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PSYC 2030U – Abnormal Psychology Case Study Assignment
PSYC 2030U Case Study Assignment – The specific learning objectives of this case study assignment are:
- to provide you the exposure to real-world clinical cases, and
- to allow you the opportunity to learn clinical diagnostic techniques by evaluating one of the case studies in an in-depth manner.
To meet this objective, you will be required to choose one of the four provided case studies (see end of this document), and author a case report that includes each of the following sections:
- Presenting symptoms
- Background info / Personal history
- Assigned Diagnosis
- Rationale for Diagnosis
- Potential Differential Diagnoses
- Treatment recommendations
- Prognosis
Please do use these headings, and ensure that you have fully covered the material within each heading in a manner that matches the grading criteria (provided below). For most sections, one complete paragraph should be sufficient. If you dedicate 1 paragraph to each section, the final paper should be between 3-4 double-spaced pages. Please do not exceed 5 double-spaced pages.
PSYC 2030U Case Study Assignment
Below I provide more information on what I expect in each section.
Presenting symptoms: Describe the key symptoms that the patient presents with at the clinic. (ie. a succinct description of why the patient has come in for treatment). This information will by and large be included within the case study. Please paraphrase the symptoms; do not copy/paste.
Background info / Personal history: Provide patient demographics including age, gender, race, ethnicity, marital status, education and work history; and detail any relevant personal history. This information will largely come from the case study itself. Please paraphrase; do not copy/paste. Examples of relevant personal history may include, but is not limited to: trauma, abuse, isolation, shyness, divorce, poverty, physical health concerns, previous psychiatric diagnoses, winning the lottery, etc. Where relevant, provide a short explanation of why these personal history items are of relevance to the patient’s symptoms/presentation/prognosis.
Assigning a diagnosis: You will be asked to provide an official DSM-V diagnosis. For this you will need to read the textbook, consider the included DSM criteria, and come to your best guess re appropriate diagnosis.
Rationale for diagnosis: Explain how and why you arrived at the DSM-V diagnosis that you did. Do not just re-describe the patient’s symptoms. Rather, explain what about their symptoms matches with the DSM-V diagnostic criteria for the disorder that you have chosen.
Differential diagnoses: When you go to the doctor with a pain in your side, the doctor devises a variety of hypotheses of what might be wrong with you, and works to rule them out. Each possible illness is a differential diagnosis. In this section, write a paragraph identifying and explaining at least one other diagnosis that the client might have. As with your primary diagnosis, back up your statements by referring back to the DSM-V criteria in your text.
Treatment recommendations. Write a final paragraph describing which form of treatment (psychotherapy, medication, etc) you would suggest given your diagnosis of the case. Be specific in what type (e.g. cognitive-behavioral therapy, systematic desensitization or antidepressants, not “drug therapy” or “psychotherapy”). Explain why you have chosen the treatment that you have. Feel free to recommend a back-up treatment option, if one is available. You may use the text, the lectures, and/or outside sources to back up your choices.
Prognosis: Describe the patient’s likelihood of controlling their symptoms, improving or degrading or recovering completely. You may use the text, the lectures, and/or outside sources to back up your claims.
PSYC 2030U Case Study Assignment Grading Rubric
The PSYC 2030U Case Study Assignment will be graded out of a total of 100 marks, broken down as follows:
80% Content
- Presenting symptoms 5%
- Background info / Personal history 10%
- Assigned Diagnosis 10%
- Rationale for Diagnosis 15%
- Potential Differential Diagnoses 15%
- Treatment recommendations 15%
- Prognosis 10%
20% Style
- Clarity, thoroughness, organization of writing and ideas 15%
- APA reference format (reference the DSM-V, your text, any external sources) 5%
PSYC 2030U Case Study Assignment APA format
Please utilize APA format for citing your references and for your reference page. I’m less concerned about APA format for title pages, page numbers, etc – so you’re not going to get docked for something like having page numbers in the top right corner instead of the bottom left. But please do use APA for your citations and references – it’s good practice to get used to that format, and it makes my (and Kristina’s/Rangina’s) job much easier because it’s the format we’re used to reading the fastest.
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PSYC 2030U Case Study Assignment Due Date
The Research Paper is due on Nov. 20th on line by 5:00pm, hard copy in class.
EARLY: Submissions will be awarded 1% for each day that they are early, including weekends, up to a maximum of 10%. Once a paper has been submitted, it cannot be returned until it has been graded (i.e., students cannot re-submit a paper even if the due date has not passed). Please double check that the version you submit is the final version of your assignment.
