ABNORMAL PSYCHOLOGY ASSIGNMENT
Introduction
Abnormal psychology deals with the branches of behavioral,
emotional, and thought patterns that deviate from social norms and might
contribute to distress or disability. The 5P model is an inclusive framework by
which the intricacies of psychological disorders could be considered.
Presenting Problem, referring to what the current problem is being addressed;
Predisposing Factors, referring to the events or circumstances leading up to
the emergence of the disorder; Precipitating Factors, which trigger the
presenting problem; Perpetuating Factors, which maintain the problem; and
Protective Factors, which cushion the impact of the disorder on the
individual's functioning. This assignment will look into the diagnosis of a
psychological disorder in two case studies—Barry and William—using the 5P model
and suggest an appropriate treatment plan.
Case
Study 1: Barry
Presenting
Problem
Barry, who is 11 years old reported to exhibit
acute school refusal, involving consistent reluctance or refusal to attend
school. He describes his physical complaints as very severe and adds that they
have progressed to repeated abdominal pain and headaches, which are worse in
the mornings. Accompanying these somatic symptoms is a fear of something
happening to his mother, who has several health problems, including epilepsy. Barry
cries or becomes belligerent when attempts are made to compel him to attend
school. Despite these problems, he seems to be reasonably well-adjusted when he
actually gets to school, although he has complained of bullying and a
particularly unsympathetic gym teacher.
Barry's refusal of school has severe
consequences for his academics, social development, and the dynamics of his
family. His somatic symptoms are probably a manifestation of anxiety that he is
going through and also a means of escape from the feared situation in school.
His excessive fear for his mother's well-being gives the impression of great
anxiety, probably increased by the health problems of the mother and the
family's reaction to it.
Predisposing
Factors
Predisposing factors in psychology and medicine
are defined as those factors, elements, conditions, or situations that really
make a person more vulnerable or susceptible to a certain order of disorder,
illness, or condition. In short, predisposing factors are not actually the
causes, but they put up a situation in which the risk of developing a certain
condition is increased. The nature of predisposing factors may be biological,
psychological, or environmental, all linking together to play a role in the cause
of developing a certain disorder. Following are such examples for Barry's
condition.
Family
History and Dynamics
Barry has come from a family with a lot issues
regarding psychological adjustment. His three other brothers have also suffered
from school refusal tendencies, which indicates that it could be being carried
down through his family. This may suggest a genetic predisposition and even a
learned response to anxiety disorders. The aloof father and a close attachment
with the mother may have created disturbances in the emotional development of
Barry and in the adjustment to stress.
Attachment
to the mother
Barry is attached to his mother who is suffering
from chronic health problems, which might be an addition to his reasons for
experiencing anxiety. Very strong attachment seems to exist between the mother
and the child. This might be as a result of the distant relationship between
the father and his children. This attachment might be the means of compensation
for the emotional support deficiency from the father. Within the attachment
theory, the fear that something will happen to his mother can be regarded as
being worry on the part of Barry. According to the theory, secure attachments
are necessary for the child in order to regulate and develop emotionally.
Personality
Traits
Barry may be predisposed to anxiety or
sensitivity, and that he may become more vulnerable to distress from the
influence of environmental stressors. Thus highly sensitive or anxious children
are much more likely to develop anxiety disorders with stressors.
Cultural
and Social Context
Expectations due to cultural norms and family
values with regard to close family relationships may be another cause. The
surroundings may further teach Barry that family must always be close, thus
increasing his fear of separation. Cultural expectations about family roles and
the importance of caregiving may also increase Barry's anxiety over his
mother's health.
Precipitating
Factors
In
psychological terms, according to the 5P model, precipitating factors are
events or provocative agents that lead to an immediate symptomatology in a
particular condition or disorder. The factors are those which trigger the
underlying vulnerability resulting from the predisposing risk factor into
action, leading to the formation or worsening of symptoms. Following are those
precipitating factors.
