PSY 210- Abnormal Psychology<\/p>\n
Case Study Assignment
\n20 points
\nNEW Due date: April 10th
\nYou will select and review ONE case study provided in this packet. You will be
\nresponsible for reviewing the case and assigning multi-axial diagnoses. You will
\nalso be responsible for providing a rationale for the diagnoses, as well as a
\ndiscussion of rule outs, differential diagnoses, and prognosis. This assignment
\nshould be 2-3 pages in length (typed, double-spaced, one inch margins). Please
\nreview the complete hand out included in the course syllabus for additional
\ninstructions.
\nCase Summary #1
\nRobin Henderson is a 30-year-old married Caucasian woman with no children
\nwho lives in a middle-class urban area with her husband. Robin was referred to a
\nclinical psychologist by her psychiatrist. The psychiatrist has been treating Robin
\nfor more than 18 months with primarily anti-depressant medication. During this
\ntime, Robin has been hospitalized at least 10 times (one hospitalization lasted 6
\nmonths) for treatment of suicidal ideation (and one near lethal attempt) and
\nnumerous instances of suicidal gestures, including at least 10 instances of drinking
\nClorox bleach and self-inflicting multiple cuts and burns.
\nRobin was accompanied by her husband to the first meeting with the clinical
\npsychologist. Her husband stated that both he and the patient\u2019s family considered
\nRobin \u201ctoo dangerous\u201d to be outside a hospital setting. Consequently, he and her
\nfamily were seriously discussing the possibility of long-term inpatient care.
\nHowever, Robin expressed a strong preference for outpatient treatment, although
\nno therapist had agreed to accept Robin as an outpatient client. The clinical
\npsychologist agreed to accept Robin into therapy, as long as she was committed to
\nworking toward behavioral change and stay in treatment for at least 1 year. This
\nagreement also included Robin contracting for safety- agreeing she would not
\nattempt suicide.
\nClinical History
\nRobin was raised as an only child. Both her father (who worked as a salesman)
\nand her mother had a history of alcohol abuse and depression. Robin disclosed in
\ntherapy that she had experienced severe physical abuse by her mother throughout
\nchildhood. When Robin was 5, her father began sexually abusing her. Although
\nthe sexual abuse had been non-violent for the first several years, her father\u2019s sexual
\nadvances became physically abusive when Robin was about 12 years-old. This
\nabuse continued through Robin\u2019s first years of high school.
\nBeginning at age 14, Robin began having difficulties with alcohol abuse and
\nbulimia nervosa. In fact, Robin met her husband at an A.A (Alcoholics
\nAnonymous) meeting while she was attending college. Robin continued to display
\nbinge-drinking behavior at an intermittent frequency and often engaged in
\nrestricted food intake with consequent eating binges. Despite these behaviors,
\nRobin was able to function well in work and school settings, until the age of 27.
\nShe had earned her college degree and completed 2 years of medical school.
\nHowever, during her second year of medical school, a classmate that Robin barely
\nknew committed suicide. Robin reported that when she heard of the suicide, she
\ndecided to kill herself as well. Robin displayed very little insight as to why the
\nsituation had provoked her inclination to kill herself. Within weeks, Robin
\ndropped out of medical school and became severely depressed and actively
\nsuicidal.
\nA certain chain of events seemed to precede Robin\u2019s suicidal behavior. This chain
\nbegan with an interpersonal encounter, usually with her husband, which caused
\nRobin to feel threatened, criticized or unloved (usually with no clear or objective
\nbasis for this perception. These feelings were followed by urges to either self mutilate or kill herself. Robin\u2019s decision to self-mutilate or attempt suicide were
\noften done out of spite- accompanied by the thought, \u201cI\u2019ll show you.\u201d Robin\u2019s self injurious behaviors appeared to be attention-seeking. Once Robin burned her leg
\nvery deeply and filled the area with dirt to convince the doctor that she needed
\nmedical attention- she required reconstructive surgery.
