Instructions: With a highlighter please identify the ...

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Instructions: With a highlighter please identify the important symptoms in each case.

Reference the DSM-IV-TR diagnostic criteria for each anxiety disorder. (These are not yours to keep)

In the space provided, provide an appropriate diagnosis, adding any notes if you deem necessary.

Case Study 1

Zelda is extremely concerned with cleanliness. In fact, before she retires at night, she goes through a cleaning ritual of her clothes and body that sometimes lasts for up to 2 hours. If she misses a step in the ritual or performs part of it imperfectly, she starts the ritual all over again.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 2

Monica is suffering from a form of amnesia. She has deliberately left her home town moved to another city 350 miles away, and has assumed a new identity, a new job, and even new personality characteristics.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 3

In an effort to help Paula regain her memory from one of her episodes of amnesia, Paula complained of an intense headache. Suddenly Paula seemed very disoriented. She did not know where she was, but she claimed that her name was Sherry and that she was thirty years old. Dr. Harpin believed that "Sherry" was created in order to protect Paula from suffering from the emotional trauma of her father’s sexual assaults. Sherry was aware of other alters within Paula, and she told Dr. Harpin of another alter, named Janet. Janet was an extremely angry teenager. She admitted that she was responsible for Paula’s alcohol abuse and her extramarital affair. Later on in therapy, Sherry told Dr. Harpin that she and Janet were very concerned for a fourth personality named Caroline. Caroline was only five years old, but she was very depressed. When Dr. Harpin was able to speak to Caroline, he noticed that she had a completely different voice from the other personalities. Both her speech and tone of voice sounded like that of an actual five-year-old child. Dr. Harpin quickly realized that he could not learn much from Caroline because she was too afraid to betray her parents, so Caroline was rarely ever summoned during therapy.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 4

Karen worries excessively about developing a rare disease. When she meets friends or writes letters to her relatives, she is constantly discussing how she feels and expresses concern that even the most minor irregularities in the functioning of her body are symptoms of underlying diseases. She spends a good deal of time consulting doctors for a second opinion.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 5

Terry complains that he is experiencing recurrent episodes of lightheadedness, rapid breathing, and dizziness, especially as he attempts to leave his house. The symptoms have become so severe that, in fact, he is leaving his house less and less frequently. He now only goes the grocery store in the company of his sister. Once in the store, he checks immediately for the exits and windows.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 6:

Amy, age 38, is a worrier. She is restless, irritable and has difficulty concentrating. She worries that she worries so much and isn’t always sure what it is that she is worried about. She can’t let her husband or children leave the house without making them call her regularly to reassure her that they are ok. Her husband is growing weary of her fretting. Her children can’t understand

what all the fuss is about. Their impatience with her only makes her worry more.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 7:

Hannah, age 55, was in a major car accident 20 years ago during a cross country trip. Ever since, she has been unable to drive on major highways. Although she does drive, she goes to great lengths to travel only on back roads and scenic routes. She is able to go where she wants but it often takes her much longer to get there than it should.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 8:

Bert is 40 years old and rarely leaves his mother’s basement. He needs her help far to much to leave, she helps him decide what to wear, what to eat and what to watch on TV.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 9:

People avoided Carlos. He was homeless and his appearance was a mess and he often wore his wool sweater even on the hottest of days. He was often seen speaking to himself and laughing even though nothing funny had just happened.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 10:

A 28-year-old woman is a rising junior executive in her investment company. Her increasing duties require her to make periodic formal presentations to the senior management of the company. However, she becomes intensely anxious at the thought of speaking in public. When she is forced to give a presentation she begins to feel anxious days in advance of the talk and the anxiety

increases as the time for the talk approaches. She is concerned that her anxiety will become noticeable during the talk or that she will do something to embarrass herself. She often cancels presentations by calling in sick.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 11:

A 28-year-old woman was walking through her local shopping mall when she began to feel intensely anxious. The anxiety was accompanied by sensations of choking, smothering, and a sudden sense that the people and stores around her were unreal. She began to fear that she was going crazy and the more she worried about this the more anxious she became. A guard, seeing that she was in distress, brought her to the mall office where she was able to lie down. A few minutes later the symptoms began to subside. She went home after leaving the mall but she did not tell her husband what happened. A week later she had a similar attack while she was walking down the street. She was able to reach her house where she lay down until the attack ended. In the following three weeks she had two or more attacks. Between attacks she was constantly worried about having another attack. The patient was finally forced to tell her husband about the problem because she was so fearful of not being able to get help if an attack occurred that she would not leave her house alone or travel on public transportation.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 12:

