case study

Schizoid

Mark, a single 48 year old man, prefers to work the third shift as a word processor for a law firm. His co-workers see him as unwaveringly serious and cold. He does not participate in any social functions, and rarely speaks to any of them. He gives short answers to questions and is unlikely to participate in water cooler sessions.

Bipolar I Disorder

B is a 40-year old male from a wealthy background. He has a very close relationship with his mother, who struggles with depression. His father has no mental illness and denies that his son does. However, B describes severe episodes of mania, where he becomes involved in impulsive and excessive behaviours such as spending large sums of money or travelling to other countries. He also describes a manic thought pattern, characterised by an influx of ideas that he feels he must act upon. In contrast, B finds that once these episodes disperse he is left with feelings of depression, low self-esteem, and lack of energy.

Obsessive Compulsive Disorder

Bert is 40 years old and works on an assembly line in a brush factory. He is terribly afraid of being contaminated by germs. He avoids shaking hands with others. He won't eat in the cafeteria. He has trouble leaving the bathroom because he isn't sure he has washed his hands well enough.

Schizotypal

Cary believes that she is a clairvoyant and can "see" things that others cannot. Although she is an American born Caucasian, she speaks with a heavy West Indian accent. She also believes that she has the mental power to "change" things around her. These beliefs have isolated her from other people, who perceive her to be weird.

Dysthymic Disorder

For the past 3 years Stacy has become a shut-in. She has been in despair about her life and doesn't see any possibilities of it getting any better. She's ultimately given up on life.

Avoidant

Danielle appears to be very shy. She desires to be around people and have friends, but is afraid of being criticized. Although she would like to be involved in a relationship, she rarely pursues one because of her uncertainties.

Adjustment Disorder

Dolores is a 45 year old married mother of a pre-teen. She was admitted to the psychiatric department on an emergency basis after having a nervous breakdown and threatening to commit suicide. 4 days before, she discovered she was 18 weeks pregnant. This was unexpected, and she felt both shocked an despaired due to her belief that she cannot manage another child at her age. The thought of her life being disrupted by a child was too much for her. She became tense and unable to sleep. She had excessive crying spells, and became easily agitated. While meeting with the psychiatrist, she had a clear conscious and did not demonstrate any distorted perceptions or delusions. 2 days after her release from the hospital, she began to calm down, she began planning for the pregnancy and having an optimistic outlook on the addition to the family.

Major Depressive Disorder

Jessica is a 28 year-old married female. She has a very demanding, high stress job as a second year medical resident in a large hospital. Jessica has always been a high achiever. She graduated with top honors in both college and medical school. She has very high standards for herself and can be very self-critical when she fails to meet them. Lately, she has struggled with significant feelings of worthlessness and shame due to her inability to perform as well as she always has in the past. For the past few weeks Jessica has felt unusually fatigued and found it increasingly difficult to concentrate at work. Her coworkers have noticed that she is often irritable and withdrawn, which is quite different from her typically upbeat and friendly disposition. She has called in sick on several occasions, which is completely unlike her. On those days she stays in bed all day, watching TV or sleeping. At home, Jessica's husband has noticed changes as well. She's shown little interest in sex and has had difficulties falling asleep at night. Her insomnia has been keeping him awake as she tosses and turns for an hour or two after they go to bed. He's overheard her having frequent tearful phone conversations with her closest friend, which have him worried. When he tries to get her to open up about what's bothering her, she pushes him away with an abrupt "everything's fine". Although she hasn't ever considered suicide, Jessica has found herself increasingly dissatisfied with her life. She's been having frequent thoughts of wishing she was dead. She gets frustrated with herself because she feels like she has every reason to be happy, yet can't seem to shake the sense of doom and gloom that has been clouding each day as of late.

Dependent

Maria allows her husband Henry to make all of the decisions in the relationship and for the family, even if she disagrees with his ideas, she won't tell him because she is scared he will leave. When Henry drinks, he often slaps her around, but Maria will make excuses for her bruises, and will accept Henry's apologies when he is sober.

Depression

Maria lost her job after working there for 15 years and now can't afford to pay her mortgage. She's constantly crying and doesn't want to get out of bed. Her family calls and she doesn't pick up and won't leave the house or answer the door. She feels worthless and is not motivated to get a job.