Mother's
Health Concerns
The situation of the mother's health must have
been a worry for Barry most of the time. Fear about something possibly
happening to her, mainly because psychologically the nature of epilepsy is
unpredictable, would be enough to trigger his anxiety and refusal to go to
school. Having a chronically ill parent creates a sense of instability and fear
among children. .
Negative
School Experiences
Barry has reported bullying and unfavorable
treatment by a gym teacher. This could be one of the reasons behind his
reluctance to attend school, worsening anxiety and physical symptoms. The
adverse interactions with peers and teachers in the school setting will
powerfully impact the sense of safety and well-being of children at school,
thereby influencing the absence of avoidance behaviors.
Family-related
stress
Such as recent change, financial difficulties,
or interpersonal conflict within the household, can lead to stress for Barry
and trigger his symptoms. Such stressors can improve a sense of instability and
fearfulness. This would heighten his anxiety and further fuel the escalation of
maladaptive coping strategies, like school refusal.
Perpetuating
Factors
Factors that perpetuate the psychological
condition or disorder once it has started to develop are called perpetuating
factors. Perpetuating factors can be defined as factors responsible for the
continuation of symptoms and, hence, make an individual's recovery from a
condition or illness quite difficult. Unlike the predisposing factors, which
merely set the stage, or the precipitating factors, which are responsible for
the trigger, the perpetuating factors are responsible for the continuous
presence and persistence of the disorder. Following are the examples.
Avoidance
Behavior
School refusal or avoidance of that particular
situation that causes anxiety reinforces Barry's symptoms. The firing of his
anxiety during staying at home only cements the behavior of avoidance, making
the breaking of this cycle all the more difficult. Avoidance behaviors preclude
the child from facing the feared situation and from realizing that nothing
disastrous happens and that the feelings of anxiety abate with time.
Family
Reinforcement
The family's reaction, in the form of
acquiescing or overprotection, can often lead to an unintentional perpetuation
of the symptoms. Not dealing with the core anxiety problem, a family may turn
to one that supports such a refusal to go to school. Overprotective or
accommodating behaviors can allow the child to realize and strengthen his fears
and avoidance strategies.
Somatic
complaints
Physical symptoms, which can be abdominal pain
and headaches, will give Barry reasons to stay at home. These somatic
complaints will always look like good reasons to stay at home and will
therefore further reinforce the behavior. Somatic symptoms can become a learned
response to anxiety, where the child associates physical discomfort with the
need to escape a stressful situation.
Absence
of Professional Intervention
If Barry has not been exposed to appropriate
psychological and medical treatment, his symptoms are bound to persist. Early
intervention goes a long way in curbing much of his psychological discomfort
and physical symptoms. The symptoms of anxiety in the child will deepen without
suitable intervention and resistance to change with time.
Protective
Factors
Despite all these odds, there are still several
protective factors which may promote Barry's well-being and recovery.
Protective factors are the conditions or characteristics, when present, that
help the individual to either resist or lower the potential harm from risk
factors, thereby reducing the probability of developing a psychological
disorder or other negative outcomes. Those factors may improve resiliency,
enhance coping, and provide support during difficult times. The protective
factors could be biological, psychological, social, or environmental. Examples
are given below.
Positive
Social Relationships
Barry has evidenced social adjustment in school.
This points to the fact that he must have positive relationships with peers or
teachers in school. These connections could be used to motivate school
attendance and facilitate emotional support. Strong social support networks
help as a buffer against stress, promote resilience.
Parental
Involvement
It will be very beneficial if the parents of
Barry, especially the mother, actively take part in the treatment.
Participation by the family in therapeutic interventions, if desired and if the
patient consents, may markedly help enhance the coping skills of Barry and
decrease anxiety. This would provide a caring atmosphere at home and reinforce
some therapeutic strategies.
The
availability and accessibility of mental health services
Especially regarding counseling and therapy
arrangements which could provide a critical support system for Barry.
