Psychological Disorders in Context

Name  _____Sean Riley_____________________ Date ___7/10/12_________ Psychological Disorders in Context Due 7/11/12 by 5pm

After you read each of the following four case studies, discuss and answer the questions below the case regarding the problem(s) that may or may not be present. Feel free to use your textbook or any other notes/resources you may have.  Remember, not every case will necessarily present you with a specific disorder and some may present you with more than one disorder (what we refer to as “comorbid” disorders). 

Case #1

Jim is a 31-year old successful salesman. He was referred by the nurse practitioner in his physician’s office. He complains of muscle tension, headaches, and difficulty sleeping. He worries about not having enough money for his family in the event he dies suddenly or is fired from his job. He worries about job stability and feels he would be unable to get another job that paid as well. In fact, he is extremely bothered by a constant preoccupation with the possibility that he might inadvertently start screaming at his boss for no reason. To make sure he doesn’t actually start doing this, he often goes way out of his way to avoid any contact with his boss. He even goes so far as to miss important meetings where his boss is likely to be present.

He has elevated blood pressure, heart palpitations, and has now missed several work deadlines because of all his worrying and preoccupations. Jim’s friends describe him as a “constant worry-wart” who is always planning for that one “disaster” that never actually comes. Jim states that he tries to stop worrying, but can’t seem to make himself stop. His worrying has begun to interfere significantly with his ability to perform his job, enjoy time with his family, or engage in any of the hobbies that he once enjoyed.

Based on the symptoms presented in Jim’s case and the four key criteria for determining whether behavior is abnormal, would you say that Jim has a psychological disorder?  Why or why not? 

Absolutely. His behavior is both atypical and irrational. His behavior is maladaptive, in that he is missing several deadlines. His behavior is irration

If you answered yes, what disorder (if any) should be considered? Explain why you chose this disorder.

Case #2

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 hidden microchip that he was forced to swallow.

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 “others” 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.

Based on the symptoms presented in Jim’s case and the four key criteria for determining whether behavior is abnormal, would you say that Jim has a psychological disorder?  Why or why not? 

Martin most likely has a mental illness. His behavior is Atypical in that most people do not fear cell phones in our culture, as well as his not attending classes. Maladaptive in that he hasn’t been going to class, and he’s paranoid about his phone being the tool of the “others” to murder him. He will flunk out of college if he does not shape up. This is obviously distressing to his family, in that his parents have tried to make him go to a psychiatrist. His fears are not rational. He’s afraid of using his cell phone in case it activates a hidden microchip he was supposedly forced to swallow.

If you answered yes, what disorder (if any) should be considered? Explain why you chose this disorder Martin has, in my opinion, lost contact with reality. Therefore this disorder he has must be psychotic.

He has positive symptoms of delusions and paranoia. While it is not expressly stated, I believe he is also hearing voices, and not just whispering to himself.

He has an aunt who has been in and out of psychiatric care, which may indicate a genetic predisposition towards mental illness.

Based upon these observations, I believe Martin has Type 1  Paranoid Schizophrenia.

Case #3

Lenore has been feeling very sad since her husband died 12 weeks ago. She hasn’t eaten very well, and has difficulty sleeping.  She cries most days but is usually able to “put on a happy face” when people stop by to comfort her. Lenore is preoccupied with thoughts of her husband and does not want to do much other than think about him. She has declined all invitations by friends to socialize and instead, spends most of her time alone looking through old photographs and remembrances.

Based on the symptoms presented in Jim’s case and the four key criteria for determining whether behavior is abnormal, would you say that Jim has a psychological disorder?  Why or why not? 

I don’t believe Lenore has a mental disorder.

It is perfectly typical for a wife to grieve her husband for 3 months. In fact, it would be atypical for her not to.

It is perfectly rational to grieve over the loss of a loved one.

Her grieving is somewhat maladaptive, as she is refusing invitations from her friends.

The behavior does not appear to be distressing to anyone. Perhaps her friends would be, but she’s able to act happy long enough to ensure they don’t worry.