Paranoid Personality Disorder

John often questions the fidelity of his wife Ellen. He has installed a GPS tracker in her car and cell phone, and often checks her underwear when she returns home from work. He uses the rationale that "women can't be trusted" to justify his behavior. He is often in disputes with his friends and employs the defense mechanism projection on them, telling them that they are weak, though internally he feels this way about himself, but must maintain a façade in front of others. He believes that showing weakness is to allow others to "take control."

Cyclothymic Disorder

Jose was in the process of getting a divorce after two years of depressive and manic behavior.

PTSD

Josh is a 27 year-old male who recently moved back in with his parents after his fiancée was killed by a drunk driver 3 months ago. His fiancée, a beautiful young woman he'd been dating for the past 4 years, was walking across a busy intersection to meet him for lunch one day. He still vividly remembers the horrific scene as the drunk driver ran the red light, plowing down his fiancée right before his eyes. He raced to her side, embracing her crumpled, bloody body as she died in his arms in the middle of the crosswalk. No matter how hard he tries to forget, he frequently finds himself reliving the entire incident as if it was happening all over. Since the accident, Josh has been plagued with nightmares about the accident almost every night. He had to quit his job because his office was located in the building right next to the little café where he was meeting his fiancée for lunch the day she died. The few times he attempted to return to work were unbearable for him. He has since avoided that entire area of town. Normally an outgoing, fun-loving guy, Josh has become increasingly withdrawn, "jumpy", and irritable since his fiancé's death. He's stopped working out, playing his guitar, or playing basketball with his friends - all activities he once really enjoyed. His parents worry about how detached and emotionally flat he's become.

Generalized Anxiety Disorder

Kristen is a 38 year-old divorced mother of two teenagers. She has had a successful, well-paying career for the past several years in upper-level management. Even though she has worked for the same, thriving company for over 6 years, she's found herself worrying constantly about losing her job and being unable to provide for her children. This worry has been troubling her for the past 8 months. Despite her best efforts, she hasn't been able to shake the negative thoughts. Ever since the worry started, Kristen has found herself feeling restless, tired, and tense. She often paces in her office when she's there alone. She's had several embarrassing moments in meetings where she has lost track of what she was trying to say. When she goes to bed at night, it's as if her brain won't shut off. She finds herself mentally rehearsing all the worse-case scenarios regarding losing her job, including ending up homeless.

Schizophrenia

Martin Continued: Martin is a 21 year-old business major at a large university. Over the past few weeks his family and friends have noticed increasingly bizarre behaviors. On many occasions they've overheard him whispering in an agitated voice, even though there is no one nearby. Lately, he has refused to answer or make calls on his cell phone, claiming that if he does it will activate a deadly chip that was implanted in his brain by evil aliens. His parents have tried to get him to go with them to a psychiatrist for an evaluation, but he refuses. He has accused them on several occasions of conspiring with the aliens to have him killed so they can remove his brain and put it inside one of their own. He has stopped attended classes altogether. He is now so far behind in his coursework that he will fail if something doesn't change very soon. Although Martin occasionally has a few beers with his friends, he's never been known to abuse alcohol or use drugs. He does, however, have an estranged aunt who has been in and out of psychiatric hospitals over the years due to erratic and bizarre behavior. Martins symptoms have continued for the last 9 months without remission.

Delusional Disorder

Martin holds the delusional belief that the police are trying to entrap him. He goes to extremes to protect his home with surveillance and security equipment. At the same time, he believes that the police won't bother him at work because his boss, with whom he gets along well, is the son of a policeman.

Schizophreniform

Martin is a 21 year-old business major at a large university. Over the past few weeks his family and friends have noticed increasingly bizarre behaviors. On many occasions they've overheard him whispering in an agitated voice, even though there is no one nearby. Lately, he has refused to answer or make calls on his cell phone, claiming that if he does it will activate a deadly chip that was implanted in his brain by evil aliens. His parents have tried to get him to go with them to a psychiatrist for an evaluation, but he refuses. He has accused them on several occasions of conspiring with the aliens to have him killed so they can remove his brain and put it inside one of their own. He has stopped attended classes altogether. He is now so far behind in his coursework that he will fail if something doesn't change very soon. Although Martin occasionally has a few beers with his friends, he's never been known to abuse alcohol or use drugs. He does, however, have an estranged aunt who has been in and out of psychiatric hospitals over the years due to erratic and bizarre behavior.

