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Case Studies: Diagnosis and Treatment

Case Study 1
Josephine is a 47-year-old single woman. The hardest times of the year for Josephine's family are holidays and family gatherings; Josephine never seems to enjoy herself. She seldom smiles, laughs, or reacts to people and events around her. She remains detached and often goes into a room and plays video games or watches TV by herself, even when the rest of the family is eating. Her family members say that she is rude and do not want her around.
Josephine lives by herself. She has held several jobs, but lost them because of her inability to interact with others. Her cool demeanor makes her difficult to approach. Josephine has no significant relationship in her personal life and cannot name any close friends.

Case Study 2
When 38-year-old Luis enters a room, everyone knows it. Shortly after making an entrance, Luis is sure to let everyone know about his successful business ventures, his many ideas for new inventions, and his latest expensive purchase. At the last office party, Luis sought out the CEO of the company and monopolized her time with accounts of his valuable contributions to the company.
Luis has no patience with others and is often described by his coworkers as a man who uses people to get what he wants. Although he has been an office assistant for 10 years, Luis is always impeccably dressed because he often says that one day he will be the CEO, and he insists on looking the part now.

Case Study 3
Two years ago, 23-year-old Anissa survived a horrific car accident in which two passengers of the car she was driving were killed. Her car was hit broadside by a drunk driver. Anissa was thrown from the car on impact. She was treated for cuts, bruises, and a broken arm, but recovered quickly and appeared otherwise unhurt.
Three months after the cast on her arm was removed, Anissa began experiencing numbness in both hands. Extensive neurological tests eventually ruled out medical reasons for the numbness. Anissa was surprised when her neurologist referred her to a psychiatrist.

Case Study 4
Larry and Karen have always wanted a family. After 4 years of marriage, Karen gave birth to Austin, a healthy baby boy. Austin developed normally, walking at 13 months and saying "dada," "mama," and "mid" (for milk) by 14 months.
At 15 months, Austin caught what appeared to be a cold. Over a 2-day period, his cold rapidly worsened, and he was hospitalized with acute respiratory distress. He was placed on a ventilator, but the infection progressed too quickly and Austin died on the second day of hospitalization. His funeral and burial took place 3 days later. In the span of 1 week, Larry and Karen had changed from being a happy family to burying their only son.
The day after the burial, Karen woke up, went to Austin's room, and panicked when she did not find him in his crib. She did not know that Austin had died, and she could not remember the events of the previous week.

Case Study 5
Tony was a straight-A student in high school. He entered college on a full scholarship, and moved into the freshman dorm. He did well during his first semester, but his roommate noticed a change in Tony during the second semester of their freshman year. Tony slept very little, was inconsistent about grooming and hygiene, and seemed preoccupied with his own thoughts, often talking to himself in a worried whisper. He was observed muttering to himself during class, prompting two professors to ask him to leave. When Tony became verbally abusive to the second professor, he was escorted off the premises by security and was required to meet with the dean. Tony appeared at this meeting unshaven and in wrinkled, unwashed clothes. He told the dean that the professors did not understand "the pressures of his new duties as an FBI agent." During their conversation, Tony often paused and tilted his head, as if listening to voices or sounds; the dean did not detect any sounds. The dean suspended Tony and recommended his parents come get Tony and seek psychiatric help for him.

This is some info I pulled out of DSM-VI,

DSM-IV: Dependent Personality Disorder http://behavenet.com/capsules/disorders/dependentpd.htm

DSM-IV: Dissociative Disorders
http://behavenet.com/capsules/disorders/dissocdis.htm

DSM-IV: Somatoform Disorders
http://behavenet.com/capsules/disorders/somatoformdis.htm
DSM-IV: Narcissistic Personality Disorder http://behavenet.com/capsules/disorders/narcissisticpd.htm
DSM-IV: Schizoid Personality Disorder
http://behavenet.com/capsules/disorders/schizoidpd.htm
DSM-IV: Obsessive Compulsive Disorder
http://behavenet.com/capsules/disorders/o-cd.htm

DSM-IV: Schizophrenia
http://behavenet.com/capsules/disorders/schiz.htm

Solution Preview

1) Josephine has schizoid personality disorder. The symptoms include avoiding interactions with others, not being interested in having any involvement with others, preferring solitary activities, and a flat affect (lack of emotional response) including not appearing to enjoy anything. This disorder (like all personality disorders) is very hard to treat. Josephine will have a very difficult time wanting to talk to a therapist or building a relationship with him / her. Psychotherapy is the usual treatment. Medication is not usually useful. Group therapy is not useful because the person will almost certainly avoid group therapy. Psychotherapy usually deals with specific problems the person is having, because the overall lack of interest in relationships or interactions is unlikely to get much better.

2) Luis has a narcissistic personality disorder. He thinks very highly of himself and is very arrogant. He only wants to associate with important or special people. He exaggerates his abilities and achievements, and makes himself sound more important than he is. He ...

Solution Summary

Five case studies are briefly analyzed; a possible diagnosis and treatment suggestions are provided. Cases range from personality disorders to schizophrenia.

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