Question

Specific phobia case: (illness phobia of HIV/Aids)

Michael was a 23-year-old final-year student nurse who lived at home with his parents. He developed a terrifying fear of ‘catching HIV’ and dying of Aids. He had intrusive unwanted thoughts and images when at work, that somehow the virus had entered his skin (although there were no cuts and he took appropriate precautions). He stated that when exposed to bloodrelated stimuli he felt very anxious, and his conviction in this belief that he was infected was 75 per cent, but afterwards he only believed it 15 per cent.

On occasions he has panicked and left the ward he was working on until his panic subdued, informing colleagues that he had a problem with asthma and nausea. His fears were worse at work, when giving blood, and in public toilets. He worried excessively about all physical feelings, which he believed were signs and symptoms of HIV/Aids. Because of his fears he constantly checked his whole body for any possible signs, read extensively about HIV/Aids and wore two or three pairs of protective gloves. He avoided all public toilets, thinking about his fears, and had begun to take time off work repeatedly. As a consequence of his time absent from work he was asked to an occupational health review but was considering leaving his training course.

In your opinion, what are the Personality information, Symptoms, Assessment methods, and Treatment. With explanation please.

Answer 1

This person is undergoing severe anxiety in context of his fear of HIV AIDS. The symptoms described are checking his whole body for any possible signs, reading extensively about HIV/Aids and wearing two or three pairs of protective gloves. He avoids all public toilets, thinking about his fears, and has begun to take time off work repeatedly. As a consequence of his time absent from work he was asked to an occupational health review but was considering leaving his training course. The concition that he has regarding his illness is closely related to psychosomatic symotoms. This means that physiologically, no symptoms are seen, however mentally the person continues to have a strong conviction of developing it despite little or no evidences in that regard. Psychosomatic means mind (psyche) and body (soma). A psychosomatic disorder is a disease which involves both mind and body. Some physical diseases are thought to be particularly prone to be made worse by mental factors such as stress and anxiety. There is a mental aspect to every physical disease. How we react to disease and how we cope with disease vary greatly from person to person. For example, the rash of psoriasis may not bother some people very much. However, the rash covering the same parts of the body in someone else may make them feel depressed and more ill. Psychosomatic assessment comprises of three major aspects: persistent somatization or the constant belief that the disease has affected the person in all its severity, allostatic overload (the wear and tear on the body" that accumulates as an individual is exposed to repeated or chronic stress) and phobic avoidance (the active evasion of feared items or scenarios by people with phobias- In this case the intentional leaving of the training course fearing donation of blood, using public toilets, etc.). Treatment methods could comprise of working on the thoughts by using CBT methods, using systematic desensitization to reduce the fear gradually, endorsing lifestyle changes for stress management, emotional supportive counseling, etc.