This case study is base on a real person, but the name is fictitious to protect their privacy and to comply with the HIPPAA laws (health insurance portability and accountability act). My subject is Keith a 15 year old African -American male, in the 10th grade at Overbrook High School lives with his Mother, Rachel, A certified nurse’s ssistant and sister, Patricia age 10. Father, Harold returned to the family after a brief separation. Statement of the Problem Keith has experienced an increasing fear of social situations for the past two years. It has been reported that Keith has always been a shy child.

Who has been unable to participate in peer activities. Keith’s younger sister is his only companion. His mother, the only financial support of the family is constantly working. Keith was raised by different people. When Keith was younger he cried a lot at daycare. He is studious about the presentation of himself. Keith has been hospitalized to alleviate his problems, family therapy is to be initiated and must obtain psychological and psychiatric evaluation. Diagnosis Axis l: 300. 23 Anxiety disorder w/Social Phobia AXIS II: WI . 09 Deferred Axis Ill: Anemia Axis lv.

Problems with primary support group/ unstable parental relationship, father abdicated responsibility, mother’s inability to be more nurturing. Problems with social environment/ unable to relate to peers. Axis V: Current Global Assessment of Functioning 41 (Serious symptoms OR serious impairment in one of the following: Criteria My subject, Keith meets the criteria for and anxiety disorder category of the DSM IV. “Anxiety Disorders categorize a large number of disorders where the primary feature is abnormal or inappropriate anxiety. Everybody has experienced anxiety.

Think about the last time a loud noise frightened you and remember the feelings inside your body. Chances are you experienced an increased heart rate, tensed muscles, and perhaps an acute sense of focus as you tried to determine the source of the noise. These are all symptoms of anxiety. They are also part ofa normal process in our bodies called the ‘fght or flight’ phenomenon. This means that your body is preparing itself to either fight or protect itself or to flee a dangerous situation. These symptoms become a problem when they occur without any recognizable stimulus or when the stimulus does not warrant such a reaction.

In other words, inappropriate anxiety is when a person’s heart races, breathing increases, and muscles tense without any reason for them to do so. Once a medical cause is ruled out, an anxiety disorder may be the culprit (Allpsych Online: The Virtual Psychology Classroom, 2004 In the case of my subject Keith, he meets the required criteria to this isorder, specified in a social phobia; Keith experiences severe stress that enables him to communicate or socialize with his peers. Keith has missed a semester of school and has been unable to function in everyday life, he spends time alone watching television or reading a book.

Symptoms include either extreme anxiety or fear associated with the object or situation or avoidance. To be diagnosed, the symptoms must be disruptive to everyday functioning (such as quitting a great Job merely because you have to use an elevator) (Allpsych Online: The Virtual Psychology Classroom, 2004 ). Characteristics The Primary Characteristics of social phobia is an irrational and intense fear that one’s behavior in a public situation will be mocked or criticized by others. People with this disorder recognize that their fears are unreasonable, yet they cannot stop themselves from worrying that others are scrutinizing them.

Although people with social phobia go to extremes to avoid such public situations, there are situations in which they have no choice; when this happens, they become crippled with anxiety’ (Halgin, 2010). Etiology “Often a traumatic event is the precursor for a phobia, which may or may not be at he conscious level (Allpsych Online: The Virtual Psychology Classroom, 2004 ). Recent interest in the topic of social phobia is leading to a greater understanding of the disorder as a biopsychosocial phenomenon. Parents of children with this disorder are more likely to be diagnosed with major depression.

Biological theories focus on abnormalities in neurotransmitters such as serotonin and norepinephrine. Some researchers have found evidence of left -hemi-sphere dysfunction in people with social phobia. This finding is important in light of the role of verbal processes in social interactions. This contributes to the stress that people with social phobia them learn more appropriate responses to the situations they fear. Behavioral and cognitive -behavioral techniques, such as those used to treat people with specific phobias (Halgin, 2010).

There may be a diathesis stress model, where Keith is concerned. But, we have no record of either of his parents being diagnosed with MDD(Major Depression Disorder). The biological theory can still be applied if we did a CAT scan to see if there are some issues with Keith’s neurotransmitters. The psychological and social factors can possibly be determined by the relationship that Keith has with his parents. Information on sociocultural variations in social phobia is slowly emerging as this phenomenon becomes more apparent.



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