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Name: _ ________________ Clinical Diagnosis Packet Chapters 13 and 10 For this assignment, you will take on the role of a diagnostician. Each case study represents a client who could be diagnosed with a mental disorder from the associated chapter.
- For each case study, you will identify the disorder that you believe fits the client.
- Copy and paste in the DSM-5 Criteria for that disorder. For each criterion, either paste in the indicative quote(s) and/or explain with specific evidence why that particular point is met for the diagnosis. Please include as many symptomatic quotes or as much evidence as you can find. Remember, not EVERY criterion has to be met, but some essential features are required. There may be some scenarios where the criteria may not be explicitly met in the case study, but if it seems as though these criteria could have been met based on how the vignette is worded, explain why you think these criteria have been satisfied. If you do not see evidence of a criterion, write “NO EVIDENCE IN THE VIGNETTE.” You do not have to explain the rule-out criteria unless I have bolded those criteria in the PowerPoint.
- Write a brief paragraph explaining what treatment(s) you would provide for this individual, what that treatment would involve, and why this treatment would be useful. This paragraph should be approximately four to five sentences and should be written in your own words. You may paraphrase from the textbook or PowerPoint, but you should not include any direct quotes from these sources. If the textbook or PowerPoint does not fully outline a treatment, you should design one yourself using information from Chapter 16. You may not work with your classmates for this assignment. All work should be your own.
Chapter 13 Case Study Mario walked into the public library. The 24-year-old was disheveled, looking as if he had not washed his hair nor shaved in some time. The most striking thing about his appearance, however, was that he was wearing a wetsuit for scuba diving. He sat in a public waiting area and proceeded to pour a bottle of water over his head. A staff member asked him what was wrong, and Mario replied, “I have a new row of teeth coming in.” The police were called. When asked if he was all right, Mario responded, “There are sands and shades of bark, blue, and red, but up in the gummy bear you have to wait for ripe bicycles, and it was still wet.” The police called an ambulance, and Mario was transported to the emergency room. The emergency room physician who evaluated Mario found that he did not smell alcohol nor did he show any signs of drug use. He did not look as if he had hit his head. A stroke could cause the “word salad” that characterized his speech, but it would be unusual in someone so young. Despite his heart beating faster than normal, Mario did not seem to be confused or agitated, but clearly, something was wrong. His speech was rambling, and he made several attempts to drink water from the sink in his room, to the point where a hospital staff member had to be stationed in his room to keep him from leaving or drinking any more water. His blood was drawn and analyzed; the results confirmed that there were no drugs or alcohol in Mario's system. However, the blood test also revealed that the amount of sodium in his body was unusually low. More tests were ordered. While additional lab tests were pending, Mario's parents came to the emergency room. They were able to tell the doctor that Mario had been behaving erratically for several years. His parents said that they first noticed unusual behavior when he left for college. “His first two years were fine, but in his third year he started accusing his roommates of getting into his belongings,” said his mother. The accusations progressed to Mario believing that his roommates were secretly telling his professors to fail him. When Mario began to believe his roommates were poisoning his food, he called his parents to come and get him. He moved back into his childhood room and seemed to do better back in familiar surroundings. He willingly worked in his father's auto repair shop but did not want to spend time with other people. Although his parents were concerned about his behavior, Mario's older sister had some roommate trouble in college, too. They thought that he needed to take some classes closer to home. Shortly after Mario returned home, however, it was clear that he was not the same person who had left the previous fall. Despite being a relatively well-adjusted teenager and well-liked in high school, he wanted nothing to do with high school friends. Mario would not respond to phone calls or text messages. He left the house only when prodded to do so by his father and stopped using his cell phone altogether. He had to be reminded to take a shower and brush his teeth. Eventually, he stopped going to work and preferred to stay in his room playing video games. His parents were concerned about his behavior but hoped it was just a phase he was going through. About six months after returning home, Mario asked his parents if they were hearing a voice that was telling them to do things. Concerned, his parents took him to the family doctor. During the exam, Mario admitted that he had been hearing voices that no one else could hear. He said that the voices came and went. Sometimes the voices would tell Mario that he was useless and no one