Dementia

Mr G. was a 74-year-old retired car salesman who was first seen at the clinic in May 1998. At that time he complained of declining memory for the past 3 years, said he had lost interest in playing golf, seemed to have lost his sense of direction, and was less energetic in activities. He was sleeping more, with prolonged daytime naps. His medical history included a triple-vessel coronary artery bypass graft in 1989. In 1997 he was diagnosed with sinus bradycardia and hypertension. His medications included ASA (325 mg daily) and acebutolol (50 mg twice a day). He was a former smoker and had previously experienced one episode of vertigo, nausea, and vomiting with no specific diagnosis. He had a depressed mood at times. Physical examination was unremarkable and laboratory values were normal. In May 1996 he had a CT head scan that showed normal ventricular size, normal sulci, and a tortuous basilar artery. In June 1998 a repeat CT head scan showed mild cerebral atrophy with normal ventricles but widened frontal cortical sulci and sylvian fissures, and bilateral calcification of the globus pallidus. Prior to the assessment he had been prescribed donepezil for 5 weeks, during which time he was more sleepy and depressed. Both he and his family were convinced that the side effects from the medication were more prominent than the perceived benefit and so it was discontinued. Six months later Mr G. became agitated and was prescribed risperidone (0.5 mg). In May 1999 he had auditory hallucinations, delusions (he couldn't take a shower because someone was in the shower stall), utilization behavior (he took shoes out of the closet and spread them around the bedroom), and effort angina. His medications now included acebutolol, paroxetine, and nitroglycerin. Serial mental status evaluations were conducted using the Mini-Mental St

Delirium

Mrs. Hubley is brought to her family doctor's office by her son. They had been to the emergency department 2 nights ago when Mrs. Hubley fell while going to the washroom at night and fractured her shoulder. She was able to call her son, who took her to the ED for xrays. After a bit of a wait, she was given a sling to wear for the arm, a prescription for analgesics, and a follow-up appointment with orthopedics. The ED doctor suggested that she go see her family doctor "in a few days". John (Mrs. Hubley's son) is more than willing to take her to see her family doctor, as she doesn't seem to be managing well at home. She doesn't seem to be eating right, her house is a mess, and he's not sure that she's changed her clothes since that night. John can't take care of her, as he works two jobs and is a single dad. They arrive at the family doctor's office and discover that the practice is being covered by a locum physician. The new doctor takes a look at Mrs. Hubley's chart before calling her into the office, but there isn't much to read as she hasn't needed to come in to see her doctor much. He notices that she looks a little disheveled. He asks a few questions about her fall and the ED visit. She seems vague, distracted, and confused. She is able to tell him that she lives alone, and this he finds concerning. He decides to call John into the office, and finds out that John had had no concerns about his mom up until she fell and broke her shoulder. He says that she was managing just fine, and was "sharper than I am". John wonders whether the pain medications may be too strong for her.

Social Anxiety Disorder

Ms. M. is a 19 year old student. She decided not to attend her university classes on the first day because she knows that in some classes the professor will instruct them to go around the room and introduce themselves. Just thinking about sitting there, waiting to introduce herself to a roomful of strangers who will be staring at her makes her feel nauseous. She knows she won't be able to think clearly because her anxiety will be so high, and she is sure she will leave out important details. Her voice might even quiver and she will sound scared and tentative. The anxiety is just too much to bear, so she skips the first day of class to avoid the possibility of having to introduce herself in class.

Pervasive Developmental Disorder

N.R. Female, Age 12 PDD N.R. was in crisis for several months when she first began using the REI Program audiotape at school and spent most of her school day in one to one lessons away from other students due to aggressive action toward other students. Aside from being very aggressive, she was very hyperactive, and was very vocal with extreme echolalia. After four weeks listening to the recording daily, she was much more calm and less aggressive. Her attention span and listening ability also improved significantly. Teachers described her as being much more able to handle her emotions and much more compliant. After eight weeks she continued to show progress in her listening ability, compliance, aggression and anxiety levels. The recording was also beneficial in relieving emotional and aggressive outbursts. She would often calm down with a minute or two of starting the recording. It was reported that she would often lay down and go to sleep while the tape was playing.

