Assignment 1.

Anxiety: Movie

Melanie Yael Ortega de León - A01284769

Esteban Valenzuela Romero - A00835271

Escuela de Medicina y Ciencias de la Salud

Instituto Tecnológico y de Estudios Superiores de Monterrey

CC.2036.103 Psychopathology

Alejandra Maza Morán

February 23th, 2024

 Clinical Chart
__________________________________________________________________________________________________

I. IDENTIFICATION FILE

Name: Helen Hudson

Age: Unknown (30-45)
Gender: Female
Location: San Francisco, CA
Occupation: Criminal Psychologist
Examiners: Melanie Yael Ortega de León & Esteban Valenzuela Romero

II. OBSERVATIONS

Under the influence of alcohol and pills (unspecified). She shows to be cooperative, but with
signs of psychological distress. In terms of her affect, she seems anxious and guarded. Her mood seems
depressed, with occasional expressions of hopelessness. Show a linear and coherent thought, with the
exception of the preoccupation of the traumatic memories and fears. In a perceptual instance, reports to
have occasional auditory and visual hallucinations in situations with lots of distress. Her intellectual
functioning seems to be intact, but shows difficulty concentrating and retrieving certain memories.
Limited insight on the impact of her trauma on her well-being, and judgment appears to be intact.

III. SYMPTOMS

Anxiety and fear: Constant reactions to perceived imminent present or future threat.
Panic attacks: Presented with pictures of murders. The brother said it had happened before and it
goes intensely with a duration tops of 30 minutes (min 28).
Hyperventilation: With the idea of going outside for the newspaper (min 19). Also she gets this
symptom when seeing a stimulus from the trauma, in this case the red dress of the conference (min 35).
Evitation of stimulus: when she opens the door to get the newspaper or the towel of the bath, she
avoids looking out, she opens the door and with the hand takes whatever she needs. (min 19 & min 35).
Dizziness: When she tries to go outside, because she is in danger inside, she starts to experience
this symptom (1 hour, min 3).
 Cloudy View: When she tries to go outside, because she is in danger inside, she starts to
experience this symptom. (1 hour, min 3).

IV. HISTORY OF DEVELOPMENT

13 months ago, the patient was captured and tortured by a serial killer, which has caused the
manifestation of several post-traumatic stress disorder (PTSD) symptoms. Also, since then, she’s been
having recurring panic attacks. The symptoms of such attacks are sweat, shaking and hyperventilation,
but the development of these symptoms throughout the 13 months is unknown. It’s inferred that her
panic attacks have caused her later on to develop agoraphobic symptoms, refusing to get out of her
apartment and manifesting anxiety and fear in situations where help might not be available.

V. DIAGNOSTIC IMPRESSION

6B02 Agoraphobia
A. The patient shows fear and anxiety in the following situations: using public transportation,
being in open spaces, and being outside of the home alone.
B. She avoids situations outside her apartment with a probable cause of fear of being in a
threatening situation and developing panic-like symptoms.
C. Being outside her apartment almost always provokes fear or anxiety.
D. Actively avoids situations where she has to be outside of her apartment, and when endured,
there’s the presence of intense fear or anxiety.
E. Even when danger is not outside her apartment, fear and anxiety is out of proportion.
F. This fear, anxiety, and avoidance has persisted for 13 months.
G. The fear, anxiety, and avoidance causes her a significant distress and an impairment in social
functioning.
H. There’s no specification of a present medical condition.
I. There’s no presence of another mental disorder that may explain the presence of these
symptoms.
 6B01 Panic Disorder
A. She manifests recurrent and unexpected panic attacks (sweating, trembling, sensations of
shortness of breath, and dizziness).
B. She has presented a significant maladaptive change in behavior related to the attacks
(agoraphobic avoidance symptoms) for over 1 year.
C. Even though she reports consuming alcohol and pills (unspecified), there’s no relation
between these behaviors nor the existing medical conditions and the appearance of the panic attacks.
D. There seems to be no presence of a mental disorder that could explain the disturbance. Even
though she might have posttraumatic stress, the panic attacks don’t occur exclusively in response to
traumatic events.

* Taking into consideration the possible coexistence of Panic Disorder and Agoraphobia, and
meeting criteria for both disorders, the diagnostic impression of this patient is a comorbidity between
these two. PTSD symptoms must be taken also into consideration.

VI. TREATMENT

We recommend that the patient goes to a psychologist with the cognitive-behavioral approach to
use relaxation and desensitization techniques, in order to reduce, little by little, the agoraphobia to a
point that it cannot longer affect her daily life. This therapy will allow her to know how to manage her
emotions and train her brain to think and respond differently.
Reflections
Melanie:
This assignment was incredible to me, because it helped me to exchange ideas about what I was
thinking during the movie and making questions about if it is a panic attack or maybe it was a panic
disorder. This assignment pushed me to think outside the box and make me question how if the
symptoms change a little bit it can change the diagnosis completely. It is good to teach myself all the
theories we see in class to cases, for us to learn all the theories and take it to practice.
At the beginning the movie didn’t catch my attention very much, but in the middle I was very
intrigued. Love the idea of seeing movies about my career.
Esteban:
Evaluating real or fictional cases seems to be a great exercise to develop the ability to assess
possible psychopathologies. While I was enjoying the movie and its interesting plot, I was also finding
very fascinating the associations that I was making between the symptoms and behaviors that the
character was manifesting. Using functional analysis while eating popcorn was a very entertaining way
of learning and I look forward to doing the next assignments.
Another thing that I found interesting and relevant was the fact that the ability of diagnosis needs
practice. While you can make assumptions about certain disorders over certain symptoms, a very good
diagnosis is founded on an excellent understanding of the theoretical framework and the constant
practice of functional analysis.