Near the beginning of Jerome’s junior year of college, he experienced a very frightening incident. He had left his history class and was walking back to his dorm when his heart suddenly started racing and his chest tightened. Jerome found it hard to breathe and began sweating and trembling. He assumed he was having a heart attack and thought he might die. He made it back to his room and collapsed on the floor, gasping for air. After a few terrifying minutes, the sensations stopped, and his breathing returned to normal. The ordeal left Jerome confused and frightened. He became even more worried after having several more, similar episodes during the rest of the semester. Over winter break, Jerome stayed with his parents and visited with his aunt and uncle as well. They were all concerned, and since both of Jerome’s grandfathers had died of heart attacks, his family urged him to be evaluated. Jerome visited his family doctor, only to be told he was in perfect health and that his heart showed no signs of trouble. He received a referral to a cardiologist, who told him the same thing. Rather than reassure him, the doctors’ diagnoses made him feel even more anxious. He constantly worried that he might die or that he might lose control of his body when the next episode hit, and he’d be horribly embarrassed. Unfortunately, Jerome could never predict when these episodes would happen, so he felt as if he couldn’t protect himself from such embarrassment. They occurred at any time and in various settings and circumstances. One of the worst, according to Jerome, happened when he was on a date. His date became frightened, and they’ve had little contact since. The only place Jerome hasn’t had an episode is in his room. According to Jerome’s friends, these attacks have had a major impact on his life. He was once very sociable, but he now prefers to keep to himself. Throughout the rest of Jerome’s junior year, his friends gradually saw him less and less frequently. He declined social invitations, rarely had friends over, and never seemed to want to see a movie or hang out. These days, he absolutely refuses to go any place where there might be a more than a few people, citing his intense anxiety about being unable to escape large gatherings. In fact, he hardly ever leaves his room because he fears venturing out on his own.The changes in Jerome’s behavior have made it very difficult for him to keep up with his studies. His friends report that he hasn’t attended class in weeks and was visibly intoxicated the last time he showed up. When confronted, Jerome said that he’d only had a few drinks to calm his nerves. His parents and friends have grown increasingly concerned about his drinking. On the rare occasions when he ventures out of his room, he’s usually moderately to severely intoxicated. Unfortunately, his drinking seems to provide little actual relief. He still has episodes of terror when he feels as if he’s having a heart attack, and he constantly worries about when the next episode will occur. 1. Jerome's condition has produced many changes in his behavior. One change in Jerome's life has been the amount of time he spends in his room.Some of the symptoms associated with various psychological disorders are summarized as follows. Indicate which symptoms are clearly present in Jerome's case.
a. Finds it difficult to control excessive worry about everyday events unrelated to a specific trauma or stimulus
b. Avoids situations where he would be seen by others
c. Experiences recurrent and persistent thoughts or repetitive behaviors
d. Thoughts of being outside the home provoke anxiety or fear