Pââââââââââââââââââââââlease review the Sample Vignette located under Resources
Anticipatory anxiety, or excessive worry about the future, is a symptom of many types of anxiety disorder. While most people tend to wonder or even stress about future events or situations to some extent, extreme levels of anticipatory anxiety can negatively impact a person’s everyday life and functioning
Vignette One
Steven is a 28-year old Mexican American man. Steven grew up in East Los Angeles where violent gang activity was prominent. The oldest of 3 boys, Steven spent most of his childhood looking out for his 2 younger brothers. Both parents were abusive alcoholics and were âheavy-handed with us kidsâ. At age 19, Steven moved by himself to a major East Coast city where he attended college and is doing well as an architect. He is currently married to a woman he met in college. The couple is expecting their first child.
Steven comes to therapy upon the suggestion of his primary care physician due to chronic worry, anticipation of failure and fear that he will not be able to financially care for his wife and new baby, in spite of his lucrative and successful career. He also has ruminative thoughts, that that he is a facade and that, âpeople will find out who I really am.âââââââââââââââââââââââ
Steven tells you that lately he has gotten dizzy when driving on the highway and recently experienced the inability to breathe when at the mall with his wife. He also tells you that sometimes when he closes his eyes, he sees his parents âbeating each other up and can hear them screaming.â He also discloses that sometimes he wakes up at night with clenched fists and feels like that scared little boy all over again. Lately he has been unable to leave the house without making sure the door is locked several times and avoids odd numbered streets on the way to work.
1. Given what you see in the vignette, with consideration of a differential diagnosis formulation, what comorbid disorders may exist? What additional information would you need to confirm your diagnostic impressions? Choose one provisional diagnosis for Steven. Support your provisional diagnosis by comparing the DSM-5 diagnostic criteria to vignette content. (See Sample Vignette Analysis located under Resources for guidance)
2. Choose 1 theoretical model to explain how you conceptualize Stevenâs clinical presentation. From the perspective of this theoretical model, discuss how you would provide clinical treatment for Steven. Integrate vignette content thoroughly in your ââââââââââââââââââââââtreatment plan.