Diagnosis Practice Activity #2

Please refer to your class notes and textbook to diagnose the people in the stories that follow. Be sure to provide a diagnosis and also your justification for making this diagnosis.

Ex: 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.

Diagnosis & Justification: Marianne seems to be developing schizophrenia. She is experiencing thought & emotional problems. She is experiencing paranoid delusions and delusions of persecution. She believes that other people are trying to control her. She also thinks that other people are trying to hurt her.

When asked to provide the d/o & the general class, please provide this along with your justification. Ex: OCD is an Anxiety D/o.

1. Ever since Winston saw a man get run over by a car on campus last year, he just can't get the accident off his mind. He frequently has distressing thoughts about the event during the day and often experiences bad dreams about it at night. The dreams are so distressing that he wakes up frequently during the night. His lack of sleep is really begin to take its toll on his schoolwork. He has become tense, cranky, and worried. He gets extremely upset whenever he passes the scene of the accident on campus. How would you diagnose Winston? What is your justification for doing so? What if the event had just happened last week? To what general category of the DSM-IV-TR does his diagnosis belong?

2. Robert, who is shy and quiet, comes to your office complaining that he can't remember large blocks of time in his day-to-day life. Sometimes he acts like a completely different person: one who is outgoing and suave, especially when he tries to flirt with you and ask you to dinner. Whenever the conversation becomes heated and full of conflict, he begins to act completely differently - he acts like a child, even talking in a childlike voice and using immature vocabulary. How would you diagnose Robert? Why? To what general category in the DSM-IV-TR does his diagnosis belong?

3. Allison seems extremely down lately. She's stopped going to work, stopped seeing her friends, and stopped seeing her family. She cries constantly and makes thinly veils references to killing herself. "Sometimes I just don't feel like going on. I just wish it all would end," she says. She also seems to be sleeping and eating much more than usual. How would you diagnose Allison? Why? What two disorders could Allison possibly have?

4. 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. How would you diagnose Judith? Why?

5. George keeps going in and out of jail. It seems that he just can't stay out of trouble. He can't control his impulses to do hurtful things to other people. He's always in fights with his neighbors. He even shot his neighbor's dog. George can be very kind when he wants to - but usually it's because he wants something. He doesn't seem to feel at all guilty about all the hurt he causes other people. What diagnosis would you give George? Why? What do you think led to the development of George's problem?

6. Tipper has been feeling extremely exhilarated lately. Although she's not sleeping much, she's been very active. She has many grand plans. She's painted all the rooms on the inside of her house, pulled all the plants out of her yard so she can plant news ones, and gone on a shopping spree for new furniture for her entire house. She becomes extremely irritable, though, when friends question her judgments. "You don't make much money. Can you really afford all these home improvements?" To earn some extra money, she cashed out her savings and went to Las Vegas to gamble - maybe she can double her money! How would you diagnose Tipper? Why?

7. Lester returned home to find that his house had been completely burned by the forest fires that had ripped through the southern portion of his state. Everything that he had ever worked for was now gone. Even his precious dog, Spot, died in the fire. Spot was just like a child to Lester, and Lester was overwhelmed with emotion when he learned about Spot's death. After seeing the devastation, he got back into his car and drove 800 miles to his former home, where his ex-wife currently lives. When he arrived, Lester didn't remember anything about the fire or the drive to his ex-wife's place. Please provide just the general category of diagnosis that you would give to Lester. Why would you assign this?

8. You've been giving rides to Loretta, the new girl at your office. You've noticed that as soon as you got to know her, she had thought you were the nicest, greatest person ever. She quickly began to call you her "best friend." However, ever since you told her that you wouldn't be able to give her a ride home from work anymore, Loretta seems to hate you. She screams at you and accuses you of abandoning her. She says horrible things about you to the other people in the office. She even shredded some important documents that were on your desk. Suddenly you went from being her best friend to her worst enemy. From what you hear, this isn't the first time this has happened. Loretta has even been institutionalized for trying to kill herself before. How would you diagnose Loretta? Why?

9. After getting into an accident on the 400 block of Jackson Street, Steve gets extremely nervous whenever he comes close to any part of the street. Lately, Steve has been taking very long routes to work, just so he can avoid driving on or crossing over Jackson Street. When Steve was riding on the city bus the other day, he got so nervous as he approached Jackson Street that he began to hyperventilate. How would you diagnose Steve? Why? To what general category in the DSM-IV-TR does his diagnosis belong?

10. 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. How would you diagnose Horace? Why? To what general category in the DSM-IV-TR does his diagnosis belong?