\nAlthough she had been able to function competently in school and at work,
\nRobin\u2019s interpersonal behavior was erratic and unstable; she would quickly and
\nwithout reason, fluctuate from one extreme to the other. Robin\u2019s behavior was
\nvery inconsistent- she would behave appropriately at times, well mannered and
\nreasonable and at other times she seemed irrational and enraged, often verbally
\nberating her friends. Afterwards she would become worried that she had
\npermanently alienated them. Robin would frantically do something kind for her
\nfriends in an attempt to bring them emotionally closer to her. When friends or
\nfamily tried to distance themselves from her, Robin would threaten suicide to keep
\nthem from leaving her.
\nDuring the course of treatment, Robin\u2019s husband reported that he could not take
\nher suicidal and erratic behavior any longer. Robin\u2019s husband filed for divorce
\nshortly after her treatment began. Robin began binge drinking and taking illegal
\npain medication. Robin reported suicidal ideation and feeling of worthlessness.
\nRobin displayed signs of improvement during therapy, but this ended in her 14
\nmonth of treatment when she committed suicide by consuming an overdose of
\nprescription medication and alcohol.
\nCase Summary #2
\nAt the time of his admission to the psychiatric hospital, Carl Landau was a 19-
\nyear-old single African American male. Carl was a college freshman majoring in
\nphilosophy who had withdrawn from school because of his incapacitating
\nsymptoms and behaviors. He had an 8-year history of emotional and behavioral
\nproblems that had become increasingly severe, including excessive washing and
\nshowering; ceremonial rituals for dressing and studying; compulsive placement of
\nany objects he handled; grotesque hissing, coughing, and head tossing while
\neating; and shuffling and wiping his feet while walking.
\nThese behaviors interfered with every aspect of his daily functioning. Carl had
\nsteadily deteriorated over the past 2 years. He had isolated himself from his friends
\nand family, refused meals, and neglected his personal appearance. His hair was
\nvery long, as he had refused to have it cut in 5 years. He had never shaved or
\ntrimmed hi beard. When Carl walked, he shuffled and took small steps on his toes
\nwhile continually looking back, checking and rechecking. On occasion, he would
\nrun in place. Carl had withdrawn his left arm completely from his shirt sleeve, as if
\nit was injured and his shirt was a sling.
\nSeven weeks prior to his admission to the hospital, Carl\u2019s behaviors had become so
\ntime-consuming and debilitating that he refused to engage in any personal hygiene
\nfor fear that grooming and cleaning would interfere with his studying. Although
\nCarl had previously showered almost continuously, at this time he did not shower
\nat all. He stopped washing his hair, brushing his teeth and changing his clothes.
\nHe left his bedroom infrequently, and he had begun defecating on paper towels
\nand urinating in paper cups while in his bedroom, he would store the waste in the
\ncorner of his closet. His eating habits degenerated from eating with the family, to
\neating in the adjacent room, to eating in his room. In the 2 months prior to his
\nadmission, Carl had lost 20 pounds and would only eat late at night, when others
\nwere asleep. He felt eating was \u201cbarbaric\u201d and his eating rituals consisted of
\nhissing noises, coughs and hacks, and severe head tossing. His food intake had
\nbeen narrowed to peanut butter, or a combination of ice cream, sugar, cocoa and
\nmayonnaise. Carl did not eat several foods (e.g., cola, beef, and butter) because he
\nfelt they contained diseases and germs that were poisonous. In addition, he was
\npreoccupied with the placement of objects. Excessive time was spent ensuring
\nthat wastebaskets and curtains were in the proper places. These preoccupations
\nhad progressed to tilting of wastebaskets and twisting of curtains, which Carl
\nperiodically checked throughout the day. These behaviors were associated with
\ndistressing thoughts that he could not get out of his mind, unless he engaged in
\nthese actions.
