Case Study Development & Theoretical Explanation

...

Then, when we refer back to DSM-V, under functional consequences of illness anxiety disorder (p.317) it states, “The health concerns often interfere with interpersonal relationships, disrupts family life and damages occupational performance,” APA, 2013. All of which the patient has suffered with due to this disorder. The last topic to cover is the treatment recommendations and based off of the diagnosis and theoretical analysis cognitive behavioral therapy (CBT) is a certainty. After further assessment and depending on the progress of CBT if the symptoms persist then perhaps introduction to antidepressant, (MFMER, 2015) ‘selective serotonin reuptake inhibitors (SSRIs)’ should be factored into the treatment process. (Mayo Foundation for Medical Education and Research (MFMER), 2015)

While researching cognitive behavioral therapy with consideration of psychodynamic theory Jacofsky, Santos, Khemlani-Patel and Neziroglu (2015), gives positive comments on CBT, “progress occurs by recognizing, understanding, and changing dysfunctional thoughts, emotions, and behaviors. It is assumed and accepted that these dysfunctional patterns have been "learned" and reinforced during prior life experiences (the past). Nonetheless, the patterns can be "unlearned" in the present by creating new experiences,” Jacofsky, Santos, Khemlani-Patel & Neziroglu, 2015. With identification of the unconscious processes through cognitive and social psychology it furthers the support of modifying the functional consequences of behavior in illness anxiety disorder.

Lastly, but would consider making this strategy as great start to CBT, a letter from the mental health care provider to primary care physician recognizing a specific diagnosis. I came upon this strategy through a web presentation by psychologist, Dr. Jeffrey Staab. He and his staff conducted research on the treatment progress of implementing the letter of identifying a specific illness, CBT, and antidepressants in somatic symptom and illness anxiety disorder. Dr. Staab (2014) mentions in this presentation of, how “having a specific diagnosis equals a specific intervention and ultimately can equal a better outcome for the treatment process,” and the recognition of a diagnosis is a general first step for the patient to identify and recognize their specific illness. (Staab, 2014) In theory this strategy is a technique used as starting point of cognitive behavioral therapy for the patient to approach the acceptance of their illness. With the patient receiving a diagnosis they can better identify and approach a form of acceptance of that diagnosis to which their symptoms have hindered their life. I have added the specific information from this presentation below on page 11 for a reference to the data obtained by Dr. Staab’s research.

In conclusion, I would like to add a great statement made by Butcher, Hooley and Mineka (2013), “Today the cognitive or cognitive-behavioral perspective on abnormal behavior generally focuses on how thoughts and information processing can become distorted and lead to maladaptive emotions and behavior,” Butcher, Hooley & Mineka, 2013 (p.79).

With consideration to this particular case, the patient learning how and where her thoughts and information processing became distorted will support her treatment process in a positive manner. Also, Dr. Staab’s strategy gives the patient a starting point with opportunity to identify and understand a specific diagnosis. Just as Jacofsky, Santos, Khemlani-Patel and Neziroglu (2015), mentioned about progress with CBT occurs with “recognition and understanding”. (Jacofsky, Santos, Khemlani-Patel & Neziroglu, 2015) It makes sense that majority of individuals that suffer with anxiety illnesses, amongst many other disorders, classifying, recognizing, identifying, accepting, etc. are all important factors for the patient to successfully utilize the treatment processes.

---------------------------------------------------------------

References

American Psychiatric Association, 2013. Diagnostic and Statistical Manual (5th Edition). Arlington, VA: American Psychiatric Publishing. Retrieved on 01/24/2017.

Butcher, J. N., Hooley, J. M., Mineka, S. M. (07/2013). Abnormal Psychology, 16th Edition. [Argosy University]. Retrieved on 01/22/2017. Retrieved from https://digitalbookshelf.argosy.edu/#/books/9781269939485/

Jacofsky, M. D., Santos, M. T., Khemlani-Patel, S., & Neziroglu, F., 08/09/2013 (Updated Oct 19, 2015). Anxiety Disorders: Theories And Therapies. The Bio Behavioral Institute. Retrieved on 01/22/2017. Retrieved from https://www.mentalhelp.net/articles/anxiety-disorders-theories-and-therapies/

Mayo Foundation for Medical Education and Research (MFMER), 07/02/2015. Diseases and Conditions Illness Anxiety Disorder: Treatments and Drugs. Retrieved on 01/23/2017. Retrieved from http://www.mayoclinic.org/diseases-conditions/illness-anxiety-disorder/basics/treatment/con-20124064

McLeod, Saul, 2007. Psychodynamic Approach. Retrieved on 01/24/2017. Retrieved from http://www.simplypsychology.org/psychodynamic.html

Staab, Jeffrey, P. Dr., Mayo Clinic Psychiatrist, 09/11/2014. Somatic Symptom Disorders Part II: Core Features and Treatment. [Online Web Presentation] Retrieved on 01/22/2017. Retrieved from

Somatic Symptom Disorder & Illness Anxiety Disorder Treatment Presentation by Dr. Jeffrey P. Staab,

“Specific Diagnosis = Specific Intervention = Better Outcome

Somatic Symptom Disorder

- Review (34 controlled trials, variable size and quality, but consistent findings)

* Consultation letter from psychologist/psychiatrist to primary care physician identifying the disorder, gives patient better outcome by identifying an illness/disorder.

2.) Cognitive Behavioral Therapy – Decreases symptoms, distress and disability related to symptoms.

3.) Antidepressants – Tricyclets Dual Action Uptake Inhibitors (TCA’s), Selective Serotonin Reuptake Inhibitors (SSRI’s), and Serotonin and Norepinephrine Reuptake Inhibitors (SNRI’s) seem to work best for SSD due to the symptom of pain, the SNRI’s have more assistance to pain but also assist in relieving depression and anxiety symptoms.

Illness Anxiety Disorder:

*Spontaneous remission does occur in approximately 50% of population.

2.)