Bipolar II Disorder

Name: Casey Roberts Source: Mad Love (Movie, 1995) Casey Roberts is a female high school student in her late teens. Upon arriving at a new high school, she appears to be fairly normal in behavior. However, it is apparent from early on that she has almost no social relationships, or even more, a desire to have any. Aside from a relationship with her parents, who appear supportive and loving, she only has one other relationship which consumes her throughout the movie: her relationship with her boyfriend Matt. This relationship is what drives many of her actions throughout the movie. Her parents say there is no past mental health history in their families. However, they are in denial of her having an actual mental illness and attribute it to her trying to get back at them for controlling her, so the real history may not be reported. No major drug or alcohol use is apparent although casual drinking is seen throughout the movie and nicotine use, especially while in her depressed episode, is also shown. There are no outward health problems visible in Casey. She is a very intelligent girl with a very strong willed personality. However, she does not seem to care too much about asserting that intelligence towards any goals. School is in no way important to her. Although Casey is at some points able of living and functioning normally, she has a past of suicidal behavior. As stated in the Background Information, she has little to no social relationships. However, she does appear to be a fairly friendly person. Probably the largest hindrance on her functioning is her impulsivity. She seems to think that she should do and be able to do whatever she wants when she pleases. Towards the end she also has a tendency towards thoughts that are very sporadic in nature. Casey displays much risk taking behavior without seeing any importan

Oppositional Defiant Disorder

Name: M Gender: Male Chronological Age: 3 years, 7 months Clinical Diagnosis: Oppositional Defiant Disorder BACKGROUND INFORMATION M was a full term baby born by cesarean delivery due to abnormal position, which caused the membrane to break. In addition, the umbilical cord was tangled. M slept very little during his early years. He always wanted to be rocked and held. His developmental milestones were accomplished in a normal time frame. His difficult behavior patterns started to concern his mom when he was asked to leave his second preschool because of his behavior. M was a strong willed child who easily refused to do anything that was asked of him. His selfcare skills were still developing. He was not potty trained and would not sleep by himself at night. He has average intelligence and his behavior was quite purposeful. His hyperactive aspects surface during oppositional phases. He has refused to pick up toys that he'd pull off shelves. He did not listen and would do what he wanted and when he wanted to.

Narcissistic

Paula believes that she is the best thing since sliced bread. She believes that she is the smartest student in her class and feels that the professor should recognize her greatness and give her an automatic A just for showing up. She has a secret fear of rejection and loss, so when she received a C in her course, she was completely devastated and complained to the dean about her grade, and trumped up allegations against her professor.

Specific Phobia

Ron Weasley is first presented to the public audience as a young, goofy 11-year-old wizard boy. Throughout the series he transitions into a mature young adult. He attends Hogwarts School of Witchcraft and Wizardry. Overall he is an average student never going above in expectations and never going under. He is the youngest boy in the Weasley family out of Bill, Charlie, Percy, Fred, and George. He also has a younger sister Ginny, who he is very protective of. His mother, Molly, is an incredibly loving woman, taking care of her children and running a very crazy household. Her husband's name is Arthur Weasley and he works a modest job at the Ministry of Magic. The Weasley family is very rare in the wizardry world because they come from what is known as pureblood. This means that the Weasley family only have witch and wizard blood in their biological line. It is rare and often used by other Wizardry family has a way to declare dominance among their kind. The Weasleys, however, do not mistreat others and do not consider themselves to be above the rest of the wizardry population. Their good nature is one of the few things they are rich with, as there are very poor with only a modest income. They have been known to pass on handed down clothing among the children and make them handmade gifts because they cannot afford much else. They struggle finically with getting their children everything they need for school and they live in a small house that is referred to as the Burrow. Ron has a particularly difficult time dealing with the teasing that is brought on to his family because of their financial standing. He often has to defend his family to other people, especially towards Draco Malfoy, who is not afraid to bring up the handed down clothing whenever he wants to insult Ron. Ron has two best friends at his school. They are t

Histrionic

Shana seems to always be involved in dramatic relationships and situations. She appears to thrive off of these situations. She is often uncomfortable within her group of friends when she is not the center of attention and will often dramatizes her stories in order to command an audience. At times she will also dress provocatively and use sexual suggestions, though when called upon her actions, will appear surprised at being called out.

Panic Disorder (w/ agoraphobia)

Stacey, a widower, is the owner of a large company. One day she experienced a dizzy spell that lasted for five to ten minutes. Similar to Karlene, she went to the doctor, but all test results were negative. A few months later, she experienced another episode, this time she went to the doctor's office accompanied by her housekeeper since she was now afraid of having an episode while she was alone in public. She has now changed her daily pattern of traveling, as she is escorted to a limousine by her housekeeper, driven to work, and is escorted to her office by two of her workers. She does not go to the bathroom alone, is escorted by her secretary, and pays additional employees to accompany her to functions at all times.

