Psychology in Health: Case Studies and Psychological Models

This article explores case studies on agoraphobia, health behavior, and psychodynamic approach in psychology and their impact on health. It discusses different psychological models and their influence on behavior and health.

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Psychology in Health
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Psychology in health
Case Study One.
Agoraphobia is where an individual suffers from an anxiety disorder which makes them
have an extreme fear of being in public and crowded places. These people experience situations
where they have an intense fear of going to open spaces which they think that they may have a
hard time escaping from. They get this fear because they had panic attacks more than once when
they were exposed to public and crowded places. Scientists are not sure about the cause of
agoraphobia, but some studies suggest that it runs in the family. Evidence shows that to
individuals who have previously experienced conditions such as traumatic situations, stressful
events, anxiety disorders and substance abuse have more of a chance of being agoraphobic. This
condition is quite rare with statistics showing that it affects almost 1% of the American
population. Women are three times more likely to have it than men, and it is more common in
young adults. The median age which agoraphobia most likely onsets is at 20 years (Wittchen et
al. 2010, pp. 122).
Psychological factors are mental factors like anxiety which affect the physical health of
an individual, the illness they are suffering from and their behaviour. In this case, Jessica who is
an agoraphobic has a variety of psychological factors which have influenced her health,
behaviour, and illness. First, is stress where she gets stressed thinking about the activities that
Kelly her psychiatric nurse wants her to do as part of treatment for her agoraphobia. When an
individual is stressed and in this case Jessica, it will affect her illness because when she
overthinks about going outside her house and to the crowded public places or even using public
transportation, it will increase her fear. She will be more fearful and feel overwhelmed because
she will think of all the bad things that will happen to her if she goes thus this will negatively

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affect any progress she has made in trying to treat her agoraphobia. Also, the stress will affect
her physical health by causing her to have tension headaches caused by stress, she will
experience chest pains and muscle pain, she will also have an upset stomach caused by
overthinking, and she will always be fatigued. The pressure will also negatively affect her
behaviour in that it will cause her to be angry and irritable for no good reason because she is
stressed. Her withdrawal from social interactions will be increased to a point where she may not
have any contact; she might resort to bad habits such as using tobacco, drinking alcohol and also
undereating or overeating to deal with the stress (Kircher et al. 2013, pp. 94).
Another psychological factor that will affect Jessica is depression. She will be depressed
because she feels sorry for the situations she is in and the fears she has. She may feel ashamed of
her mental condition because she is afraid of even going outside her house. Depression will
affect her illness in that she will not be motivated to go on with her treatment because she is sad
and sees no point in the therapy therefore negatively affecting any progress she might have
made. It will also influence her behaviours where she will experience extended periods of
insomnia which is associated with depression and which will negatively affect her physical
health in turn. It will lead to her having suicidal thoughts because she feels sorry for herself, she
will also socially isolate herself. Further, she will also begin abusing drugs and alcohol, and she
might also experience eating disorders which will negatively affect her physical health. She will
also have more problems in any relationship she is in or more conflicts with her family. The
depression will jeopardise her health in that it will increase her risks of getting heart attacks, her
eating disorders might lead to conditions like diabetes, and it will also lead to the weakening of
her immune system (Seligman and Csikszentmihalyi 2014, pp. 287).

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Jessica also will be affected by her perception in a variety of ways. How an individual
perceives herself and the situation can affect her. It will affect her illness in that she will perceive
going outside her house and facing her fear of being dangerous and there is little that can be done
to change her mind about it. If she sees this situation as dangerous and that will cause her to have
panic attacks, she will not be able to go on with her treatment. She will not also see how severe
her symptoms are therefore she will not see the importance of going on with her treatment. It will
also affect her behaviour because she will start becoming negative about any situation she is in
and start viewing them with a pessimistic mind which is not good. It will lead to her being more
isolated and suffer from anxiety which is not good for her mental and physical health.
Perception will also affect her health in that will lead to hormone imbalances, affect her thyroid
function and lead to fluctuation of her glucose levels which will affect her physical health
(Sarafino and Smith 2014).
Kelly who is a psychiatric nurse has started to treat Jessica's agoraphobia using a medical
model which is meant to change her behaviours and therefore improve her health. This treatment
I believe is intended to help Jessica to slowly transition and start facing her fears and with time
treat or manage her agoraphobia without using medication. I think in this conditioning approach
as changing her behaviours will lead to her seeing no need to be fearful or get panic attacks when
she is exposed to situations that once brought her anxiety and caused her panic attacks. In the
end, it will change her behaviour with time she will be able to get back to normal life. This
medical model changes her behaviour in a variety of ways and starts conditioning her slowly by
slowly till she is comfortable in situations that would previously cause her to panic. First, by
opening the door and just stepping outside the house, Jessica will be able to see with time that
nothing bad happens when she steps out of the house. Therefore this will enable her to go outside

