PSY 3500 Module 3 Sample Paper

Differential Diagnosis in a Composite Adult Case Presenting With Recurrent Unexpected Panic Attacks

Student Name

Thomas Edison State University

PSY-3500: Abnormal Psychology

Module 3 Written Assignment

Mentor Name

March 3, 2026

What this page is doingThe title states the genre, the population and the presenting feature, which is what a case analysis title is for. Writing composite into the title is a small honesty move with real weight: it tells the reader at the door that no real person is described, so no sentence later has to carry that disclaimer. Naming the presenting feature rather than the eventual diagnosis also signals that the paper reasons toward a conclusion instead of announcing one and gathering support for it.

Case Presentation

Ms. T is a composite adult constructed for this paper from the presentation patterns described in the diagnostic literature; she is not a real person and no real record has been de identified. She is 38, works as an accounts payable specialist, and lives with a partner and two school age children. She sought an evaluation at a primary care practice seven months after the first of a series of episodes. The first began without warning while she was driving on an interstate at midday: an abrupt surge of pounding heartbeat, shortness of breath, chest tightness, dizziness, tingling in both hands, and a strong fear that she was losing control. The surge peaked within about five minutes and eased over the next half hour.

Eleven further episodes have occurred in the past three months, an average of close to four a month. Four of those episodes had no identifiable cue: two happened while she was sitting at home in the evening, one while she was asleep and woke her, and one at her desk during routine work. Between episodes she reports near daily concern that another will come, and she checks her pulse several times a day. She now avoids interstate driving entirely, taking surface roads that add about 25 minutes to each direction of her commute, and she has declined two work trips that would have required highway travel. Her partner reports that she asks for reassurance about her heart most evenings.

Two emergency department visits during the seven month period produced normal findings: electrocardiogram without arrhythmia, negative troponin, unremarkable complete blood count, and thyroid stimulating hormone at 1.8 mIU/L. She takes no stimulant medication and no over the counter decongestants. Caffeine intake reached roughly 500 mg a day at its peak and has since been reduced to about 200 mg, with no change in episode frequency. An alcohol screening returned a score of 1, and she reports no cannabis or other substance use. On brief self report measures administered at intake she scored 13 on the GAD-7, in the moderate range, and 8 on the PHQ-9, in the mild range, with sleep averaging five and a half hours a night.

What this page is doingThe case sheet gives every fact the later reasoning will use, and gives it in numbers where numbers exist: eleven episodes in three months, four of them uncued, 25 added minutes each way, a thyroid value, two screening scores. Rubric rows on case description are usually written around completeness and specificity, and a description that says she has frequent attacks and feels anxious cannot support a differential later. Note also that the medical and substance information appears here, before any criterion is applied.

Applying the Diagnostic Criteria

Criterion A for panic disorder requires recurrent unexpected panic attacks, where an attack is an abrupt surge of intense fear or discomfort that reaches a peak within minutes and carries at least four of thirteen listed symptoms (American Psychiatric Association, 2022). The described episodes meet the symptom count with six: palpitations, shortness of breath, chest discomfort, dizziness, paresthesias, and fear of losing control. They meet the abruptness and peak timing requirements as described. The word unexpected does the heavy lifting in this criterion, and the four uncued episodes, including one that woke her from sleep, are what satisfy it. Attacks that occur only in an anticipated situation would not.

Criterion B asks whether at least one attack has been followed by a month or more of persistent concern about further attacks or their consequences, or of significant maladaptive change in behavior connected to the attacks. Both limbs are present here across a seven month course rather than one. The near daily worry and the repeated pulse checking speak to the first limb; the abandonment of highway driving, the added 50 minutes of daily commuting, and two declined work trips speak to the second. Recording the behavioral change in measurable terms matters, because a criterion phrased as significant change is only demonstrated when the change is described concretely enough for another reader to weigh it.

Criteria C and D are exclusions rather than confirmations, and they are where a case analysis earns or loses its credibility. Criterion C requires that the episodes not be attributable to the physiological effects of a substance or another medical condition. Criterion D requires that they not be better explained by another mental disorder. Neither can be settled by asserting that the presentation looks like panic disorder; each requires that the plausible alternatives be named and then set aside for a stated reason. The next section takes the six alternatives that the record in this case makes live, and gives the reason for setting each of them aside or keeping it open.

What this page is doingCriteria are taken one at a time and matched to specific facts, which is the difference between applying a manual and gesturing at it. The symptom count is stated as six of the thirteen listed, not as enough symptoms. Criterion B is answered on both limbs with the worry and the behavior change separated. Most marks in a criteria section are lost by treating the exclusion criteria as formalities, and this sheet ends by refusing to do that and setting up the differential instead.

Differential Reasoning

The medical alternatives come first because they carry the greatest cost if missed. Cardiac arrhythmia and hyperthyroidism both produce palpitations, breathlessness and a sense of dread, and both are ruled in or out by ordinary testing rather than by interview. The two emergency department workups, with a normal electrocardiogram, negative troponin and a thyroid stimulating hormone of 1.8 mIU/L, address them within the limits of what a single point in time can show. A substance related explanation is also live: caffeine at 500 mg a day is enough to produce anxiety symptoms in some adults. The episodes continued unchanged after intake dropped to 200 mg, and several occurred more than twelve hours after the last cup, so the timing does not fit a caffeine induced disorder.

