Case Study #1: Edna
Edna is a 25-year-old woman brought in for evaluation after being arrested for assisting her boyfriend in a series of hold-ups of convenience stores. She has received no mental health treatment, but has consistently been in trouble with the law since she was 12 years of age. Her numerous infractions include bar fights, petty theft, and minor fraud. While she seems angry at having been caught, she does not feel any guilt and she expresses no remorse about harming her victims. In general, ever since she was a teenager Edna has been emotionally detached from other people (including her boyfriend) — even though she can come across to other people as “charming” when it suits her purposes. Although Edna is very intelligent, she often acts impulsively, especially when it comes to satisfying her needs.
What general diagnosis would best fit with Edna’s clinical symptoms?
Case Study #2: Sam
Sam is a 25 year old man. Two months ago, he was seen at his local emergency room for what he feared was a heart attack. While walking his dog, he suddenly felt his heart pounding, became dizzy and nauseous, and felt tingling in his hands and feet. Feeling that something was desperately wrong, he immediately returned home and asked his room-mate to take him to the hospital. Tests revealed that there was no indication of a heart attack, heart disease, or any other disorder that might account for his symptoms. Since his first episode, Sam reports there have been a couple of similar episodes, and that he is constantly concerned that he might have an episode at any time.
What general diagnosis would best fit with Sam’s clinical symptoms?
Case Study #3: Rob
Rob P., a 47-year-old male, sat across from the therapist with his eyes cast downward, speaking noticeably slowly and softly, expressing how tired he was not only from the week, but also from life in general. He stated that his days are mostly spent lying on his girlfriend’s couch, watching t.v., or just staring out her picture window watching neighborhood children play. Although his past history includes working as a licensed pilot, an engineer, and an entrepreneur, he currently has no motivation to pursue any work. He claims that he is “….just too tired,” and that he experiences chronic leg pain from an old gunshot wound he experienced years ago during an ill-fated business deal that went “..really bad.” Rob fears that this time his feelings of sadness and fatigue will not improve, and that he will never again feel energized and “alive.” His description of feeling “alive” includes having lots and lots of energy, being able to stay up and work/play for days at a time, and having moments of “genius” during which he is capable of doing most anything. He describes one incident during one of his last “alive” episodes during which he “maxed out” his credit cards, put a down payment on a plane, and began putting together a flight school. He felt at the time that “..the world was (his) oyster and there wasn’t anything (he) couldn’t do.” However, it was during this time that his girlfriend threatened to leave him, claiming that his behavior was erratic, impulsive, and at times frightening. During this argument, he broke down a closed door to get to her and threw her glass coffee table through a window. After 6 months of being apart, he started his current episode of feeling sad and tired, and they are working toward restoring their relationship. Rob is seeking help to figure out “…who (he) really is”, and whether he would rather be “alive” or continue to have this relationship with his girlfriend. He recognizes that he sometimes gets into trouble during his energized periods.
What general diagnosis would best fit with Rob’s clinical symptoms?
Case Study #4: Carol
Carol M., a 40-year old mother of 5 has come into the emergency room of a small town hospital, stating in a soft, hoarse voice that “….my throat is closing up, and I’m losing my ability to breathe well or speak! Please help me!” As doctors rush to run several medical tests, staff interview Carol to learn more about her and her situation. While relating her recent history, she tells them that she recently experienced a divorce after 15 years of marriage, and has temporarily relinquished custody of her 5 sons to her ex-husband. She since has also remarried a man who was arrested three weeks ago in a high profile cocaine bust. She further states that she must get better quickly since she was on her way over the mountain pass to attend a deposition about her husband’s case and is afraid of how upset he’ll be if she does not make an appearance. Upon evaluating Carol’s test results, doctors can find no medical reason for her extreme throat symptoms, but do acknowledge that these symptoms appear to be quite real and not feigned. Carol does indeed appear to be losing her voice. After additional tests with several specialists, still no physical findings are evident in her case.
What general diagnosis would best fit with Carol’s clinical symptoms?
Case Study #5: Eddie
Eddie G. was admitted to a Day Hospital program after his family reported that they could no longer have him in their home. Eddie had one day attacked his mother and sister with a knife, claiming that they were part of a plot of “the devil” who was out to kill him. When engaged in conversation, Eddie often speaks of a medical degree that he possesses and that he has devised a cure for cancer, in spite of evidence indicating that he never finished high school. He sometimes wears a hat made of aluminum foil to protect his brain, since he believes that space aliens would like to steal his thoughts about his cure for cancer. It can be quite difficult to hold a conversation with Eddie since he tends to skip from topic to topic with little coherency. During group therapy meetings, he usually appears completely without emotion, although at times he displays strong emotions that seem incongruent with group themes. For example, during a particularly poignant group discussion about traumatic war experiences, Eddie suddenly began laughing uncontrollably, and yet cried during a group holiday party. He seems disconnected from the social and emotional communications of other group members. Eddie also lives in a group care home so that he can be reminded to bathe and eat regularly, and take medications. He will likely require care for the rest of his life.
What general diagnosis would best fit with Eddie’s clinical symptoms?
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