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without fearing what she will encounter outside as she will be used to what is outside. Next,
when Kelly gives her praises everytime, she goes out it helps her. She will now associate being
outside with positive things. Therefore, she will look forward to going outside and thus she will
have made progress (Lueken et al. 2014, pp. 383).
After she has gotten used to spending time outside her house and she sees that nothing
will trigger her panic attacks she then would start walking down the path to her gate. By doing
this, she will over time start getting comfortable being in an open space, and because she knows
her compound, she knows where to escape to when she feels overwhelmed (Sánchez-Meca et al.
2010, pp. 40). Also, Kelly will be praising her every time she does this. With time she will get
used to this routine. Therefore, she will not associate open spaces with panic feelings but with
happy feelings from Kelly’s praises. Then she progresses to the next step in the model where she
will walk past her gate to get to the café at the end of her street. As she likes the restaurant this
will be good she will be happy with the time that she can get to the place and she will see there is
no need for panicking. She will then be able to handle being around a crowded place slowly by
slowly and if it's too much she knows she can go back to the safety of her home (Ogden 2012).
After she is used to the crowd at the café, the goal is for her to be able to use public
transportation to go to do her shopping. It will be achievable with this model because they have
dealt with situations that brought her anxiety before like open places, the outside, and crowded
places. This model is good because it creates a routine for Jessica to follow and once she follows
through with it she can be able to slowly but surely deal with her agoraphobia, and she will be
able to feel in control. Also by Kelly praising her, she will associate her going outside with being
praised which is suitable for her condition and behaviour (Gloster et al. 2011, pp. 406).

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Case Study Two.
Health behaviour is any act or behaviour by an individual that affects their physical
health outcomes by either positively or negatively influencing the risk of its severity. There are a
variety of psychological models which can influence an individual’s behaviour and their health
(Diener and Chan 2011, pp. 33). In this case, I believe that if Sean had not associated not being
kind with suffering consequences, he would have grown up being indifferent to those in need. He
would not have been as generous as he was had the situation with his father not happened.
However, I believe that the operant conditioning by his father does not adequately explain his
generosity because he was just punished once and therefore it was not a common occurrence. For
the model to work the condition has to be set and done many times for the behaviour to be
formed (Brannon, Feist and Updegraff 2013).
There exist different psychological models which can also explain his behaviour. These
models can be compared with this case in mind. First is the protection-motivation model which
is where an individual is motivated to protect themselves from any danger or consequences that
they may suffer. Therefore it plays on an individual's fears and depends on one being so fearful
of a situation that they act how they are supposed or expected. It is mostly applied in health
situations where one knows about the threat and severity of illness and thus are motivated to
protect themselves from getting it (Plotnikoff and Trinh 2010, pp. 95). In this case, Sean knows
that when he did not give money to the homeless person he suffered consequences therefore even
when he is grown he has remained fearful of not giving because he is afraid of he will feel. On
the other hand, the Operant Conditioning model is a bit similar but different at the same time to
this model. By using positive reinforcement, Sean now knows when he gives to those he needs
he will feel good, and this makes it different. However, it is similar when negative punishment is

