AP Psychology Agoraphobia with Panic Disorder Treatment: Cognitive. I. Causes Innate Temperament.

ANSWER Factors to consider: CHILDHOOD / SOCIAL FACTORS could remember the fear of being separated in a public area (patient recalls the time she got lost in an amusement park and in the mall) - Was told at a young age by parents the possibility of being taken away by kidnappers as a child if she gets lost. - Parents observed that the patient often cries when given to an unfamiliar person. - Often confined at home; when interacting with other kids during playtime, always had an adult to accompany her. (parent or nanny) - grew up with the aid of a full-time nanny; was forbidden to venture out alone in public. - Matriarch of patients family has a history of bipolar disorder. ILLNESS: - Was diagnosed with Primary Complex Tuberculosis at the age of 6; both parents are smokers. Was under medication for a year; full recovery by the age of 7. (Weak respiratory response) - Head trauma back in 2005 ; Subgaleal hemorrhage. - Bipolar Disorder II diagnosed in 2007. Genetic. LIFEEVENTS: - Histories of real and feared separation from parents/caretakers. (unresolved childhood anxiety) TESTED FOR: - Xray, MRI Scan, ECG test and 24hr ECG Holter exam. All negative.

1st 2006. Blacked out and collapsed during lunch time at new schools common room. Had to be brought to nurses office using a stretcher because patient was immobile. Symptoms consisted of no-vision, hyperactive palpitating heart rate and overall needle sensation. 2nd 2008-2009 during freshman year, fainted and had full blown panic attack during schools general assembly which consisted of more than 4000 people in 1 venue. Symptoms consisted of needle sensation, lightheadedness, numbing, pale appearance, hard time breathing, choking, nausea, cold sweat until paramedics came to response and had to carry her out. Lasted for more than 20 seconds. Avoided general assemblies after and often isolated by school officials during events like this. 2009- had full blown panic attack in new school again. This time, felt tingling sensation until she fully collapsed in classroom. On the same year, sought for treatment and went to a neurologist. Reported about her mild head trauma back in 2004 but incident does not affect current symptoms. Underwent ECG testing and 24hr Holter; results came out as negative. Treatment for this disorder: Cognitive Behavioral Therapy (CBT)