PSYC 2030U Case Study Assignment Assignment Submission
You should submit your paper electronically, via Blackboard, and bring a hard copy to class. Given that you have the remainder of the semester to complete the assignment, little leniency will be granted for late assignments.
If the paper is submitted even one minute after 5:00 pm on Tuesday, November 20th (so at 5:01 pm), it will be logged as late by Blackboard.
Papers registered as being submitted after 5:00pm on Tuesday, November 20th will be late and docked 10%.
**Submissions will be docked 10% for each day that they are late, including weekends, even if it is only 1 minute late.** Papers submitted over 10 days late will receive a grade of 0, but will still be marked to provide feedback.
PSYC 2030U Abnormal Psychology Case Study Assignment- Case Summary #1
Robin Henderson is a 30-year-old married Caucasian woman with no children who lives in a middle-class urban area with her husband. Robin was referred to a clinical psychologist by her psychiatrist. The psychiatrist has been treating Robin for more than 18 months with primarily anti-depressant medication. During this time, Robin has been hospitalized at least 10 times (one hospitalization lasted 6 months) for treatment of suicidal ideation (and one near lethal attempt) and numerous instances of suicidal gestures, including at least 10 instances of drinking Clorox bleach and self-inflicting multiple cuts and burns.PSYC 2030U Case Study Assignment
Robin was accompanied by her husband to the first meeting with the clinical psychologist. Her husband stated that both he and the patient’s family considered Robin “too dangerous” to be outside a hospital setting. Consequently, he and her family were seriously discussing the possibility of long-term inpatient care. However, Robin expressed a strong preference for outpatient treatment, although no therapist had agreed to accept Robin as an outpatient client. The clinical psychologist agreed to accept Robin into therapy, as long as she was committed to working toward behavioral change and stay in treatment for at least 1 year. This agreement also included Robin contracting for safety – agreeing she would not attempt suicide.
Clinical History
Robin was raised as an only child. Both her father (who worked as a salesman) and her mother had a history of alcohol abuse and depression. Robin disclosed in therapy that she had experienced severe physical abuse by her mother throughout childhood. When Robin was 5, her father began sexually abusing her. Although the sexual abuse had been non-violent for the first several years, her father’s sexual advances became physically abusive when Robin was about 12 years-old. This abuse continued through Robin’s first years of high school.
Beginning at age 14, Robin began having difficulties with alcohol abuse and bulimia nervosa. In fact, Robin met her husband at an A.A (Alcoholics Anonymous) meeting while she was attending college. Robin continued to display binge-drinking behavior at an intermittent frequency and often engaged in restricted food intake with consequent eating binges. Despite these behaviors, Robin was able to function well in work and school settings, until the age of 27.
She had earned her college degree and completed 2 years of medical school. However, during her second year of medical school, a classmate that Robin barely knew committed suicide. Robin reported that when she heard of the suicide, she decided to kill herself as well. Robin displayed very little insight as to why the situation had provoked her inclination to kill herself. Within weeks, Robin dropped out of medical school and became severely depressed and actively suicidal.PSYC 2030U Case Study Assignment
A certain chain of events seemed to precede Robin’s suicidal behavior. This chain began with an interpersonal encounter, usually with her husband, which caused Robin to feel threatened, criticized or unloved (usually with no clear or objective basis for this perception. These feelings were followed by urges to either self-mutilate or kill herself. Robin’s decision to self-mutilate or attempt suicide were often done out of spite- accompanied by the thought, “I’ll show you.” Robin’s self-injurious behaviors appeared to be attention-seeking. Once Robin burned her leg very deeply and filled the area with dirt to convince the doctor that she needed medical attention- she required reconstructive surgery.
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Although she had been able to function competently in school and at work, Robin’s interpersonal behavior was erratic and unstable; she would quickly and without reason, fluctuate from one extreme to the other. Robin’s behavior was very inconsistent- she would behave appropriately at times, well mannered and reasonable and at other times she seemed irrational and enraged, often verbally berating her friends. Afterwards she would become worried that she had permanently alienated them. Robin would frantically do something kind for her friends in an attempt to bring them emotionally closer to her. When friends or family tried to distance themselves from her, Robin would threaten suicide to keep them from leaving her.
During the course of treatment, Robin’s husband reported that he could not take her suicidal and erratic behavior any longer. Robin’s husband filed for divorce shortly after her treatment began. Robin began binge drinking and taking illegal pain medication. Robin reported suicidal ideation and feeling of worthlessness. Robin displayed signs of improvement during therapy, but this ended in her 14 month of treatment when she committed suicide by consuming an overdose of prescription medication and alcohol.
