Name: Sample

Biography Portrayal

Diagnosis: Panic Disorder without Agoraphobia

Write your narrative in this space. It may be easier to fill in the info below first, then come back and write your narrative.

Imagine that you’re seeing a therapist for the first time. You haven’t been diagnosed with anything yet. What information would you give them? What information might they ask about? Write about your history, your family, what your life is like now. Write about anything that applies to the disorder you’ve chosen.

Write about some incidents that are particularly telling. “I was 14 when I had my first panic attack.” Whatever you write in the right-side column below needs to be covered in your narrative, unless it’s something that doesn’t apply to you. For instance, as I’m describing a panic attack, I wouldn’t say, “but I don’t have a fear of dying.”

Notice that this last section is very similar to what you’ve done for the case analyses.

DSM DIAGNOSTIC CRITERIA	MY SYMPTOMS
A. Both (1) and (2):	Both are met
(1) recurrent unexpected panic attacks	Had panic attacks
CRITERIA FOR PANIC ATTACK: A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:  (1) palpitations, pounding heart, or accelerated heart rate  (2) sweating  (3) trembling or shaking  (4) sensations of shortness of breath or smothering  (5) feeling of choking  (6) chest pain or discomfort  (7) nausea or abdominal distress  (8) feeling dizzy, unsteady, lightheaded, or faint  (9) derealization (feelings of unreality) or depersonalization (being detached from oneself)  (10) fear of losing control or going crazy  (11) fear of dying  (12) paresthesias (numbness or tingling sensations)  (13) chills or hot flushes	Had 7 of the symptoms for panic attack (pounding heart, sweating, trembling, shortness of breath, nausea, dizzy, paresthesia)
(2) at least one of the attacks has been followed by 1 month (or more) of one (or more) of the following	Each attack has been followed by 2 or 3 months of 2 of these.
(a) persistent concern about having additional attacks	Worried about having this happen again
(b) worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy")	I worry that I don’t have control over myself. If I don’t have control, people will think I’m insane, I won’t be able to drive, I won’t be able to take care of my kids.
(c) a significant change in behavior related to the attacks	Not applicable
B. Absence of agoraphobia.	I’m not afraid of being out of my house, or being in crowds, or other such things.
C. The Panic Attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).	I’m not using any drugs, and my doctor has assured me I don’t have a medical condition.
D. The Panic Attacks are not better accounted for by another mental disorder, such as social phobia (e.g., occurring on exposure to feared social situations), specific phobia (e.g., on exposure to a specific phobic situation), obsessive-compulsive disorder (e.g., on exposure to dirt in someone with an obsession about contamination), posttraumatic stress sisorder (e.g., in response to stimuli associated with a severe stressor), or separation anxiety disorder (e.g., in response to being away from home or close relatives).	Not applicable Social phobia – I’m not afraid of social situations Specific phobia – I don’t have a panic attack in response to a specific trigger OCD – I don’t have obsessions or compulsions PTSD – I haven’t had anything major happen to me. Separation anxiety disorder – I don’t have any problems being away from those I’m close to.
ETIOLOGY FROM TEXT	MY ETIOLOGY
Note: I didn’t include biological factors here because they tell us what is happening during a panic attack, but they don’t say anything about what triggers them
Genetic factors: “… panic disorder was 10 times more likely in families with a member who has panic disorder than in comparison families.” Pg. 221	My dad would sometimes ‘freak out.’ My parents divorced when I was young, and he moved away, so I don’t remember too much about this – but I remember finding it frightening.
Psychological factors:
Fear of fear – “… the panic disorder is the result of a random panic attack, which is sufficient to set off this hypervigilant response, which in turn sets off additional panic attacks.” Pg. 221	After the first one, I worried and worried that it would happen again.
Bodily sensation misinterpretation Pg. 221	I’ve noticed that I’ve become really tuned in to my body. I know exactly what state my body is in at all times.
Anxiety sensitivity Pp 221-222	Not applicable
DIFFERENTIAL DIAGNOSIS
Generalized anxiety disorder	GAD is about incessant worrying, not just worrying about having a panic attack.
Phobias	My panic attacks seem to be random; they don’t have a specific trigger.
Posttraumatic stress disorder	I haven’t had anything major happen to me.
Substance-induced anxiety disorder (caffeine, amphetamine, cocaine intoxication	I use caffeine some, but the panic attacks don’t seem to be correlated with caffeine use.