Week 9 Application Case Study Of Mrs. Hudson

Week 9 Application Case Studycase Of Mrs Hudsonmrs Hudson Is A 37 Y

Mrs. Hudson is a 37-year-old Haitian American woman experiencing anxiety symptoms that began four months ago. She reports episodes characterized by heart racing, shortness of breath, sweating palms, and chest tightness, often occurring during activities like shopping or at her children's school. These episodes caused her to fear a heart attack and led her to seek emergency medical attention. After initial episodes, her symptoms subsided but have since repeated, prompting her to avoid leaving her home, calling in sick from work, and withdrawing from social and religious activities, which has strained her marriage and jeopardized her employment. Her recent history indicates a pattern of anxiety and avoidance that has significantly impacted her daily functioning.

Mrs. Hudson grew up in Haiti with her paternal grandmother until age 7, after which she moved to the United States to live with her mother, father, and siblings. Her father, a former doctor, was unable to practice medicine in the U.S., and her mother worked as a laborer. Her relationship with her father was tense; she sought his approval throughout her life. She is close to her mother and siblings, especially her sister. Mrs. Hudson is bilingual in Creole/French and English, with English being her primary language. She completed college and medical school, working part-time as a primary care physician to care for her children. Her husband is a firefighter, and they have two children, an 8-year-old son and a 2-year-old daughter with a severe heart condition requiring ongoing medical monitoring.

Religiously, Mrs. Hudson was raised Catholic but now attends a nondenominational Christian church. Her health history is unremarkable except for her daughter’s cardiac condition. She has never experienced mental health treatment before and was referred to therapy by her primary care doctor.

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Mrs. Hudson’s presentation aligns with symptoms indicative of an anxiety disorder, particularly panic disorder, given the sudden onset of intense physical symptoms and subsequent avoidance behaviors. The episode of chest tightness, shortness of breath, sweating, and heart palpitations closely mirrors criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for panic attacks (American Psychiatric Association, 2013). Her persistent worry about experiencing future episodes and avoidance of situations she associates with her attacks fit the diagnostic framework for panic disorder with agoraphobia, although her avoidance appears primarily centered around her home environment and social activities, rather than open or public spaces alone (Greathead, 2010).

The cultural and socio-economic factors play a crucial role in understanding Mrs. Hudson’s mental health. Her immigrant background, immigration experiences, family dynamics, and religious transitions all contribute to her psychological profile. Research indicates that immigrant women often face barriers to mental health care, including stigma, language barriers, and cultural differences in expressing psychological distress (Alegría et al., 2010). Her Haitian heritage, coupled with her limited English proficiency and unacquired U.S. citizenship, could influence her help-seeking behaviors and perceptions of mental health issues (Vega et al., 2010).

Psychologically, her childhood experiences, particularly her relationship with her father and the pursuit of his approval, could have fostered underlying issues related to self-esteem and emotional regulation (Kirmayer & Minas, 2000). The loss of her father to cancer and her ongoing efforts to gain his approval may have contributed to vulnerability to anxiety disorders. Additionally, her recent social withdrawal and health anxiety could be exacerbated by her daughter’s chronic health condition, which introduces ongoing stress and worry (O’Hara & Swain, 1996).

Understanding Mrs. Hudson’s situation requires a biopsychosocial approach. Biologically, her symptomatology suggests a panic attack pathway involving dysregulation of the autonomic nervous system. Psychologically, her history and current stressors, including her daughter’s health and her strained social life, reinforce anxiety responses. Socially, her immigrant status, family obligations, and cultural background influence her experiences and coping mechanisms (Engel, 1977).

Effective intervention should include cognitive-behavioral therapy (CBT), focusing on identifying and restructuring maladaptive thought patterns associated with anxiety, as well as exposure strategies to reduce avoidance behaviors (Craske et al., 2014). Incorporating culturally sensitive techniques is essential, considering her background and language preferences. Pharmacotherapy, such as selective serotonin reuptake inhibitors (SSRIs), may be beneficial in managing symptom severity, especially given her rapid onset of symptoms and impairment (Blumenthal et al., 2007). Collaboration with her primary care provider is vital to monitor medication and address any somatic concerns.

Furthermore, integrating family therapy could help address relational dynamics, particularly involving her husband and support system, to foster understanding and reduce strain. Addressing her spiritual and cultural beliefs through culturally competent care can enhance engagement and treatment adherence. Psychoeducation about panic disorder and stress management practices would empower Mrs. Hudson with coping skills to handle future episodes effectively (Hofmann & Smits, 2008).

In conclusion, Mrs. Hudson’s case underscores the importance of a holistic, culturally sensitive approach to mental health assessment and treatment. Recognizing the interplay of biological, psychological, and social factors is essential to developing an effective, individualized treatment plan. Supporting her through therapy, medication, and social support systems can improve her quality of life, restore functional independence, and help her re-engage with her community and family.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Alegría, M., Chatterji, P., Wells, K., Cao, Z., Chen, C.N., Meng, X.L., & Meng, X.L. (2010). Disparity in depression treatment among racial and ethnic minorities in the United States. Psychiatric Services, 61(11), 1264-1272.
• Blumenthal, S. R., Hamang, M., & Roy-Byrne, P. (2007). Pharmacotherapy for panic disorder. Journal of Clinical Psychiatry, 68(8), 4-10.
• Craske, M. G., Kircanski, K., Zelikowsky, M., & Mystkowski, J. (2014). Cognitive-behavioral therapy for panic disorder. Psychiatric Clinics of North America, 37(4), 837-852.
• Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129-136.
• Greathead, R. (2010). Anxiety and panic disorders. The Clinical Advisor, 13(3), 221-224.
• Hofmann, S. G., & Smits, J. A. J. (2008). Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis. Clinical Psychology Review, 28(2), 139-156.
• Kirmayer, L. J., & Minas, H. (2000). The future of cultural psychiatry: An international perspective. Canadian Journal of Psychiatry, 45(4), 367-374.
• O’Hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression—a meta-analysis. International Review of Psychiatry, 8(1), 37-54.
• Vega, W. A., Rodriguez, M. A., & Bustillo, J. R. (2010). Disparities in treatment and care for Latinos with mental health disorders. Psychiatric Services, 61(10), 1007-1014.