PSYC 2030U Abnormal Psychology Case Study Assignment- Case Summary #2
At the time of his admission to the psychiatric hospital, Carl Landau was a 19-year-old single African American male. Carl was a college freshman majoring in philosophy who had withdrawn from school because of his incapacitating symptoms and behaviors. He had an 8-year history of emotional and behavioral problems that had become increasingly severe, including excessive washing and showering; ceremonial rituals for dressing and studying; compulsive placement of any objects he handled; grotesque hissing, coughing, and head tossing while eating; and shuffling and wiping his feet while walking.PSYC 2030U Case Study Assignment
These behaviors interfered with every aspect of his daily functioning. Carl had steadily deteriorated over the past 2 years. He had isolated himself from his friends and family, refused meals, and neglected his personal appearance. His hair was very long, as he had refused to have it cut in 5 years. He had never shaved or trimmed his beard. When Carl walked, he shuffled and took small steps on his toes while continually looking back, checking and rechecking. On occasion, he would run in place. Carl had withdrawn his left arm completely from his shirt sleeve, as if it was injured and his shirt was a sling.
Seven weeks prior to his admission to the hospital, Carl’s behaviors had become so time-consuming and debilitating that he refused to engage in any personal hygiene for fear that grooming and cleaning would interfere with his studying. Although Carl had previously showered almost continuously, at this time he did not shower at all. He stopped washing his hair, brushing his teeth and changing his clothes. He left his bedroom infrequently, and he had begun defecating on paper towels and urinating in paper cups while in his bedroom, he would store the waste in the corner of his closet. His eating habits degenerated from eating with the family, to eating in the adjacent room, to eating in his room. In the 2 months prior to his admission, Carl had lost 20 pounds and would only eat late at night, when others were asleep.
He felt eating was “barbaric” and his eating rituals consisted of hissing noises, coughs and hacks, and severe head tossing. His food intake had been narrowed to peanut butter, or a combination of ice cream, sugar, cocoa and mayonnaise. Carl did not eat several foods (e.g., cola, beef, and butter) because he felt they contained diseases and germs that were poisonous. In addition, he was preoccupied with the placement of objects. Excessive time was spent ensuring that wastebaskets and curtains were in the proper places. These preoccupations had progressed to tilting of wastebaskets and twisting of curtains, which Carl periodically checked throughout the day. These behaviors were associated with distressing thoughts that he could not get out of his mind, unless he engaged in these actions.
Carl reported that some of his rituals while eating were attempts to reduce the probability of being contaminated or poisoned. For example, the loud hissing sounds and coughing before he out the food in his mouth were part of his attempts to exhale all of the air from his system, thereby allowing the food that he swallowed to enter an air-free and sterile environment (his stomach) Carl realized that this was not rational, but was strongly driven by the idea of reducing any chance of contamination. This belief also motivated Carl to stop showering and using the bathroom. Carl feared that he may nick himself while shaving, which would allow contaminants (that might kill him) to enter his body.
The placements of objects in a certain way (waste basket, curtains, shirt sleeve) were all methods to protect him and his family from some future catastrophe such as contracting AIDS. The more Carl tried to dismiss these thoughts or resist engaging in a problem behavior, the more distressing his thoughts became.
Clinical History
Carl was raised in a very caring family consisting of himself, a younger brother, his mother, and his father who was a minister at a local church. Carl was quiet and withdrawn and only had a few friends. Nevertheless, he did very well in school and was functioning reasonably well until the seventh grade, when he became the object of jokes and ridicule by a group of students in his class. Under their constant harassment, Carl began experiencing emotional distress, and many of his problem behaviors emerged. Although he performed very well academically throughout high school, Carl began to deteriorate to the point that he often missed school and went from having few friends to no friends. Increasingly, Carl started withdrawing to his bedroom to engage in problem behaviors described previously. This marked deterioration in Carl’s behavior prompted his parents to bring him into treatment.
PSYC 2030U Abnormal Psychology Case Study Assignment- Case Summary #3
Hank Allen is a 32 year-old married Caucasian male who was brought to this screening center for psychiatric evaluation following his arrest for the murder and sexual assault of ten women. His wife, Jody, who eventually testified against him, had worked as his partner, luring victims to their deaths.