\nCarl reported that some of his rituals while eating were attempts to reduce the
\nprobability of being contaminated or poisoned. For example, the loud hissing
\nsounds and coughing before he out the food in his mouth were part of his attempts
\nto exhale all of the air from his system, thereby allowing the food that he
\nswallowed to enter an air-free and sterile environment (his stomach) Carl realized
\nthat this was not rational, but was strongly driven by the idea of reducing any
\nchance of contamination. This belief also motivated Carl to stop showering and
\nusing the bathroom. Carl feared that he may nick himself while shaving, which
\nwould allow contaminants (that might kill him) to enter his body.
\nThe placements of objects in a certain way (waste basket, curtains, shirt sleeve)
\nwere all methods to protect him and his family from some future catastrophe such
\nas contracting AIDS. The ore Carl tried to dismiss these thoughts or resist
\nengaging in a problem behavior, the more distressing his thoughts became.
\nClinical History
\nCarl was raised in a very caring family consisting of himself, a younger brother, his
\nmother, and his father who was a minister at a local church. Carl was quiet and
\nwithdrawn and only had a few friends. Nevertheless, he did very well in school
\nand was functioning reasonably well until the seventh grade, when he became the
\nobject of jokes and ridicule by a group of students in his class. Under their
\nconstant harassment, Carl began experiencing emotional distress, and many of his
\nproblem behaviors emerged. Although he performed very well academically
\nthroughout high school, Carl began to deteriorate to the point that he often
\nmissed school and went from having few friends to no friends. Increasingly, Carl
\nstarted withdrawing to his bedroom to engage in problem behaviors described
\npreviously. This marked deterioration in Carl\u2019s behavior prompted his parents to
\nbring him into treatment.
\nCase Summary #3
\nAt the time of his admission to a private psychiatric hospital, Sonny Ford was a
\n24-year-old single Latino male who lived with his adoptive parents. Sonny had
\nbeen referred for hospital admission by his outpatient psychotherapist. Over the
\npast 2 years, Sonny had struggled with symptoms such as concentration
\ndifficulties, anxiety, and obsessional thinking. More significantly, within the year
\nprior to his admission, Sonny began to experience paranoid and delusional
\nthoughts that had become quite persistent. These difficulties began after Sonny
\nsmoked marijuana. While experiencing the effects of marijuana, Sonny believed
\nthat his mind had gone \u201cnumb.\u201d From that time on, Sonny believed that the
\nmarijuana had permanently \u201cwarped\u201d his brain. He became increasingly distressed
\nand frustrated over his inability to get others to agree that marijuana had this
\neffect on him. More recently, Sonny had developed concerns that the police and
\nFBI were \u201cout to get him.\u201d In addition, he had begun to feel that certain television
\nshows had special importance to him and important information was embedded
\nin these programs directed specifically at him. Sonny believed that these messages
\ncoming to him through the television were sent to remind him that he was at risk
\nfor some sort of plot by the authorities. Sonny also heard voices in his head.
\nAlthough he could not make out what they were saying, Sonny perceived the
\nvoices as \u201cangry\u201d and \u201ccritical.\u201d
\nOver the past few months, Sonny\u2019s symptoms had worsened to the point that they
\nwere interfering substantially with his attendance at work as a state office janitor.
\nBecause of these factors and the lack of improvement in outpatient counseling,
\nSonny was referred to this inpatient hospital.
\nAt the intake evaluation for his inpatient admission, Sonny\u2019s emotions were
\nrestricted. Although appearing tense and anxious, Sonny\u2019s face was mostly
\nimmobile for the duration of the interview. He engaged in very little eye contact
\nwith the interviewer and his body movements were agitated and restless, as
\nevidenced by rocking movements of his legs and body. His speech was hesitant
\nand deliberate, and he often answered the interviewer\u2019s questions with brief and
\nempty replies. For example, when the interviewer asked \u201cwhat difficulties are you
\nhaving that you would like help for?\u201d Sonny replied, \u201cI think it was the marijuana.\u201d
\nClinical History
\nSonny was adopted at birth, and no records were available about medical or
\npsychiatric history of his family origin. Sonny was raised in a household of four: in
\naddition to his parents, he had a sister 4 years older who had also been adopted.