At this time, I would not classify Lenore as having a mental illness. I would, however, be cautious in this assessment. If Lenore continues her behavior, it will become atypical and distressing.

If you answered yes, what disorder (if any) should be considered? Explain why you chose this disorder.

Case #4

Sister Margaret has been a member of her congregation for 20 years. She is 45 years old and the Director of Religious Education for a large suburban parish. She seems to be the perfect fit for the job. Her high energy, her overflowing enthusiasm, talkativeness, and engaging personality make her a favorite of the staff and parishioners. In particular, she seems to connect emotionally with adolescents who enjoy her enthusiasm. Everyone marvels at her ability to do so much with as little as two to three hours of sleep each night.

Prior to entering religious life, Sr. Margaret had abused alcohol and had incurred some significant credit card debt. After entering her community, she seemed to channel her energies into her ministry. Although she continuously overworked, she did not appear to be having other significant life problems. In the last several years, however, she has taken on more and more responsibility at work and is more stressed. A few months ago, she began to act out sexually with another sister in her community. Currently, she finds herself depressed; she is struggling to keep up with her many ministerial commitments. The sisters living with Sr. Margaret are experiencing many forms of distress. Some feel angry because their routines are often disrupted and others feel anxious. because they continuously anticipate a change in her mood, going from highs to lows almost weekly. With her mind racing at night, her increased inability to sleep and the increasing distress in her local community, Sr. Margaret decided to talk with someone on her leadership team. After an assessment, she was admitted to a local treatment facility.

Based on the symptoms presented in Jim’s case and the four key criteria for determining whether behavior is abnormal, would you say that Jim has a psychological disorder?  Why or why not? 

I don’t know who Jim is(Other than Captain James T. Kirk, that is), but I believe Sister Margaret may in fact have a mental disorder.

She is atypical in that she began sexually acting out with another sister, and is struggling to keep up with her commitments.

Her actions, specifically the sexual acts, are not rational. She will be removed from the order if she continues to act out in such ungodly ways.

She is maladaptive due to the same reasoning for rational. She is depressed.

The community is having a lot of distress. Some sisters are angry, and others are anxious.

If you answered yes, what disorder (if any) should be considered? Explain why you chose this disorder.

I believe Margaret has bipolar disorder.

“continuously anticipate a change in her mood, going from highs to lows almost weekly. “

She seems to have Type 1 bipolar, as she has manic episodes as well as the lows.

Case #4

Elise is a 35-year-old architect. She comes to you in great distress, feeling that she is unable to work, and generally unable to function. She says that she feels tired all the time, to the point of feeling completely exhausted. She says that she cries easily, and almost every day, is having difficulty sleeping, and has lost 20 pounds in the last 2 months without trying.  She also describes herself as a “worrier” and tells you that she constantly feels restless, irritable and has difficulty concentrating.  She can’t let her husband or children leave the house without making them call her regularly to reassure her that they are okay. Her husband is growing weary of her constant worry and distressed mood.  Her children can’t understand what all the fuss is about. Their impatience with her only makes her feel worse.

She says that things have been “real bad” for the last 2 months; she doesn’t enjoy doing anything and thinks frequently of suicide. However, she also says that she has never been a very happy person. She says that things rarely go right for her, and she has given up on expecting good things to happen for her.

Based on the symptoms presented in Jim’s case and the four key criteria for determining whether behavior is abnormal, would you say that Jim has a psychological disorder?  Why or why not? 

Her experience is atypical, she has an extremely pessimistic outlook on life.

She is not being rational. She’s lost 20 pounds, endangering her life, and she’s constantly calling her kids and husband.

She is maladaptive in that she is incapable of functioning correctly anymore. She’s incapable of sleeping, and her husband appears to be on the brink of leaving her. Her children are also becoming fed up.

The behavior is distressing to herself, her husband, and her children.

If you answered yes, what disorder(s) (if any) should be considered? Explain why you chose this disorder.

I would diagnose this woman as having depression. She does not sleep, she’s having trouble eating, and she constantly wishes to murder herself.