Abnormal Psychology
Rachel Bianca Mallari
Dr. Linda Mayers
CASE STUDY: MR. G
History:
Mr. G is a 68 year old widowed. He lives independently in an apartment that he and his wife shared for 30 years. He had a good marriage and has two children. Both children are grown and live in another state. He used to be an outgoing, social person, active in community affairs and a devoted member of his church prior to his retirement.
Clinical Assessment:
Mr. G’s persistent complaint about tension headache, poor attention span, and hypersomnia are well known primary presentations of depression in the elderly. Poor eyesight and memory lapse are the common indicator of senility.
Assessment Questions:
1. Have you had been hospitalize for a major illness?
2. How often have you experiencing memory lapse?
3. Are you comfortable socializing with others?
4. How do you feel now about the death of your wife and your retirement?
This questions are asked to determine the distinction between a mental disorder and the process of aging. The last two questions are to identify if Mr. G is suffering from a late life onset social phobia.
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Diagnosis:
Axis I- Major depression and Dementia.
Mr. G is undergoing a late life depression stage. His depression is a psychological disorder that is triggered by specific stressors such as the grief following the death of his beloved wife and the forced retirement from the company that gives him a sense of purpose and worthiness. Mr. G’s case indicates a condition marked by the loss of the ability to remember which makes him vulnerable for having dementia.
Intervention/Recommendation:
The reasons for treating depression in Mr. G’s case is very compelling.
Psychosocial treatment along with medication constitutes the utmost treatment for late life depression. A grief counseling may be prescribed to eradicate or prevent depression from exacerbating. Mr. G needs a comprehensive system of care that considers the broad range of functional and social consequences of depression. Depression in late life frequently coexist with medical illness. Thus, medication is also vital in achieving the paramount success in recovery.
Maintenance treatment with antidepressant is also considered somewhat helpful.
However, Mr. G cannot not or may not tolerate or respond to biological treatment.
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CASE STUDY: MRS. S
History:
Mrs. S is a 32 year old scientist. She is married and currently works for a large pharmaceutical company. She has never been hospitalized for a psychiatric disorder and hasn’t had any previous contact with a therapist. She is in good physical health and has no history of drug or alcohol abuse. She feels comfortable in crowds, and shows no evidence of agoraphobia or social phobia.
Clinical Assessment:
Mrs. S looked sloppy and unkempt. She is unable to sit still and fidgets throughout the entire interview. She has pressured speech and finds difficulty in answering questions. She exhibits anxiousness for finding a cure for AIDS.
Assessment Questions:
1. How far are you willing to go in finding a cure for AIDS?
2. How do you feel about coming into therapy?
3. How often do you spend time socializing with friends or going in a family outing?
4. How’s your relationship with your husband?
The questions establish the border line between a personality disorder and a mental illness. Also, it determines the current psychological state of Mrs. S.
Diagnosis:
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Axis I- Bipolar I Disorder and Generalized Anxiety Disorder.
Axis II- no axis II disorder identified. Mrs. S’ case doesn’t suggest long standing maladaptive behavior. Therefore, it couldn’t be diagnosed under Axis II.
Mrs. S manifests hypomanic, pressured speech, and decrease need for sleep which are the symptoms for Bipolar I Disorder. Signs of General Anxiety Disorder such as excessive anxiousness is patent in Mrs. S’ case.
Intervention/Recommendation:
Mrs. S may benefit from a combination of biological and cognitive treatments. Relaxation training may help Mrs. S to properly relax her mind and body. Medication is also a critical part of the treatment. A benzodiazepine such as Xanax or Valium may be prescribed. If Mrs. S is unable to tolerate the side effects of this drug, the drug Buspar may then be given. Anxiety management may also be recommended.
MRS. S Prognosis:
Treating general anxiety disorder is very difficult, and Mrs. S, like others with this type of disorder does not believe that she has a problem. Mrs. S doesn’t agree that she is in need of psychiatric evaluation. This factor contributes to Mrs.
S’ poor prognosis. She does not believe that she has a disorder and does not believe that therapy is necessary.
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