An old version of the diagnostic section of the exam

Does this behavior qualify for any of the diagnoses we've discussed? If it doesn't, why? Which diagnosis fits this case best? Briefly justify your diagnosis. (4 pts each.)

1. Jarrell (28) wouldn't describe himself as any more "nervous" than his friends. However, he occasionally experiences something he initially thought of as a "heart attack." Out of the blue he will begin sweating and shaking, have severe chest pain and is dizzy. At first he thought he was going to die. Since his doctors have ruled out heart problems as well as mitrovalve prolapse and thyroid dysfunction, he just believes he is "going crazy." More and more he finds it difficult to leave his home -- he's recently lost his job as a result -- and will only do so with his mother or his girlfriend.

2. Karyn (14) has felt "out of sorts" for a long time. She had been outgoing and cheerful, but now describes herself as having "very poor self-esteem," no energy, and "I'm just hopeless about life." She still sleeps poorly, has a poor appetite, and has seen her grades drop from previously high levels. You're concerned and discover, on further questioning, that she doesn't remember any good periods lasting longer than a day or two since her parents' death four years ago.

3. Pablo (47) has come to see you at the Veteran's Hospital, complaining of problems that have been causing him a lot of problems at home. He has been having nightmares more often than not, often waking up screaming. He rarely sleeps through the night any more. He is very irritable and often gets into "unreasonable" arguments with family and friends. He often has distressing images of a child who he saw burned in a napalm attack. When asked, he admits that he tries not to think about Viet Nam and avoids anything that reminds him of it. (It was difficult for him to even come to the hospital today.) He admits that he has a difficult time getting close to others now, but doesn't see this as a problem because "I don't really think I will ever get married and don't expect to be around much longer."

4. Leesa's (24) twin brother died unexpectedly in February. Since then she has been crying frequently, has little appetite, and rarely sleeps through the night. She wonders how she can go on without "my best friend" and thinks about him "all the time when I don't think about dying myself." Her parents are worried about her and think that she is "falling apart." She used to be a happy-go-lucky person, but has lost her interest in most of her old life. She has lost her job, rarely gets out of bed before 3pm, is tired most of the time, and has stopped seeing most of her friends. She says, What's the use? When asked , she admits being suicidal most of the time, but wouldn't do it because "it would kill my parents to lose another child."