Interventions by professionals could be the type of support that Barry needs at
this particular time in order to develop some coping strategies against the
sources of his anxiety. Further access to specialized mental health services
would help in assessment and treatment planning.
Resilience
and Coping Skills
Therapy can be built on any inherent resilience
or formerly acquired coping skills that Barry might have. Such skills will very
importantly need to be strengthened to help him deal with his anxiety and
return to school. Interventions could focus on building resilience to help a
child better deal with stress and adversity.
Treatment
Plan
Cognitive-Behavioral
Therapy (CBT)
Focus: Treating
Barry's anxiety and school refusal by applying cognitive restructuring and
exposure therapy.
Techniques:
Gradual exposure to school settings, challenging irrational thoughts about the
safety of his mother, and relaxation techniques to decrease somatic symptoms.
Using CBT will help Barry modify his maladaptive thoughts and behaviors and
learn more adaptive ways to cope.
Family
Therapy
Goal:
Improvement of family dynamics and communication, overcoming overprotective
behaviors, and being supportive for Barry.
Methods: Work
with the family in sessions to explore interaction patterns and strategies that
will encourage Barry to attend school. Family therapy has good potential for
collaborative work in finding ways to address the anxiety of the child and
school refusal.
.
Medical
Evaluation
Objective:
Emphasize the possibility of medication that may be indicated to decrease acute
symptoms, including mild anxiolytics. Observe physical complaints that are
amenable to treatment so that they are not used to mask other health-related
issues. Certain systematic medical clearance may indicate any underlying
medical condition that may be contributing to the child's symptoms.
School-Based Interventions:
Interventions:
Collaborate with school staff to ensure that the school environment remains
conducive to Barry. It may include addressing bullying and accommodation issues
to make adjustment easier. School-based interventions will offer a safe
learning environment.
Psychoeducation
Barry and his family should be educated about
anxiety, school refusal, and about the avoidance behaviors. Information may
empower them to become engaged in treatment. Through psychoeducation, the
family will likely make better sense of the child's condition and thus improve
their participation in treatment.
Case
Study 2: William
Presenting
Problem
William is a 56-year-old man who shows symptoms
typical of Obsessive-Compulsive Disorder (OCD) with symptoms showing
contamination fears and safety checks. William repetitively washes his hands,
causing his skin to crack and get red; he also compulsively checks doors and
windows for closure and lockup. He has an overwhelming urge to clean his house
if he sees any dust.
The excessive handwashing and cleaning behaviors
were indicative of high distress related to contamination fears, while the
compulsive checking behaviors were indicative of great anxiety over safety and
security. These compulsions act as maladaptive coping mechanisms to reduce the
very high anxiety levels the obsessive thoughts provoke.
These activities are occupying much of his time
and, at times, interfere with daily routine, cause enormous distress, and
functional impairment. William's OCD has affected his quality of life,
day-to-day routine, relationships, and general well-being.
Predisposing
Factors
Listed below are some predisposing factors that
may have added to William's OCD. .
Genetic
Predisposition
William's chance of getting OCD is higher when
there is a family history of anxiety disorders or OCD. Genetic determinants
play an important role in the causation of OCD and point out that this has some
heritable feature of the disorder. William's genetic makeup will predispose him
to being in a state of high anxiety-related conditions and thus affect the
development of OCD. .
Personality
characteristics
Perfectionism, high conscientiousness, and a
tendency to over-responsibility, can contribute to vulnerability to OCD.
William's carefulness and the need for control perhaps underlie such
personality characteristics. Accordingly, those with these personality
characteristics are more likely to develop obsessive-compulsive behaviors in
such a way that will help them decrease anxiety and keep things in order.
Early Life
Experiences
Trauma, neglect, or excessively-protective
rearing may be some of the childhood experiences gained by the person who is
suffering from OCD. Maybe William had experienced some early environmental
factors that were driving his preventive measures and vulnerabilities toward
anxiety disorders. Undesirable events happened during childhood affect healthy
coping mechanisms, so there could be an increased risk of developing OCD later
in life.