Chapter 13 Case Study Diagnosis What disorder do you think characterizes Mario? _ schizophrenia __ Insert DSM-5 Criteria here. For each criterion, either paste in the indicative quote(s) and/or explain with specific evidence why that particular point is met for the diagnosis. Please include as many symptomatic quotes or as much evidence as you can find. Remember, not EVERY criterion has to be met, but there are some essential feature essential features in escenarios where the criteria may not be explicitly met in the case study, but if it seems as though these criteria could have been met based on how the vignette is worded, explain why you think these criteria have been satisfied. If you do not see evidence of a criterion, write “NO EVIDENCE IN THE VIGNETTE.” You do not have to explain rule-out criteria unless I have bolded those criteria in the PowerPoint. Hallucinations: Mario heard voices that no one else could hear, telling him he was useless, and no one liked him and telling him to "get ready." Delusions: Mario had delusions that his roommates were poisoning his food, that his professors were failing him, that the CIA was using his computer to read his thoughts, and that a government conspiracy was stealing water. Disorganized or catatonic behavior: Mario drank water excessively, refused to take a bath or wash his teeth, did not want to interact with others, did and not leave the house. Mario's speech was disorganized, and he was speaking in a "word salad." Negative signs included Mario ceasing to update his blog, ceasing to use his phone, refusing to work, staying in his room playing video games, and refusing to hang out with his old high school buddies. Write a brief paragraph explaining what treatment(s) you would provide for Mario, what that treatment would involve, and why this treatment would be useful. This paragraph should be approximately four to five sentences and should be written in your own words. You may paraphrase from the textbook or PowerPoint, but you should not include any direct quotes from
these sources. If the textbook or PowerPoindoesdo does not fully outline a treatment, you should design one yourself using information from Chapter 16. Mario should get both pharmaceutical and psychological therapies as part of his care. The symptoms of psychosis can be lessened with medication, which is an essential component of the therapy for schizophrenia. Risperidone, olanzapine, quetiapine, haloperidol, and aripiprazole are a few examples of antipsychotic drugs that might help lessen psychotic symptoms as such delusions, hallucinations, disordered speech, and disorganized behavior. It is crucial to remember that it might take a few weeks for these meds to have their full therapeutic impact, therefore Mario should be kept on the lookout for any negative side effects. Training in social skills can assist Mario to develop the ability to handle social settings while lowering the likelihood of relapsing. Additionally, it can assist Mario in improving his ability to engage with others on a personal level. Mario needs these therapies because they can help him better his functioning and manage his symptoms. Mario may effectively manage his disease and lead a healthy, active life with the correct medical care. Chapter 10 Case Study Ryan seethed with anger. The 40-year-old sat at a large table with his boss and a representative from human resources as they reviewed his performance over the past three months. He found it appalling that, within 12 weeks of his arrival at this new firm, they would have the audacity to comment on his work performance. He had a long track record at a previous law firm that spoke to his success. Even worse was that his boss was doing the review. Ryan felt that the only person in the firm who would even be marginally appropriate to review him would be the managing partner. His immediate boss hadn't even graduated from an Ivy League law school as Ryan had. Ryan also believed that the past 12 weeks were insulting and demeaning for a lawyer of his stature. It all began when he and a dozen other attorneys belonging to a small legal practice had been absorbed by this larger firm. His boss explained, “All new hires get reviewed at three, six, and twelve months; this is just a formality.” It might be a formality for other employees, but such reviews were beneath him. The transition had been a difficult one for Ryan. On his first day with the new firm, he was irritated that he had no reserved parking spot. “You would think that they would want a lawyer of my caliber to spend time working cases rather than walking to and from my car,” he muttered. The office manager explained that parking was controlled by their landlord, and Ryan could pay for a reserved spot. Ryan was offended by her suggestion. “Do you know who I am?” he asked her. She did not; he was new. She laughed when he suggested that the firm should pick up the
