Reference no: EM133425314

Assignment:

Jane Fox is a 25-year old female with no previous significant medical history. On a random Tuesday evening, Jane enters the emergency room in fear of having a heart attack after experiencing an episode of significant chest pain, difficulty breathing, and numbness in her arms. During her initial intake, she states the following to the attending physician:

"I was walking my dog earlier when I started sweating. Since it isn't hot outside, I couldn't quite understand why...then I started having trouble breathing and really got scared. My heart was pounding so hard I thought it might explode out of my chest. My knees felt weak - it seemed like my whole body was shaking, then my arms went numb. Apparently the whole thing only lasted a few minutes, but it felt like each second was an hour. Did I have a heart attack? Am I going crazy? I felt like I was going to die."

Jane is given an EKG and a thorough physical examination, but all the tests comes back in normal range, suggesting she did not have a heart attack. Given the lack of medical abnormalities, the physician believes Jane may have had a panic attack and refers her to a clinical psychologist.

Four weeks later, Jane sees the psychologist and reports that she has experienced over two-dozen panic attacks with similar symptoms since her time in the emergency room. At this point, her day-to-day functioning is significantly impaired; she avoids work, time with family and friends, and walking her dog because she thinks it might trigger another attack. There is no concrete source of anxiety or fear in Jane's life other than fear of the attacks themselves.

You are Jane's psychologist. Complete the following questions:

1. What symptoms are Jane presenting with? What diagnostic criteria are met?

2. While we don't have a lot of background information, what are some possible causal factors for the symptoms per your text our outside sources that are often seen in this diagnosis?

3. How would you suggest treating Jane? What barriers to treatment do you forsee being an issue with Jane?

4. Are there any additional/comorbid diagnoses you should make too?