For each case listed below provide the specific diagnosis.
Remember, this is supplemental only. It's not intended to replace information gathered in LECTURE OR IN YOUR TEXT!
Tony sometimes seems very "wound up." At those times he seems full of energy, talks very rapidly, and makes very grandiose plans. One time he gave away all of his belongings and was planning to move to Washington, D.C. so he could advise the President. At these times he also seems to need almost no sleep. During other periods of time, Tony seems very "down." During these times he doesn't take care of himself. He seems to want to sleep all the time, and he often makes thinly veiled references to wanting to commit suicide.
Judith has not left her house for several months. When she tries to go out, she experiences great anxiety. She says she is afraid that if she leaves her house to go somewhere, she will not be able to get back. Before all this started, Judith seems fairly normal except for having several eipsodes where, for no apparent reason, her heart started pounding, she started to sweat profusely, and she experienced all the symptoms of fear and terror. One of the reasons she is afraid to leave the house is because she is afraid she will have one of these episodes again.
Horace sleeps a lot, has great difficulty getting out of bed in the morning, and generally does not want to do anything. He has stopped seeing friends who he used to see often, and declines all invitations to do things socially. His most common response is "I just don't feel like it." He looks sad all the time and does not seem to take pleasure in everyday activities. This has been going on for the past two months.
Marianne is a 34 year old female showing signs of disorganized thought & flat affect. She says that she hears voices telling her to do things. She believes that her behavior is being controlled by other people that she thinks that all her former friends have formed a conspiracy and are out to get her. She also tends toward repetitive, highly ritualized behavior. (please just provide me with the general class of the disorder in this case!)
Sandy feels dirty unless she bathes and changes clothes at least four times a day, and she is fastidious about the house as well. Every room is scrubbed at least twice a week and the bathroom is taken care of daily.
Although he was not personally injured, Harry has had problems since the earthquake two years ago. He is listless and quarrelsome and sleeps fitfully, reliving the quake in nightmarish dreams.
Allison is 45 years old. For as long as she can remember, Allison has always felt down. It just seems like she is never happy. While it seems she is always sad, Allison's sadness hasn't been bad enough to keep her from going to school or work.
Joel becomes very anxious whenever he has to go to the doctor. Sometimes he gets so worked up in the waiting room that he has to just vomit. This is strange because Joel routinely visits other places where medical procedures occur without incident, like his dentist's office. He even gives blood at the local blood bank throughout the year. (Be very specific here with your diagnosis.) warning: this one is *tricky*
Frank was attending college in San Francisco during a recent earthquake. He lived in the area that was hardest hit by the quake. Frank was not home when the earthquake hit and was not injured in any way, but when he returned home he found his building demolished and his two roommates had been crushed to death. Frank immediately drove himself to the airport, bought a ticket to Boston, and got on the plane. His parents found him on their doorstep in Boston the next morning. Frank remembers nothing about the earthquake and nothing about going to college in San Francisco. The last thing he remembers is being a high school student and living with his parents in Boston. (provide me with the general class).
Right after her car wreck, Maria had great difficulty sleeping and concentrating on her tasks throughout the day. It was so strange - before she had always loved to drive. But afterwards, she would freak out at even the thought of driving in a car. While he symptoms were pretty crippling, they went away after only 3 weeks.
For each one you get right, you get 0.5 points. The total possible value of this assignment is 5.0 points.
disorder - specifically, Bipolar I. - he oscillates between wild ups and bad downs. In Bipolar I disorder, the manic symptoms are much worse than in Bipolar II. Since the book doesn't make a great distinction between the two, I will accept either for this assignment.
Panic D/o w/ agoraphobia
- not only is she stricken with panic attacks, but, because of these, she has developed a fear of even leaving the house. Judith had several episodes where for no apparent reason she was overwhelmed by these physical symptoms. In order to garner a dx of Panic D/o, some of these attacks must be unexpected. She's agoraphobic, as well, because she is afraid to even leave the house. This is very different from social phobia. Social phobia implies only anxiety about social/performance situations. Ppl w/ social phobia can still leave the house. Ppl with agoraphobia often times, in very extreme cases, cannot leave the house. If you answered only panic d/o or only agoraphobia, I gave .25 points.
major depressive d/o
- Horace has reached an extreme emotional low. It's impairing his ability to live his life! He is sleeping more, and having difficulty mustering the energy to even get out of bed. He quit engaging in activities with his friends, and he's sad all the time. He's lost pleasure in his daily activities. If severity of symptoms is a confusing factor, think about it this way. Since Horace has only been this way for 2 months, there's NO WAY he could be diagnosed w/ Dysthymic D/o - that must occur 2 yrs before a dx can be made. I accepted depression for this one, but, keep in mind for the test that the official dx is major depressive d/o.
Schizophrenia - disorganized thought and behavior, paranoid delusions - not a pretty picture This belongs to the general class of Schizophrenia and Other Psychotic D/o
OCD - she's obsessed w/ cleanliness and engages in compulsions (changing clothes, washing repetitively) in an effort to neutralize the worry about being dirty. This is different from a phobia - she's having unwanted thoughts and engaging in bx to neutralize the anx caused by those unwanted thoughts. If you said something along the lines of obsessions or compulsions, then credit will not be given. It is critical in this d/o that both be present.
- he has been reliving the event for a long time through his nightmares, he's also very irritable. Also - consider the time factor. This has been going on for 2 years. Acute stress d/o is no longer diagnosed if symptoms persist for longer than one month.
- Allison just seems to always be down - for as long as she can remember. She's been feeling down for years! However, the symptoms haven't been severe enough to keep her from going on about her daily duties, so it is not as crippling as major depressive d/o. While this description sounds similar to a PD, there isn't a sad that is marked by chronic, down mood.
Specific phobia - situational type
- it appears he is only afraid of the doctor's office. It's not a fear of needles or anything like that since he is able to give blood and calmly go to other places where medical procedures occur. If you put phobia only, you got .25 points.
- the general class - suddenly just lost touch with his identity, took off across the country and has no recollection of how he got there or where he had been.
Acute stress d/o
- symptoms of PTSD, however, the symptoms fade within a month of the incident.