Jen had been sad for about 7 years now. She is not sure why but she never seems to be happy anymore. She still has friends at work but even they can’t seem to bring joy to her life.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 13:

Yesterday Jen no longer felt like an ordinary housewife. Instead, she felt organized and accomplished. She wrote poetry all day yesterday and today she has been painting non-stop. Tomorrow she plans to write down all her great ideas about improving the lives of mentally retarded children and improving the environment. Jen’s husband is terribly worried that Jen will become extremely sad in few days – he’s seen this kind of behavior before…

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 14:

A 27-year-old, athletic young man has an intense fear of needles. He tries to rationalize his fear by explaining that he is just being cautious and protecting himself from acquired immunodeficiency disease syndrome (AIDS). He realizes that his fear is irrational but is unable to control it. The patient has fainted twice in the past when his blood was drawn during a physical examination.

He becomes extremely anxious at the sight of a needle and worries for days before an appointment with his physician or dentist.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 15:

A 36-year-old man and his young son were driving through an intersection when another car ran through a red traffic light and struck them. The two were trapped in the car until a fire department rescue team freed them. The patient was bruised but not seriously hurt. His son had a broken leg. The first few days after the accident the patient was preoccupied with arranging care for his

son and getting the car repaired. A few days later he began having recurrent distressing thoughts and images of the accident. These symptoms lasted for several weeks. The memory of his son’s screams after the car was struck seemed particularly vivid. The patient became irritable, had difficulty concentrating, and avoided talking about the accident. He went out of his way to avoid driving down the street where the accident occurred. As time went on he could no longer remember whether the traffic light was red or green when he approached it.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 16:

Tom always seems a down this time of year, sometimes in the winter he just can’t seem to get out of bed. He doesn’t seem to cheer up until weather gets sunny and warm.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 17:

Sherry paraded into the party drunk and continued to drink throughout the night. Laughing and

giggling, she flirted with many of the men and to two of them expressed her “deep affection.”

Twice during the evening she disappeared for almost half an hour, each time with a different man.

After a violent argument with one of them, because he took “too long” to get her a drink, she locked

herself into the bathroom and attempted to swallow a bottle of aspirin. Her friends encouraged her

to go home, but she was afraid to be alone in her apartment.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 18:

Winston spent most of the time talking about his trip to Europe, his new

Mercedes, and his favorite French restaurants. People seemed bored being around him,

but he kept right on talking. When he made a critical remark about how one of the

woman was dressed - and hurt her feelings - he could not apologize for his obvious

blunder. He tried to talk his way around it, and even seemed to be blaming her for being

upset.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 19:

Doreen embezzled 3 million dollars from the firm she worked for. During her trial, she was amazed that the jury found her guilty and gave her 25 years in prison. Of course she didn’t feel any remorse, the people who ran the company were idiots, they deserved to have their money stolen.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Case Study 20:

Jim was vice president of the freshman class at a local college and played on the school's football team. Later that year he dropped out of these activities and gradually became more and more withdrawn from friends and family. Neglecting to shave and shower, he began to look dirty and unhealthy. He spent most of his time alone in his room and sometimes complained to his parents that he heard voices in the curtains and in the closet. In his sophomore year he dropped out of school entirely. With increasing anxiety and agitation, he began to worry that the "Nazis" were plotting to kill his family and kidnap him.

DIAGNOSIS: _______________________________

NOTES ON DIAGNOSIS:

Correct Answers:

Case Study 1: Obsessive-Compulsive Disorder

Case Study 2:Dissociative Fugue

Case Study 3: Dissociative Identity Disorder

Case Study 4: Hypochondriasis

Case Study 5: Phobic Disorder (In This Case, Agoraphobia)

Case Study 6: GAD

Case Study 7 Specific Phobia – (Driving on Highways)

Case Study 8: Dependent Personality Disorder

Case Study 9: Schizophrenia (disorganized)

Case Study 10: Social Phobia

Case Study 11 Panic Disorder With Agoraphobia

Case Study 12 Dysthymic Mood Disorder

Case Study 13 Bipolar

Case Study 14 Specific Phobia (needles)

Case Study 15: PTSD

Case Study 16: SAD (Seasonal Affective Disorders)

Case Study 17: Borderline Personality Disorder

Case Study 18: Narcissistic

Case Study 19: Anti-social personality disorder

Case Study 20: Schizophrenia (with paranoia)

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