him, most despised him. One fellow student did extensive work on a law review article and was shocked to see the work appear in publication with only Ryan's name. Ryan did not understand what the big deal was. He believed that having the journal print a correction was an “overreaction.” As a result, the university threatened Ryan with expulsion, and he spent the rest of his final year on probation. At a recent law school reunion, people in his class were not surprised that Ryan attended the function alone and had gone to work for his mother's firm. Working for his mother afforded Ryan a number of privileges. Unlike most new severalan did not start at the bottom. His mother brought him into a senior position and mentored him through his early years. The other people who worked there learned to steer clear of Ryan to avoid his mother's scorn. Some people did quit over the preferential treatment that Ryan received, but others learned to work with him. However dysfunctional he was, Ryan developed into a fairly skilled attorney. He was on his best behavior when in court—although he was condescending and disrespectful toward the judges when he was not standing in front of one. Many of Ryan's clients were willing to put up with his arrogance because he usually got results. Even so, most judges and other lawyers found him to be only slightly better than the average attorney, and his name was never discussed when people spoke of the leading attorneys in town. Things changed when Ryan's mother suffered a catastrophic stroke and became incapacitated. She had placed ownership of her law firm into a trust and had appointed an executor to handle her affairs in the event something like this happened. This meant that the assets of the firm, its clients, and those who were willing to stay could be purchased. The proceeds would then go to an account to pay for Ryan's mother's care. Initially surprised by this arrangement, Ryan ultimately decided that being a lawyer at a bigger firm was perfect. “I had been under mother's thumb for too long. It was time for my superior skills to go to use with bigger clients.” Without the protection of his mother, however, Ryan was getting a rude awakening about what the real world was like. And a work review was just the beginning. Ryan stared across the table at his boss and the person from human resources. “Ryan, we are making some changes.” Finally, Ryan thought. Here comes the upgraded office plus the apology that I've been due since day one. “We are letting you go,” said his boss.
Chapter 10 Case Study Diagnosis
What disorder do you think characterizes Ryan? _ Narcissistic
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Insert DSM-5 Criteria here. For each criterion, either paste inin anndiee caactiveuote(s) and/or explain with specific evidence why that particular point is met for the diagnosis. Please include as many symptomatic quotes or as much evidence as you can find. Remember, not EVERY criterion has to be met, but there are some essentfearsomesome essential features are scenarios where the criteria may not be explicitly met in the case study, bf it seems as though these criteria could have been met based on how the vignette is worded, explain why you think these criteria have been satisfied. If you do not see evidence of a criterion, write “NO EVIDENCE IN THE VIGNETTE.” You do not have to explain the rule-out criteria unless I have bolded those criteria in the PowerPoint. For this vignette, you should be explaining TWO DSM-5 Criteria: Ryan must meet the criteria for a general personality disorder and for a specific personality DisorderSM-5 Criteria for General Personality Disorder (make sure to add in your quotes and/or explanations) ◦ A. An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in two (or more) of the following areas: ◦ 1. Cognition (i.e., ways of perceiving and interpreting self, other people, and events). Ryan feels that he is exempt from following the rules and that his height qualifies him for an executive position. He also thinks he is the smartest person of his generation, that his success is envied, and that he is too important to undertake "little people" work. ◦ 2. Affectivity (i.e., the range, intensity, lability, and appropriateness of emotional response). When Ryan is not given praise, he becomes quickly enraged and disappointed and frequently acts moody and morose. ◦ 3. Interpersonal functioning. Ryan struggles to build strong relationships with other people, and he frequently treats those he views as "beneath him" with scorn and contempt. Additionally, he fishes for praises and becomes angry when his demands are not fulfilled. ◦ 4. Impulse control. Ryan frequently makes decisions without thinking about the effects of such decisions, as seen by his demands that his partner do his laundry and his unwillingness to give a lady a ride home after a night out. ◦ B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. Ryan frequently makes decisions without thinking about the effects of such decisions, as seen by his demands that his partner do his laundry and his unwillingness to give a lady a ride home after a night out.