Among the anxiety disorders, three alternatives deserve a stated answer. Generalized anxiety disorder is suggested by a GAD-7 of 13, but the content of the worry decides the question rather than the score: her worry is tied to the attacks and to what they might mean about her heart, not spread across finances, health of family members, work performance and daily obligations. Social anxiety disorder would predict attacks cued by scrutiny, and hers occur alone in a car and in sleep. Specific phobia of driving would account for the highway episodes but not for the one that woke her. A screening score is a flag, not a diagnosis, and here it points to a symptom the diagnosis already contains.

Agoraphobia is coded separately from panic disorder and requires marked fear or avoidance in at least two of five situation types, such as public transportation, open spaces, enclosed places, lines or crowds, and being outside the home alone. The described avoidance is confined to one situation, highway driving, while she continues to shop, ride a bus, stand in lines and stay home alone without fear, so the second diagnosis is not supported on this record. A depressive disorder is the last alternative worth naming. The PHQ-9 of 8 and the short sleep are real, but there is no reported period of 14 consecutive days of low mood or loss of interest, and the low mood she describes follows the attacks rather than preceding them.

What this page is doingThe differential is ordered by consequence, with the medical alternatives first because a missed arrhythmia costs more than a mislabeled anxiety disorder. Each alternative is then closed with a fact rather than an opinion: the timing of the caffeine reduction, the content of the worry, the location and sleep onset of the uncued episodes, the number of feared situation types. The line about the screening score is the sentence graders look for, because it shows the writer knows what a measure can and cannot decide.

Formulation and the Limits of a Composite Record

On the record as described, the presentation is consistent with panic disorder: recurrent unexpected attacks meeting the symptom threshold, more than a month of persistent concern and of behavior change tied to the attacks, no substance or medical explanation supported by the available testing, and no other disorder that accounts for the uncued episodes. Agoraphobia is not supported as a second diagnosis at present, and the mild depressive symptoms are better read as a consequence of the attacks and the restricted routine than as an independent episode. Panic disorder is not rare, with 12 month prevalence estimated at roughly 2 to 3 percent of adults in large national surveys (Kessler et al., 2005).

Three limits belong on the face of this analysis. The case is a composite written for coursework, so it contains only the information the writer chose to include, and a real evaluation would test the same criteria against a longer history, collateral report and repeated observation. Structured interviewing and repeated measurement over months carry weight that a single narrative cannot (Craske & Barlow, 2014). A written exercise of this kind also produces no clinical recommendation: diagnosis and any decision about care belong to a licensed clinician working directly with the person, and nothing in this paper is guidance for a reader who recognizes their own symptoms in the description. Naming what the record cannot settle is part of the analysis, not an apology for it.

What this page is doingThe closing sheet does three things at once: it states the conclusion in criterion language, it disposes of the two secondary questions of agoraphobia and depressed mood, and it names the limits of a composite record. The final sentences also draw the boundary that psychology coursework has to draw, keeping the paper an academic exercise rather than advice to a reader. Writers who skip that boundary sentence often drift into recommending care, which no case analysis is positioned to do.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). https://doi.org/10.1037/0000165-000

Craske, M. G., & Barlow, D. H. (2014). Panic disorder and agoraphobia. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (5th ed., pp. 1-61). Guilford Press.

Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617-627. https://doi.org/10.1001/archpsyc.62.6.617

National Institute of Mental Health. (2023). Panic disorder. U.S. Department of Health and Human Services. https://www.nimh.nih.gov/health/statistics/panic-disorder

Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092-1097. https://doi.org/10.1001/archinte.166.10.1092

How this PSY 3500 Module 3 example is structured

Thomas Edison State University publishes no module by module deliverable names, so this PSY 3500 Module 3 example follows the genre this point in an upper level undergraduate course almost always wants: in many sections this module asks for a written case analysis that applies diagnostic criteria to a described presentation, and your course instructions and rubric decide the exact form. The paper runs in four sections. The case is presented first and in full, because criteria cannot be applied to facts the reader has not been given. The criteria are then walked one at a time, with the exclusion criteria flagged rather than assumed. The differential section names the alternatives and the reason each is set aside. The last section states the formulation and the limits of a composite record.

PSY-3500 Module 3 questions, answered

What does PSY 3500 Module 3 usually ask for?

Thomas Edison State University does not publish a module by module deliverable list, so the form varies by section. In many sections this module asks for a written case analysis that applies current diagnostic criteria to a described presentation and reasons through the alternatives. Your course instructions and rubric decide the exact form, including case length, citation style and whether a composite is supplied.

How do I cite the DSM-5-TR in APA 7?

Treat it as an authored reference work with the American Psychiatric Association as author, the 2022 date, the title in italics, and the edition and text revision noted in parentheses. Include the DOI the publisher assigns. In text, use the full association name at first mention with an abbreviation in brackets, then the abbreviation afterwards.

How much differential reasoning does a case analysis need?

Enough to close every alternative a reader would raise from the facts you gave. A workable habit is to name the medical and substance explanations first, then the disorders that share the main symptom, then any second diagnosis the case might also carry. Each one gets a fact from the record as its answer, not a general statement about the disorder.

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PSY 3500 Module 3: sample paper, in real form