Provide a brief overview of the case, along with introduction. Also
discuss biological, psychological, and social factors involved in this case.
Case Study: Taylor Experiences Cardiovascular Disease, Job and Family Stress, and Type A Personality (Biopsychosocial)
Taylor is a 60-year-old biracial male of African American and Korean heritage who works as a trial lawyer. Taylor has been divorced from his wife for the past three years following a highly contentious settlement
and has one adult son who is married with two children.
Presenting Problem: Taylor recently experienced a cardiac arrest after a longstanding history of hypertension. He smokes a pack of cigarettes a day, exercises rarely, and works long hours in a high-stress job. His father died of a heart attack in his fifties, and cardiovascular disease is rampant throughout his paternal family history. Taylor’s cardiologist has recommended that he make significant lifestyle and behavioral changes to maximize his opportunities for medical rehabilitation.
Biological Factors: Taylor’s extensive family history of cardiovascular disease and his African American ethnicity clearly place him at increased risk for hypertension and heart attack. Taylor’s cigarette smoking, lack of exercise, and stressful work likely exacerbate his medical condition.
Psychological Factors: Taylor manifests the classic Type A personality as a hard driving,competitive, high-achieving, aggressive,time-urgent individual. The Type A personality is associated with cardiovascular disease, as are high-stress jobs and lifestyles. Thus, Taylor’s personality, stressful work, and personal life may be contributing to his health problems. Finally, his smoking and lack of exercise further reflect his tension and poor health.
Social Factors: Taylor’s recent divorce and lack of social life outside his work contribute to his high stress level and lack of support.Taylor’s biracial ethnicity has prompted him to feel the need to perform exceptionally well in order to succeed as an ethnic minority in the field of law. Finally, Taylor has identified more strongly with his mother’s Korean ancestry and traditions, which were actively integrated into the home, and yet has ultimately felt conflicted and alienated from both heritages given his dominantly African American appearance and love for his father as well.
Biopsychosocial Formulation and Plan:
In addition to the regimen of medication and follow-up prescribed by his physician, Taylor would benefit from a number of other interventions as well. While his physician has told him to ‘‘stop smoking and start exercising,’’ behavior and lifestyle are exceedingly difficult to change, and Taylor may well benefit from psychological consultation to develop a smoking cessation and exercise program. Cognitive-behavioral, group, and medical (e.g., nicotine patch, nicotine gum) interventions may be combined to assist with smoking cessation, while a behavioral program may be developed in conjunction with an exercise physiologist to develop a gradual build-up in exercise. Psychological intervention would also be useful in contending with Taylor’s Type A personality and response to the considerable work and personal stressors in his life, such as cognitive-behavioral, psychoeducational, and supportive techniques. Finally, Taylor may benefit from increased social support. Consultation regarding his family relationships, ethnic attitudes and identities, and leisure needs could be beneficial.