Cultural and
Social Influences
Influences such as norms and societal
expectations about cleanliness, order, and safety can also play a role in
William's OCD.
Cultural values that emphasize cleanliness and
personal responsibility further support obsessive-compulsive behaviors.
Cultural factors shape the content of obsessions and compulsions and,
therefore, should have an impact on the expression of OCD symptoms.
Precipitating
Factors
Precipitating factors are defined as specific
events or stressors that may have triggered William's OCD. Examples regarding
those factors are given below.
Stressful
Life Events
High-order stressors, such as job loss,
financial strain, or personal bereavement, can be a cause of or act as a
precursor to a worsening of OCD symptoms. William may have experienced one or
more of these high-order stressors in the very recent past that appear to have
served to elevate his condition into severe impairment. Stressful life events
increase the levels of anxiety and then, by way of a maladaptive coping
strategy, will turn on obsessive-compulsive behaviors. .
Health Concerns
Fears of recent illness or the existence of
chronic medical conditions may have heightened William's contamination fears
and safety concerns. This health-related stress might intensify underlying
anxiety, which would contribute to the development of OCD symptoms. Health
concerns and fears for well-being could be triggers for intrusive thoughts and
compulsions about contamination and safety.
Environmental
Change
Any change in living environment, such as moving
house or composition of household, can be a stressor. In William's case,
symptoms of OCD could alternatively become very intense because of changes in
his environment that therefore disturbed his natural balance and sense of
security. Environmental changes can result in uncertainties and anxiety which
can possibly lead to more acts of obsessive compulsions.
Interpersonal
conflicts
Feeling in strained or conflicted relationships
with family or work colleagues leads to increased tensions and anxieties that
exacerbate OCD symptoms. Interpersonal conflicts may cause emotional
disturbance and a desperate necessity for obsessive-compulsive behaviors to be
triggered in order to handle the stress and to control the environment.
Perpetuating
Factors
Perpetuating factors are those that further
worsen or maintain William's OCD symptoms over time. William's compulsive
behaviors, like handwashing and checking, reduce his anxiety in the short term
but perpetuate the cycle of OCD in the long term. When he avoids situations
that provoke anxiety, habituation does not take place, and thus the compulsions
are further reinforced. Avoidance behaviors help maintain the cycle of OCD by
preventing the individual from confrontation and overcoming of fears.
Family
Accommodation
William's family might, unbeknownst to them,
enable his OCD by going out of their way in accommodating his compulsions,
whether it is cleaning or reassurance for safety checks. Family accommodation
thus furthers and maintains this circle of OCD by supporting the individual's
fears and compulsions.
Lack of
Treatment
Most probably, William's symptoms will be
persistent or even worsen without proper intervention. The inability to offer
effective treatment strategies, such as cognitive-behavioral therapy, maintains
this cycle of OCD. This lack of access to specialized treatment for OCD will
therefore impede an individual's potential to learn how to manage and reduce
their symptoms.
Cognitive
Distortions
William's distorted beliefs about contamination
and safety maintain his OCD. Cognitive distortions that go on and on will involve
overestimation of threat and intolerance of uncertainty, continuing to fuel his
compulsive behavior issues. Challenging such cognitive distortions and
restructuring them are considered one very important component in reducing OCD
symptoms.
Environmental
Triggers
In William's case, the continuous environmental
triggers such as uncleanliness or perceived risks to safety will hold up the
symptoms of OCD. These triggers further increase his compulsive behaviors and prevents
him from recovery. The environment holds factors that may trigger the obsessive
thoughts, thus increasing anxiety in the individual and compulsive behaviors.
Protective
Factors
Although on the whole case, risks seem to be at
a little disadvantage, there are several protective factors that can still help
William in his recovery process. Such factors are given bellow.