Wanting to further her husband’s fantasy of finding the “perfect lover,” Jody had accompanied him to shopping centers or county fairs and talked young girls into climbing into their customized van. Once inside, the victims were confronted by her husband, who held a handgun and bound them with adhesive tape. Most were teenagers, though two of the final victims were adults; the youngest was 13. The oldest victim, age 34, was a bartender who closed up late one night, went out to her car, then rolled down her window to talk to the couple, who had been inside drinking and who now approached her. The Allen’s kidnapped her and drove her back to their own residence. While Jody sat inside watching an old movie on television, Hank assaulted his victim in the back of the van, scripting her to play the role of his teenage daughter. When he was through, Jody rejoined him and drove away in the early morning hours, the radio blaring to drown out the sounds of her husband in the back of the van, strangling his victim to death. That evening they celebrated Hank’s birthday at a restaurant.
Most of Hank’s victims were petite blonds like Jody and Hank’s own daughter. All were sexually abused, then shot or strangled to death; several were buried in shallow graves. One, a pregnant 21-year-old hitchhiker (Jody was also pregnant at the time), was raped, strangled, and buried alive in sand.
Hank rated the sexual performance of each of his victims and always made sure that Jody knew she was never number one. Jody tried to redeem herself in the eyes of her difficult husband by submitting to his every demand. Even when she finally separated from him, she was unable to say no. They had been apart for several months when Hank called her, asking that they get together one more time. She agreed, and that day they claimed their ninth and tenth victims.
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Clinical History
Hank’s violence was a legacy from his father. When he was born, his 19-year-old father was serving a prison sentence for auto theft and passing bad checks. A later conviction earned him a term for second-degree robbery, but he escaped. In an ensuing saga of recapture, escape, recapture, and escape, he killed a police officer and a prison guard, blinding the latter by tossing acid into his face before beating him to death. Often told that he was going to be just like his father when he grew up, Hank was 16 when he learned that his father had been captured and executed in a gas chamber after his mother betrayed his hiding place. Hank later confessed to the police: “Sometimes I [think] about blowing her head off. . . . Sometimes I wanna put a shotgun in her mouth and blow the back of her head off. . . . ”
In a forensic psychiatric evaluation, Hank revealed that his mother was the object of his most intense sexual fantasy:
“I was gonna string her up by her feet, strip her, hang her up by her feet, spin her, take a razor blade, make little cuts, just little ones, watch the blood run out, just drip off her head. Hang her up in the closet, put airplane glue on her, light her up. Tattoo “bitch” on her forehead. . . “
Hank’s mother had beaten and mocked her son, a bed wetter until age 13, calling him “pissy pants” in front of guests. One of her husbands punished him mercilessly, forcing him to drink urine and burning a cigar coal into his wrist. When his mother tried to intervene, his stepfather smashed her head into a plaster wall. From that point on, she joined in the active abuse of her children. As far back as he could remember, Hank had nightmares of being smothered by nylon stocking material and being strapped to a chair in a gas chamber as green gas floated into the room.
Hank began to burglarize with an older brother at 7, and at 12 was put on probation. A year later he was sent to the California Youth Authority for committing “lewd and lascivious acts” with a 6-year-old girl. As a teenager he faced charges of armed robbery and auto theft. A habitual truant, he was suspended from high school at 17 with F’s in five academic subjects and F’s in five categories of “citizenship.” That same year he married for the first time. Often knocked unconscious in fights, he was comatose twice, briefly at 16 and for over a week at 20. A computed tomography brain scan revealed “abnormally enlarged sulci and slightly enlarged ventricles.” A neuropsychological battery showed “damage to the right frontal lobe.” Hank married seven times. He beat each of his wives, sometimes badly. Most of the marriages lasted no more than a few months. One wife described him as “dominant” and said “he’s got to be in control.” Another, who had had clumps of hair yanked from her head, called him “a Jekyll and Hyde.” Yet another said he was “vicious.” When she told him she wanted out, he took revenge by beating her parents. His first marriage ended when he beat his wife with a hammer. When she left him, she replaced his mother in his central fantasy. They had married 5 days after the birth of a baby daughter and a custody battle ensued. In spite of his lengthy record of assaults, thefts, and parole violations, Hank won.
When he was 23, Hank went on a crime spree that eventually covered five states. Stealing license plates and cars, holding up bars and drugstores, he eluded capture until caught and convicted for the armed robbery of a motel. Sent to prison for 5 years to life, he molested his 6-year-old daughter for the first time during a conjugal visit. He was 30, and his divorce from his fifth wife had not been finalized when he moved in with Jody. By the time they met, Hank had been arrested on 23 separate occasions. The following summer Hank was fired from his job as a driver. He had been fired often, and it was an event that usually left him sexually impotent.