\nHe could recall very few memories from his early childhood. However, Sonny said
\nthat throughout his life he had always been a loner who, to this day, never had any
\nfriends. Sonny\u2019s parents, who were present at the time of his admission to the
\nhospital, confirmed that Sonny had always been frustrated by social interactions
\nand added that their son had always been hypertensive to real or perceived
\ncriticism during his school years. Sonny was very attached to his father and, for
\nmay years, experienced considerable distress and loneliness when he was
\nseparated from the family\u2019s home or his father for extended periods. Whereas
\nSonny described his father as \u201ca very accepting person\u201d he claimed that his mother
\nwas \u201cexcessively critical and not accepting of me as a person.\u201d Sonny also claimed
\nthat his mother was an alcoholic, a statement that was not supported by either of
\nhis parents.
\nWhen Sonny was 16, he realized that he was homosexual. Although his father had
\nbeen accepting Sonny reported that his mother had been very unaccepting of his
\nhomosexuality and often referred to him with pejorative labels, such as \u201cfag.\u201d
\nWhile Sonny accepted his sexual orientation, he said that being gay had caused
\nhim many troubles one of which was loneliness. Many of Sonny\u2019s persistent and
\nobsessive thoughts focused on the possibility of contracting the HIV virus from
\nhaving unprotected sex on one occasion. Sonny\u2019s fears of having HIV had not been
\nquieted by the fact that the person with whom he had sex with was HIV negative
\nor by the fact the all of his recent HIV tests were also negative.
\nDespite lifelong difficulties with social adjustment, Sonny had been able to meet
\nmost of the demands and responsibilities of adolescence. Following his graduation
\nfrom high school (with a C+ average), sonny decided to attend a local college to
\ntake introductory courses. This decision was strongly influenced by his
\napprehension of moving out of his parent\u2019s house to attend school away from his
\nimmediate community. However, it was during his freshman year that Sonny had
\nsmoked the marijuana that he believed permanently damaged his brain. Following
\nthe incident, Sonny dropped out of college due to the worsening of behaviors.
\nSonny enrolled at a second college for only one semester before dropping out
\nagain, because of his inability to cope with sitting in crowded classrooms and
\ncompleting assignments and tests on time.
\nSonny has held his current position as a janitor for the last 18 months, in part
\nbecause this position allows him to work alone and does not require extensive
\nsocial interaction.<\/p>\n","protected":false},"excerpt":{"rendered":"
PSY 210- Abnormal Psychology Case Study Assignment 20 points NEW Due date: April 10th You will select and review ONE case study provided in this packet. You will be responsible for reviewing the case and assigning multi-axial diagnoses. You will also be responsible for providing a rationale for the diagnoses, as well as a discussion […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2230,2229,2225,2226,2223,2213,2224,2228,2072,2227],"tags":[2217,2204,2218,382,2215,2205,2216,2202,2203,2219],"class_list":["post-9196","post","type-post","status-publish","format-standard","hentry","category-australia-early-childhood-education-assessment-help","category-early-childhood-education-assessment-assignment-help-australia","category-early-childhood-education-education-academic-writing-assistance","category-education-dissertation-writing-service","category-education-essay-assignment-help-uk","category-education-homework-help-answers","category-education-teaching-essay-assignment-writing-help-uk","category-homework-help-with-my-education-assignments","category-professional-psychology-and-education-essay-paper-writers","category-write-my-education-thesis","tag-academic-writing-help","tag-assignment-help-education","tag-custom-education-essays","tag-dissertation-assistance","tag-homework-support-teaching","tag-learning-homework-help","tag-professional-essay-writers","tag-research-paper-service","tag-school-education-essay-writers","tag-teaching-assignment-assistance"],"_links":{"self":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/posts\/9196","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/comments?post=9196"}],"version-history":[{"count":0,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/posts\/9196\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/media?parent=9196"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/categories?post=9196"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/tags?post=9196"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}