Case Study: Abnormal Psychology – Diagnosis and Recommendation

PSYC3018 ABNORMAL PSYCHOLOGY
WRITTEN ASSIGNMENT 2014
Read the case description of Isabella, a 29-year-old woman, below. Write a 2000-word
essay, answering the following questions:
1/ (40 percent of total mark)
Do you agree with the diagnosis of ‘Adjustment Disorder with Anxiety’ for Isabella? Why or
why not? In your answer,
a) take into account both Isabella’s verbal reports and her questionnaire scores
b) consider possible alternative diagnoses and/or comorbidities
c) indicate whether any further assessment is necessary
d) draw a conclusion regarding the most appropriate diagnosis
2/ (60 percent of total mark)

Should mindfulness-based interventions (MBSR or MBCT) be considered as first-line
treatment options for Isabella’s problem (i.e., her primary diagnosis, as established by you)?
In your answer,
a) critically evaluate the relevant empirical evidence concerning the effectiveness of
mindfulness-based interventions for this particular diagnosis,
b) draw a conclusion and make a recommendation regarding the best treatment
currently available for Isabella.
Recommended reading:
Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological
interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental
Disorders (5thed.). (DSM-5). Washington, DC: American Psychiatric Association.
Depression Anxiety Stress Scales website: http://www2.psy.unsw.edu.au/groups/dass/
Further information
Including an abstract (maximum 200 words) and a separate reference section with your
assignment is compulsory. These do NOT count in the total word count.
Follow APA guidelines in writing and referencing. How to reference the DSM-5:
http://blog.apastyle.org/apastyle/2013/08/how-to-cite-the-dsm5-in-apa-style.html
The recommended readings, as well as your textbook and lecture and tutorial notes, should
be used as your initial starting points for a more specific search of the literature.
Assignments will be marked by your tutor in accordance with the attached Feedback Sheet,
and discussed with the course coordinator. The marked assignments will be returned to
students by the end of week 12. General feedback will be given in tutorial class in week 13.

Case description
Isabella, a 29-year-old woman has been referred by her GP to consult a clinical psychologist.
In the referral, the GP describes Isabella’s problem as experiencing ‘severe anxiety and panic
attacks associated with work stress’, and reports that her scores on the Depression Anxiety
Stress Scales (DASS, Lovibond and Lovibond, 1995) were 10 for Depression, 19 for Anxiety,
and 40 for Stress. Based on Isabella’s verbal description of her problem and her DASS scores,
the GP suggests a DSM-5 (APA, 2013) diagnosis of Adjustment Disorder with Anxiety, and
recommends Mindfulness-Based Stress Reduction (MBSR) as the best treatment option.
In the first interview with Isabella, the psychologist finds out the following information:
Isabella initially sought help from her GP because she noticed herself getting increasingly
anxious, worried and panicky during the past 12 months, to the extent that her anxiety
attacks and worrying began to seriously interfere with her work performance. She became
especially anxious about 2 months ago, when her supervisor nominated her for a promotion
which would require her to travel, give presentations and lead a team. She felt incapable to
comply with these requirements and decided to decline the promotion offer.
Isabella reports that when experiencing an ‘anxiety attack’, she would suddenly find it
difficult to catch her breath, she would notice her heart pounding, her hands trembling and
getting sweaty, and she would feel dizzy and lightheaded. During the past 6-8 months, she
found herself increasingly worrying that yet another of these unpleasant experiences of
intense fear and anxiety would occur. She especially worries about blushing and shaking in
front of her colleagues and of her mind ‘going blank’. She finds these instances extremely
embarrassing. To make matters worse, Isabella in fact did forget her words and lost the

thread in conversations several times lately. As a result, she has been trying to keep
interactions at work to a minimum, to make sure that she is not shaking or blushing, and to
generally ‘look normal’ when talking to others.
Upon further questioning, Isabella reports that she tends to worry about a variety of other
things, in addition to her job performance. She also worries about her health, her finances,
her physical appearance and safety, and several other minor things, such as being late or
paying her bills on time. She often finds herself unable to sleep because of her worrying. She
reports that she has always been a ‘worrier’, ever since she was a child. She can not recall
the precise time when her worrying first started.
However, she can recall that she experienced the first of her ‘anxiety attacks’ when she was
16 years old, during a class presentation in high school. She stumbled on her words, got
confused, felt herself blushing and shaking and her heart pounding, and noticed that some
of the girls in the class started to giggle. She says she ‘felt like an idiot’ during the
presentation and for a long time thereafter. She has experienced similar attacks several
times since then. Another time she recalls was when she was a bridesmaid at her best
friend’s wedding about 9 months ago. She endured that event with great difficulty,
constantly worrying about looking silly or making a mistake. She reports that she avoids
eating in restaurants and travelling on public transport whenever possible, and that she
rarely ventures to the cinema or the theatre because she hates crowds and ‘being stared at’.
PSYC3018
Written Assignment Feedback Sheet 2014
Note: This form is intended to provide you with guidance for writing your assignment. Further
comments and/or corrections to explain your final mark will be available with your marked essay.

1/ Do you agree with the diagnosis of Adjustment Disorder with Anxiety for Isabella? Why or why not?
excellent good satisfactory limited absent
Considered evidence regarding original diagnosis
Considered alternative options for diagnosis
Considered possible comorbid conditions
Justified conclusion in terms of DSM-5 criteria
Considered relevance of verbal reports to diagnosis
Considered relevance of DASS scores to diagnosis
2/ Should Mindfulness-based interventions (MBSR or MBCT) be considered as first-line treatment options
for Isabella’s problem (i.e., her primary diagnosis, as established by you)?
excellent good satisfactory limited absent
Identified relevant research studies
Critically evaluated research studies
Considered criteria for treatment effectiveness
Considered alternative treatment options
Drew appropriate conclusions regarding treatment
3/ Overall presentation
excellent good satisfactory limited absent
The abstract summarises the essay clearly
Arguments and facts referenced accurately
Citations in body of essay in APA format
Reference list in APA format
Clarity of writing: Spelling / Grammar/ Vocabulary
Word length within 5 % limit yes/no