Psychology

Agnes lives in a relatively constant state of worry and diffused uneasiness. She is scared to be left alone and is troubled about a  heart disease  which the doctor assures her has no pathology and is probably a result of nervousness and strain. She lives in anxious apprehension, which is defined as a future-oriented mood state in which a person attempts to be constantly ready to deal with upcoming events (Barlow, Chorpita,  Turovsky, 1996). This mood state is characterized by high levels of negative affect, chronic over arousal, and a sense of uncontrollability (Barlow et al., 1996). This is apparent when Agnes acknowledges that her behavior is absurd but is still compelled to perform within a pattern not warranted by her environment.

In addition to their excessive levels of worry and anxious apprehension, people with generalized anxiety disorder often have difficulty concentrating and making decisions, dreading to make a mistake (Carson, Butcher,  Mineka, 2000). This is supported by the fact that Agnes has made no effort in pursuing a college degree despite yearning for it. Individuals with this disorder also commonly complain of somatic symptoms like heart racing and difficulty breathing (Carson et al., 2000) which coincides with what Agnes interprets as  heart disease .

300.01     Panic Disorder without Agoraphobia
Diagnostically, panic disorder is defined and characterized by the occurrence of unexpected panic attacks that often seem out of the blue. According to the DSM-IV definition, the person must have experienced recurrent unexpected attacks and must have been persistently concerned about having another attack or worried about the consequences of having an attack for at least a month. To qualify as a full blown panic attack, there must be abrupt onset of at least 3 to 14 symptoms such as shortness of breath, heart palpitations, sweating, dizziness, depersonalization or derealization, fear of dying, of  going crazy  or of  losing control  (Carson et al., 2000). These descriptions coincide with the incident where Agnes was left alone in her daughter s house and had a panic attack at the thought of isolation. Following the incident, Agnes refused to be alone, perhaps fearing that, at the event of another attack, no one would be there to help her.  Thus, she insisted that her daughter accompany her everywhere.

Axis II
301.83     Dependent Personality Disorder
Individuals with this disorder show extreme dependence on other people, clinging and submissive behavior. They also show acute discomfort, even panic, at the possibility of separation or sometimes of simply having to be alone, often leading to excessive reliance on emergency medical services (Bornstein, 1997). This coincides with tendency of Agnes to constantly cling to her daughter.

These individuals usually build their lives around other people and subordinate their own needs to keep those people involved with them. As a result of their lack of self confidence, dependent personalities passively allow other people to take over the major decisions in their lives. This is apparent in the subservient behavior Agnes exhibits with her husband.

They are often preoccupied with a fear of being left to take care of themselves and lack the ability to initiate projects or do things on their own. Both of which are characteristics exhibited by Agnes.

Axis III
None
Axis IV
Agnes grew up with a father who had a moderate drinking problem. It has been seen that adult children with parents who have alcohol problems  feel isolated, and uneasy with other people, especially authority figures. To protect themselves, they become people-pleasers, even though they lose  their own identities in the process. They become reactors rather than actors, letting others take the initiative. (Adult Children of Alcoholics World Service Organization. n.d.)

Agnes has always been with male figures that makes it easy for her to slip into submissive or subservient roles which she has also observed with her mother. Agnes must be able to develop self-confidence so she may become more secure in her interactions with the world.

Axis V
GAF60
Code 51-60 Some mild symptoms (e.g., depressed mood and mild insomnia) OR some difficulty in social occupational, or school functioning (e.g., occasional truancy or theft within the household), but generally functioning pretty well, has some meaningful interpersonal relationships. (American Psychiatric Association, 1994, p.32)

Agnes experiences depression due to a sense of helplessness about the events happening in her world, a phenomenon referred to as  learned helplessness . She experiences difficulty to function well when left alone and is prone to panic attacks. However, Agnes manages to maintain a relationship with her husband and daughter, albeit the daughter has become frustrated by Agnes s escalated clinging behavior for the last six months.