, has difficulty controlling the worry, and at least three of the following symptoms, which are restlessness, easy fatigue, irritability, muscle tension, and sleep disturbance (Comer, 2011). One also suffers from significant distress or impairment. When one experiences excessive anxiety in most circumstances and worries about almost anything, it is described as free-floating anxiety (Comer, 2011). Free-floating anxiety describes anxiety that does not have an association with a particular event or object, or situation; therefore it is brought on without a specific trigger (DeepDiveAdmin, 2011).
In the United States more than 6 million people suffer from generalized anxiety disorder (GAD) and 60 percent are women while 40 percent are men, and it is estimated that 8 to 9 percent of the population will develop generalized anxiety disorder (GAD) during the course of one’s life, and over 10 percent of the diagnosed will seek treatment in a mental-health clinic (DeepDiveAdmin, 2011).
Through the biological model, generalized anxiety disorder’s origin can be explained. Proponents of the biological model believe that a full understanding of one’s thoughts, emotions, and behavior must therefore include an understanding of one’s biological basis (Comer, 2011). Therefore, biological treatments are the more effective. Biological theorists view abnormal behavior as an illness, such as generalized anxiety disorder, which is brought on by malfunctioning parts of the organism (Comer, 2011). Malfunctioning parts of the organism are usually considered the brain anatomy or brain chemistry, therefore their malfunctioning is the cause of abnormal behavior. Through research clinicians have discovered connections between certain psychological disorders such as generalized anxiety disorders, and problems in specific areas of the brain (Comer, 2011).
The specific areas of the brain, such as neurons in the cerebrum, which includes brain structures such as the basal ganglia, hippocampus, amygdala, corpus callosum, and cerebral cortex are where abnormal functioning takes place and psychological disorders can be traced (Comer, 2011). Researchers and studies point toward psychological disorders in relation to problems in the transmission of messages from one neuron to another neuron, therefore abnormal activity by certain neurotransmitters can lead to specific mental disorders (Comer, 2011). Abnormal chemical activity in the body’s endocrine system also can be related to mental disorders as well (Comer, 2011). Biological abnormalities that are the cause of or are related to psychological disorders such as generalized anxiety disorder may be the end result of genetics, evolution, and viral infections.
Potential treatments for generalized anxiety disorder (GAD) through the biological model are biologically based. The leading biological treatments used for psychological disorders are drug therapy, electroconvulsive therapy, psychosurgery, and a combination thereof. Drug therapy consists of the use of psychotropic medications, which impact the central nervous system. Psychotropic medications have four major psychotropic drug groups. The four psychotropic drug groups are antianxiety, antidepressant, antibipolar, and antipsychotic drugs. Antianxiety drugs (minor tranquilizers or anxiolytics) are prescribed to reduce anxiety and tension. Antidepressant drugs are prescribed to improve one’s mood who is depressed. Antibipolar drugs (mood stabilizers) are prescribed to steady the mood of one that suffers from a bipolar disorder. Antipsychotic drugs are prescribed to reduce the confusion, hallucinations, and delusions of psychotic disorders, disorders (such as schizophrenia) marked by a loss of contact with reality (Comer, 2011).
Electroconvulsive therapy (ECT) is primarily used for one who suffers from depression. This biological treatment, consist of attaching two electrodes to one’s forehead, then an electrical current of 65 to 140 volts is passed briefly through the brain, therefore causing a brain seizure that lasts up to a few minutes (Comer, 2011). Once seven to nine Electroconvulsive therapy (ECT) sessions are completed, which are spaced two or three days apart, one may feel considerably less depressed (Comer, 2011). Comer, (2011) “the treatment is used on tens of thousands of depressed persons annually, particularly those whose depression fails to respond to other treatments” (p. 36). Psychosurgery (neurosurgery) is brain surgery for mental disorders, which is considered experimental and is only used when certain severe disorders continue for years without responding to any other form of treatment (Comer, 2011).
Case studies are an in-depth study of one, such as Marla. Case studies are used to analyze almost all aspect of the one's history and life in order to find causes and patterns for certain behaviors. Case studies are subjective, therefore clinical assessments are used to delve deeper into what causes one’s behavior and which psychological disorder is responsible for those behaviors. Once a psychological disorder is diagnosis one should refer to the models of abnormality. Through the models of abnormality one can find the origins of psychological disorders and treatments. Marla’s case study pointed toward generalized anxiety disorder, and with a clinical assessment that was confirmed. Through the biological model, the origin of Marla’s psychological disorder of generalized anxiety disorder is explained and treatments are found.
Reference
Comer, R. J. (2011). Fundamentals of abnormal psychology (6th ed.). New York, NY: Worth.
Hauser, J. (2005). PsychCentral. Retrieved from http://psychcentral.com/disorders/anxiety/gad.html
DeepDiveAdmin. (2011). PsyWeb.com. Retrieved from http://www.psyweb.com/Glossary/ffanxiety.jsp
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