In the case of Sarah it would appear that she might be suffering from a panic disorder with agoraphobia, which is characterised, by panic attacks and avoidance of open or public places. It is categorised within the DSM-IV as suffering recurrent panic attacks and also being deeply concerned and embarrassed about any future attacks, and that these attacks are not substance induced. The agoraphobia causes Sarah to suffer severe anxiety about being in a situation that may be difficult to escape; and the anxiety attacks Sarah suffers cause her intense fear and discomfort.
It begins with feelings of anxiety and then dizziness; Sarah is then consumed by the thought of either fainting or even having a heart attack meaning that she may also suffer heart palpitations or an accelerated heart rate in these attacks. Sarah resorts to preventing the risk by staying at home and avoiding the situation altogether. Panic disorder with agoraphobia differs from schizophrenia; Schizophrenia is characterized by disruption in cognition and emotion affecting the language, thought, perception, affect, and sense of self.
This array of symptoms, while wide ranging, can also include psychotic manifestations, such as hearing internal voices or experiencing other sensations not connected to an obvious source (hallucinations) and assigning unusual significance or meaning to normal events or holding fixed false personal beliefs (delusions). Both disorders result in abnormal behaviour but the panic disorder with agoraphobia occurs in a certain given situation, whereas the disorder schizophrenia is messages interpreted by the brain as voices or instructions.
Which can occur for no reason at all, other than the psychotic manifestations. There is no embarrassment felt with schizophrenia as they can consider the behaviour normal whilst deluded, however sufferers of the panic disorder with agoraphobia are constantly conscious of the abnormal behaviour that they display. Biomedical (Biological) Approach This approach has been devised upon the evidence of genetic factors within the development of Twins with phobias. Where panic disorder with agoraphobia is concerned Harris et al.
(1983) discovered that close relatives of agoraphobic clients were more likely to also suffer from agoraphobia than the close relatives of the non-anxious individuals. Noyes et al. (1986) discovered that 12% of relatives of agoraphobics had also suffered agoraphobia, and 17% of them also suffered with panic disorder. In the case of Sarah it is not known of any other family other than her husband, so without the full family history it is difficult to establish if this disorder is genetically based.
With the findings of the biomedical approach it is also difficult to decide whether these disorder symptoms are just imitation or actually genetically inherited. It could be considered that Sarah may have a high level of physiological arousal making her more vulnerable to such a phobia as agoraphobia, or even that the phobia has increased her arousal. The only reliable findings within the biomedical approach is that there is an increase in heart and respiratory rate which Sarah has displayed, thus suffering with a panic attack, but these findings only support a cognitive rather than a physiological account of panic disorder with agoraphobia.