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used where Sean now knows he will suffer from adverse consequences when he does not give
which makes it similar (Glanz and Bishop 2010, pp. 413).
The next model is Classical Conditioning whereby an individual learns to behave by
associating it with something. An individual will merely now associate two stimuli; they will
know that if this happens, the other will automatically occur. It occurs in this case in that Sean
associated him giving to the needy person with him getting complimented by his father.
Therefore he developed the new behaviour where he now associates giving with feeling good,
and he does so regularly (Henton and Iversen 2012). In comparison, the operant conditioning,
however, uses reinforcements to increase or decrease the occurrence of a behaviour. In this case,
Sean gives more to the needy because he knows what will happen when he does not why is he
will feel bad (Sallis, Owen and Fisher 2015, pp. 50).
The final model is the observational learning which is at times called the social-cognitive
theory. It where an individual’s behaviours and health are shaped by watching or observing how
others behave. It can have either positive or negative consequences to an individual’s behaviour.
In this case, Sean’s friends have observed him giving to the poor for a long time which will
either affect them in two ways (Burke, Tobler, Baddeley and Schultz 2010, pp. 14435) One is
that some will start acting as he does because they see it brought joy to him. Secondly, others
will associate giving with negativity because Sean sometimes gives out more than he can afford
and they will perceive this negatively. On the other hand, the operant conditioning in this
instance works in where his friends will most probably start giving because they saw him giving
to the poor and he was happy, and also because of the story; he told them (Folkman 2013, pp.
1914).

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Case Study Three.
The psychodynamic approach is where an individual’s personality is explained by using
both conscious and unconscious forces such as one have unconscious beliefs and desires. It is
believed that these forces affect their character and also their childhood experiences shape their
personality too. People can sometimes have events called Freud slips where they reveal what is
on their mind by saying what they did not mean to say (Shedler 2010, pp. 98). With this
approach, traumatic events will make an individual to develop defense mechanisms which will
then lead to the creation of some behaviours like she stopped going to work and also withdrew
from hanging out socially with her friends. In this case, this patient appears to be using a defense
mechanism to deal with her traumatic ordeal. When the person who killed her boyfriend was
arrested, it made her relieve the trauma which negatively affected her. Therefore, she developed
a defense mechanism to deal. She was regressed in that even though she appeared to be doing
good and dealing with her grief, once the murderer was arrested she spiralled and suffered from
negatives from the trauma (Ward 2013). She also seemed to repress her memories when she
appeared to deal with her grief because triggered with the arrest this shows that she did not
entirely forget her feelings, but she pretended to and put it in the back of her mind (Kramer 2010,
pp. 217). She was also in denial where she started to daydream to escape the trauma she was
relieving through her nightmares and lack of sleep. Finally, she dealt with the situation by
reaction formation. She decided to isolate herself socially, avoided her friends and also stopped
going to work as she could not concentrate on her tasks thanks to her constant daydreaming
(Martindale and Summers 2013, pp. 118).
There are some psychological principles which can be utilised to manage the health
concerns of patients. First, is communication where the patient and the healthcare professionals

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have a clear means which they can communicate. Also, the patient needs to feel comfortable
enough to talk to their doctor so that they can let them know if any situations are affecting them
and the doctor will do their part. In this communication is key where if the patient had felt
comfortable enough with her doctor she would have communicated with them about her feelings
before she devolved to this level. The doctor would then have come up with a treatment plan
designed to help her deal with her feelings, and the arrest of the murderer would not have
triggered her (Lovallo 2015). The next principle is the theory of reasoned action which suggest
that a person’s behaviour affects how they perceive their treatment and how useful it will be. The
doctor, in this case, would hold sessions with the patient where they would talk out the issues she
was facing. Then she would be able to see slowly that there was more benefit in going on with
her treatment and also she would be able to deal with anything that could trigger her PTSD
(Melton et al. 2017).
The next principle is self-regulation where an individual is taught skills to help them to
cope with the situations they find themselves in. These skills are useful in assisting people to
cope, and therefore they will be able to move on with their lives. In this case, she should have
been taught some self-regulation skills which would have helped her deal with the arrest of the
murderer better (Lawn and Schoo 2010, pp. 210). Another principle is socialisation which insists
on the importance of one having relationships, social interactions and being in a community. In
this example, she would have been made by her doctors to slowly start interacting with those
around her especially her family who will help her through any trouble she might face in future.
Another principle that can be used in treating health issues is control. It is essential for the patient
to have a sense of control and they have choices in the treatment that they are getting. In this

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case, the doctor should talk with the patient and inform her what the treatment will be therefore
she will feel that she is in control of one aspect of her life. (Dollard and Bakker 2010, pp. 591).
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