Agoraphobia in The Movie Copycat

How is stress related to Agoraphobia, the disorder is displayed by the character chosen?

The selected movie is the Copycat. This is an American psychological thriller that centers on the life of Dr. Helen Hudson a criminal psychologist who was a serial killer field expert. Helen offered criminal psychology as a guest lecturer at a local university. She was later concerned in the restroom of the lecture hall by Daryll Lee Cullum one of her past subjects that had escaped from jail. Cullum attacked Helen brutally and managed to murder a police officer. He was however subdued by another police officer and returned to the hospital. However, Helen developed agoraphobia; anxiety characterized by feeling insecure or unsafe. Helen developed agoraphobia following the traumatic experience with his ex-patient Cullum. The encounter stressed her, making her fear similar attacks following that she had attended several individuals such as Cullum.

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What are some of the irrational or abnormal beliefs, attitudes, and behaviors the characters displayed, and how did they manifest? Provide specific examples?

Some of the irrational or abnormal beliefs that the Hellen displayed was the belief that she will be attacked again and be killed. Helen developed excessive fear for her safety. She developed anxiety disorder typified by anxiety symptoms in situations where she perceived her environment to be unsafe. This makes her take the action of confining herself in a hi-tech, expensive apartment, where she conducted all her activities on a computer screen. She also got assistance from friends to be able to build her new safe nest. The agoraphobia also pushed her to shoot a suspect who had surrendered. After being on Foley’s trail for a long time and being almost near death in his hand, Helen shot him to death despite having surrendered. Her agoraphobia made her so scared to reason. The fear of death and the feeling of being unsafe rushed her adrenaline, giving her extra strength to take excessive measures to defend herself from danger, even after the danger had ceased. This destroyed her reasoning and although her colleague had managed to subdue the suspect, Helen shot him, denying then the only chance they had of knowing the serial killer mastermind. 

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Using current DSM and ICD diagnostic codes, what is a possible diagnosis for this character?

Agoraphobia is classified as F40 in ICD-10 that is identified with phobic anxiety disorder. Its actual ICD -10-CM diagnosis code is F40.00 and it is unspecified. It is under mental, behavioral, and neurodevelopmental disorders that are classified from F01 to F99. It is clinically identified as an anxiety disorder typified by an irrational, intense fear of going out in open places or conditions where help may not be accessible in case panic or excessive anxiety symptoms occur. It also involves excessive fear of being alone, being in a public place. The patient demonstrates persistent, obsessive, and intense open places fear. According to DSM-IV criteria and DSM-5 criteria, agoraphobia is classified as an anxiety disorder. Agoraphobia is identified as anxiety or fear regarding two or more of the listed five situations including being in open spaces, being outside the house alone, being in a crowd or standing in line, being in enclosed places such as cinemas, theaters, stores, or shops, and using public transportation. Agoraphobia can be accompanied by a panic attack or it can occur without a panic attack.DSM-5 criteria individuals are considered to suffer from agoraphobia when they avoid or fear the above-named situation due to the thought that escape may be hard or help may not be accessible in the event of panic-like symptoms development or other embarrassing or incapacitating symptoms. Agoraphobic individuals end up imprisoning themselves and they may demonstrate sudden and extreme fear explosions. They are more likely to experience panic attacks while in public places. An individual with agoraphobia might sometime become depressed due to the severe limitations the disorder places in their lives. Other considerable diagnostic measures include having significant impairment or distress, and symptoms that continue for not less than six months (Comer, 2015).

What psychological model best explains the case of the symptoms/behaviors?

 Agoraphobia classical conditioning involves a learning process where two incidences that repeatedly happen close together are somehow tied together in the mind of an individual and therefore create a similar response. For instance, being in an enclosed place and being attacked are two events that happened together which eventually provoked the feeling of fear. The agoraphobia early theory perceived avoidance behavior as the accustomed response to fear. One popular model is the Mowrer two-factor theory that suggested that fear is initially obtained from a classical conditioning experience, then avoidance of or escape from the conditioned stimulus condition maintains the fear of safeguarding extinction of the response fear. Based on this view the fear of particular public places would initiate when some form of the aversive or noxious event takes place in that context and the individual became motivated to evade that specific situation as a result of their condition response to fear (Hazlett-Stevens, 2016).

Based on this model explain a possible treatment plan, including some ways the character can modify the stress and reduce anxiety (cope)?

Clinicians have made very little effect on agoraphobia. Nevertheless, approaches have currently been developed that permit many individuals with agoraphobia to venture out with minimal anxiety. There are new approaches that provide considerable relief to agoraphobia. Some of these approaches include exposure therapy. Extra features in exposure therapy specifically include the application of home-based self-help programs and support groups to encourage clients to add their effort to their treatment. In the support group approach, a minute group of individuals with agoraphobia goes out together for session exposure that lasts for some hours. The support of group members and encourage one another and ultimately coax each other to move away from the group safety and conduct exposure activities on their own. In the self-help, home-based programs clinicians grant clients and their families comprehensive instructions to conduct exposure treatments (Comer, 2015). When agoraphobia is characterized by a panic attack, cognitive-behavioral therapy (CBT) needs to be considered. CBT engages in enhancing the skills development in behavioral exposure and cognitive restructuring to lower panic anxiety and confront underlying fears. It characteristically engages group sessions of 10 to 15 persons that might include self-monitoring, psychoeducation, cognitive restructuring, and relaxation training. Treatment outcome and duration depend on symptom severity, biological or psychological comorbidities, patient treatment resistance, skill maintenance, aptitude to master the CBT concept, and competence of the treatment provider (Aslam, 2012).

Conclusion

Helen experienced the development of agoraphobia following a direct attack from one of her past patients. This made her isolate herself from the public and employ high-security measures to avoid attacks. However, she still needed to engage in serial killing incidences that exposes her to the things she was fearing. Eventually, the panic attack forced her to employ excessive self-protection measures, killing an arrested suspect. Hellen’s situation was initiated by a situation that needed to be treated to be able to overcome the aspects that trigger fear.

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