Acute Stress Disorder

Stanley obtained his driver's license in May. In July he was involved in a three car collision in which a passenger in another vehicle was killed. For two weeks Stanley had vivid memories of the accident and refused to drive. By the beginning of the third week, Stanley was driving again, although he felt some unease behind the wheel the first few times after the accident.

Antisocial Disorder

The Grinch, who is bitter and cave-dwelling creature, lives on the snowy Mount Crumpits, a 10,000 foot high mountain that is north of Whoville. His age is undisclosed but he looks to be in his 40's and does not have a job. He normally spends a lot of his time being alone in his cave. The patient appears to be suffering from antisocial personality disorder with depressed mood. There was no background history on his family, as he was abandoned as a child. The Grinch was taken in by two ladies who treated him like he was their own like every other Who children with love for Christmas. He does not have any social relationship with his friends and family. The only social companion the Grinch has is his dog Max. There was no history of drug or alcohol use. The Grinch did have some life difficulties when he was a little boy being made fun of the way he looks at his school. The Grinch had no goal in his life except to stop Christmas from happening. The coping skills and weakness was to run away from his problems and leave the town, rather than facing problems. The Grinch displays a number of problems. The Grinch was not a very happy man with life. He hated Christmas and wanted to stop it from happening. When he was little, he got irritated and aggressive at the school because he was being made fun of by the fat boy who now is the mayor of the town. The Grinch threw a fit and picked up the Christmas tree and threw it to the other side of the classroom. After that he no longer liked Christmas. Years and years later the Grinch decided that he was going to stop Christmas from happening. He decided to dress as Santa Claus and take away all the Christmas trees and presents from the people of Whoville. He failed to plan ahead to know what the consequences would be. As he went to Cindy Lou Who's house to steal their tree and present,

Borderline

Tia met Jay and it seems as though she "fell" for him hard. The couple had sex on their second date, and subsequently Tia told Jay that she was in love with him. Tia would call Jay several times throughout the day, often telling him that she wanted to see him. After three weeks, Tia was a frequent overnight guest at Jay's house and already began leaving clothes there. They had sex often, with Tia frequently telling Jay that he was special, and she couldn't imagine life without him. Jay noticed that at times Tia slept in late and did little during the day. He also noticed little fresh cuts on her arm, but Tia's response was usually that she fell. After two months, Tia began to seem cold and distant. She stopped spending nights at Jay's house and would often ignore his phone calls. One day she sent an email to Jay telling him that she's not in love with him anymore and she prefers not to see him again.

Obsessive/Compulsive

Ty was the oldest son in a single parent household. He assumed responsibilities when he was young, and it seems to have carried over when he got older. He is very serious and lacks a sense of humor. He has alienated his siblings because of his desire to maintain control over them although they are all adults now. He tends to run his family much like his mother raised him and his siblings, and is rigid in his rules.

Conduct Disorder

When John was 9, he told his mom that he wanted to buy lunch instead of bring it. His mom at that point still believed that some of what John said was innocent of any other purpose, and so she let him. She did notice that he was very hungry when he came home from school. He said the lunches were small and for an extra 75 cents he could get seconds. She believed this. Two weeks later the principal called to report that John was caught with cigarettes on the playground. John's mom was amazed, as she did not smoke and neither did her husband. Not only that, but he had a whole pack. Well, it took a lot of "interrogation" to get the story out. The lunch money went to buy cigarettes from a boy in Jr. High. John then smoked a few of those and then sold the rest at a big profit. His parents remembered that two years later when he was found drunk in the locker room at Jr. High. Now his parents are lots wiser. John still thinks his parents are totally unreasonable. The rule is you get your allowance and phone privileges as long as those random urine drug screens are normal. If he doesn't cooperate, then they are assumed to be positive. So he ended up poor and lonely for a few weeks, but now that is under control. As far as cigarettes go, if he can buy them, he can smoke them outside. If he is caught drinking or around people who are drinking, good-bye allowance and phone. John hates it and can't wait until he moves out so he can finally do what he wants.

Panic Disorder (w/o Agoraphobia)

While watching television one day, Karlene experienced a rush of anxiety, accompanied with a pounding heart, numbness in her fingers and toes, violent shaking and chest pains which left her gasping for air. Thinking she had just experienced a heart attack, she went to the emergency room, but all test results were negative. 5 months later she experienced another episode on her way to work. A third attack occurred 3 weeks thereafter, and soon the attacks picked up in frequency. She soon become so preoccupied with the fear of having an attack that she could not concentrate on her work.

Source - For the movie references

https://abnormalpsych.wikispaces.com/casestudies