Shortly before his final arrest, Hank, a gun enthusiast, owned a semiautomatic assault rifle, an automatic pistol, two revolvers, and a derringer. He was working as a bartender. A co-worker described him as a ladies’ man and said that women called him at work at all hours. After hanging up, he would rate them. For his crimes, he eventually received multiple death sentences. Five years after his arrest, he now awaits execution.
PSYC 2030U Abnormal Psychology Case Study Assignment-Case Summary #4
At the time of his admission to a private psychiatric hospital, Sonny Ford was a 24-year-old single Latino male who lived with his adoptive parents. Sonny had been referred for hospital admission by his outpatient psychotherapist. Over the past 2 years, Sonny had struggled with symptoms such as concentration difficulties, anxiety, and obsessional thinking. More significantly, within the year prior to his admission, Sonny began to experience paranoid and delusional thoughts that had become quite persistent. These difficulties began after Sonny smoked marijuana. While experiencing the effects of marijuana, Sonny believed that his mind had gone “numb.” From that time on, Sonny believed that the marijuana had permanently “warped” his brain. He became increasingly distressed and frustrated over his inability to get others to agree that marijuana had this effect on him. More recently, Sonny had developed concerns that the police and FBI were “out to get him.” In addition, he had begun to feel that certain television shows had special importance to him and important information was embedded in these programs directed specifically at him. Sonny believed that these messages coming to him through the television were sent to remind him that he was at risk for some sort of plot by the authorities. Sonny also heard voices in his head. Although he could not make out what they were saying, Sonny perceived the voices as “angry” and “critical.”
Over the past few months, Sonny’s symptoms had worsened to the point that they were interfering substantially with his attendance at work as a state office janitor. Because of these factors and the lack of improvement in outpatient counseling, Sonny was referred to this inpatient hospital. At the intake evaluation for his inpatient admission, Sonny’s emotions were restricted. Although appearing tense and anxious, Sonny’s face was mostly immobile for the duration of the interview. He engaged in very little eye contact with the interviewer and his body movements were agitated and restless, as evidenced by rocking movements of his legs and body. His speech was hesitant and deliberate, and he often answered the interviewer’s questions with brief and empty replies. For example, when the interviewer asked “what difficulties are you having that you would like help for?” Sonny replied, “I think it was the marijuana.”
Case History
Sonny was adopted at birth, and no records were available about medical or psychiatric history of his family origin. Sonny was raised in a household of four: in addition to his parents, he had a sister 4 years older who had also been adopted. He could recall very few memories from his early childhood. However, Sonny said that throughout his life he had always been a loner who, to this day, never had any friends. Sonny’s parents, who were present at the time of his admission to the hospital, confirmed that Sonny had always been frustrated by social interactions and added that their son had always been hypertensive to real or perceived criticism during his school years. Sonny was very attached to his father and, for may years, experienced considerable distress and loneliness when he was separated from the family’s home or his father for extended periods. Whereas Sonny described his father as “a very accepting person” he claimed that his mother was “excessively critical and not accepting of me as a person.” Sonny also claimed that his mother was an alcoholic, a statement that was not supported by either of his parents.
When Sonny was 16, he realized that he was homosexual. Although his father had been accepting Sonny reported that his mother had been very unaccepting of his homosexuality and often referred to him with pejorative labels, such as “fag.” While Sonny accepted his sexual orientation, he said that being gay had caused him many troubles one of which was loneliness. Many of Sonny’s persistent and obsessive thoughts focused on the possibility of contracting the HIV virus from having unprotected sex on one occasion. Sonny’s fears of having HIV had not been quieted by the fact that the person with whom he had sex with was HIV negative or by the fact the all of his recent HIV tests were also negative.
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Despite lifelong difficulties with social adjustment, Sonny had been able to meet most of the demands and responsibilities of adolescence. Following his graduation from high school (with a C+ average), sonny decided to attend a local college to take introductory courses. This decision was strongly influenced by his apprehension of moving out of his parent’s house to attend school away from his immediate community. However, it was during his freshman year that Sonny had smoked the marijuana that he believed permanently damaged his brain. Following the incident, Sonny dropped out of college due to the worsening of behaviors. Sonny enrolled at a second college for only one semester before dropping out again, because of his inability to cope with sitting in crowded classrooms and completing assignments and tests on time. Sonny has held his current position as a janitor for the last 18 months, in part because this position allows him to work alone and does not require extensive social interaction.
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