Supportive
Relationships
William's relationships with family members or
even friends who understand his condition, who can support him, may be the key
ingredient in his recovery journey. Social support can decrease feelings of
isolation and increase motivation to engage in treatment. Such supportive
relationships can provide both emotional and concrete help in better management
of OCD symptoms.
Motivation
to Change
William's distress and ability to recognize the
effects of symptoms on daily living can motivate him to seek help and abide by
treatment. There is evidence that intrinsic motivation strongly predicts good
treatment outcomes. The stronger the desire to change, the greater the
commitment to the process of treatment.
Access to
Treatment
Availability and Accessibility of Mental Health
Services, in Particular, Specialized Treatment for OCD: Services are so much
needed. Professional intervention, more so through cognitive-behavioral
therapy, will give some effective strategies for symptom management. Access to
specialized treatment may ensure proper assessment with evidence-based
interventions.
Previous
Coping Skills
Any previous experience of overcoming anxiety or
stress may turn out to be building blocks for new coping skills. Building from
existing skills will tend to increase William's resilience. Building up on the
current coping skills will facilitate a platform to build newer ways of
managing the OCD symptoms.
Treatment Plan
Cognitive-Behavioral
Therapy (CBT)
Focus: The
most common form of inpatient therapy for OCD, particularly ERP, is to reduce
compulsions slowly by exposing William to the situations that he fears and then
preventing responses.
Techniques: The
ERP exercises for William are tailored to his individual obsessions and
compulsions; there is cognitive restructuring for the challenging irrational
beliefs and the development of alternative coping. Outcomes of this course will
enable William to have acquired thought patterns and coping strategies that are
more adaptive.
Medication
Management
Meds: The
most common therapy for OCD is selective serotonin reuptake inhibitors (SSRIs).
Evaluation and monitoring of medications and possible medications and
medications' effects and side effects often are required. Medication management
can be symptomatic and significantly enhances the impact of CBT.
Psychoeducation
William and his support network will be educated
about OCD, obsessions, compulsions, the treatment process, and the necessity
for consistency. Psychoeducation can help increase understanding and
involvement in the treatment process. Mindfulness and Relaxation Technique.
Objectives: To
employ mindfulness activities and relaxation strategies to help William manage
his anxiety and urge so that he can do less compulsions. Mindfulness and
relaxation strategies will assist him in emotional self-regulation and stress
reduction. Support Groups:
Participation:
Patients with OCD should be enrolled in active support groups. In such a
setting, they will be able to share their experiences and strategies with
others who understand what it feels like to face such challenges. Support
groups offer a sense of community and therefore decrease feelings of isolation.
Plan:
Relapse prevention, through identifying any potential triggers and very early
signs of relapse, coupled with regular follow-up sessions beyond the
above-mentioned treatment course to assess progress and further treatment
planning. A relapse prevention plan would be useful, therefore, to maintain
treatment gains and prevent symptom recurrence.
References
American Psychiatric Association. (2013).
Diagnostic and statistical manual of mental disorders (5th ed.). American
Psychiatric Publishing.
Barlow, D. H., & Durand, V. M. (2020).
Abnormal psychology: An integrative approach (8th ed.). Cengage Learning.
Butcher, J. N., Mineka, S., & Hooley, J. M.
(2017). Abnormal psychology (17th ed.). Pearson.
Carson, R. C., Butcher, J. N., & Mineka, S.
(2000). Abnormal psychology and modern life (11th ed.). Allyn & Bacon.
Comer, R. J. (2018). Abnormal psychology (10th
ed.). Worth Publishers.
Freud, S. (1901). The Psychopathology of
everyday life. Macmillan.
Maslow, A. H., & Mittelmann, B. (1941).
Principles of abnormal psychology. Harper & Brothers.
Millon, T., Blaney, P. H., & Davis, R. D.
(Eds.). (1999). Oxford textbook of psychopathology (1st ed.). Oxford University
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(6th ed.). McGraw-Hill Education.
diposting oleh TUGAS MAHASISWA @ Oktober 16, 2024
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