Case Study

Within Unit VIII, you have learned about various psychological disorders and the complexities involved with proper diagnoses and treatment efforts. Now it is time to put your skills to the test. Choose ONE of the cases listed below and create a mental health assessment for your chosen case. In the assessment, you should address the following: a. Why is your client coming for treatment? b. What are his or her current symptoms? c. Does he or she have a history with this problem? If so, please describe it. d. How could the issue affect his or her daily life functions? e. What is your client’s specific diagnosis? f. What is the general class(es) of disorders to which this disorder belongs? g. What are your recommendations? What specific treatment plan will you prescribe for this patient? You should use your textbook as a reference to substantiate your plan. h. How could you get his or her family involved? Chose ONE of these cases to analyze. Tony sometimes seems very wound up. At those times, he seems full of energy, talks very rapidly, and makes very grandiose plans. Once, he gave away all of his belongings and was planning to move to Washington, D.C., so that 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 does not 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. Paula 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, Paula seemed fairly normal except for having several episodes 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. Hint: there are two specific diagnoses here. 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 whom he used to see often and declines all invitations to do things socially. His most common response is “I just do not 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. Patricia is a 44-year-old female who reports that she has periods of time where she cannot remember what she has done. She reports that after one such period, she received a telephone call from a man who claimed to have met her in a bar where she was “the life of the party.” She had also told the man her name was Priscilla. Patricia thinks that this is odd because she does not drink, and she is a rather shy and retiring person. However, the man had her correct telephone number and was able to give a good physical description of her.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 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. In your case study, you must incorporate research from the textbook to substantiate your diagnosis. You may also use the CSU Online Library for additional reference material if needed, but this is not required. Your response should be at least two pages in length. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations APA Format. Course Textbook(s): Wade, C., & Tavris, C. (2017). Psychology [VitalSource Bookshelf version] (12th ed.). Retrieved from https://online.vitalsource.com/#/books/97813235982…
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UNIT VIII STUDY GUIDE
Abnormal Behaviors
and Therapies
Course Learning Outcomes for Unit VIII
Upon completion of this unit, students should be able to:
6. Identify symptoms of various abnormal conditions.
6.1 Differentiate the major symptoms of psychological disorders.
6.2 Prepare a therapeutic treatment plan.
6.3 Describe how an individual’s daily life functions could be affected by an abnormal condition.
Reading Assignment
Chapter 15:
Psychological Disorders, pp. 537-574
Chapter 16:
Approaches to Treatment and Therapy, pp. 581-607
Additional Reading Assignment:
In order to access the following resources, click the links below:
Russell, G. (Producer). (2015). Addiction to video games (Segment 9 of 15)[Video file]. Retrieved from
https://libraryresources.columbiasouthern.edu/login?auth=CAS&url=http://fod.infobase.com/PortalPla
ylists.aspx?wID=273866&xtid=124990&loid=442191
To view a transcript of this video, click here.
TED (Producer). (2007). The Capgras delusion (Segment 2 of 13)[Video file]. Retrieved from
https://libraryresources.columbiasouthern.edu/login?auth=CAS&url=http://fod.infobase.com/PortalPla
ylists.aspx?wID=273866&xtid=48098&loid=132941
To view a transcript of this video, click here.
Unit Lesson
Chapter 15: Psychological Disorders
How do you define abnormal behavior? Does a person who behaves strangely automatically have a mental
disorder? During this unit, you will learn the difference between abnormal behavior and a mental disorder.
Although these terms are often used interchangeably, the definitions are quite different. The reference used to
diagnose various mental disorders is the Diagnostic and Statistical Manual of Mental Disorders (DSM). The
DSM provides diagnostic categories to assist researchers and physicians on proper identification and
treatment options. As a matter of fact, the American Psychiatric Association released the 5th version of the
manual in 2013 (DSM-V). This version has undergone numerous changes to include updated research
findings within mental health. For instance, autism spectrum disorder now encompasses four disorders, which
were previously separated: Asperger’s, autism, pervasive developmental disorder not otherwise specified,
and childhood disintegrative disorder. Posttraumatic stress disorder (PTSD) has been updated with four
categorical symptom clusters. Another notable change is the fact that premenstrual dysphoric disorder now
has an official diagnosis in the DSM-V. Furthermore, hoarding disorder has been identified separately from
obsessive-compulsive disorder (OCD). Numerous additional changes have occurred, and, of course, as with
any change, there are critics. Ultimately, the DSM-V is a reference tool to help clinicians provide effective
PSY 1010, General Psychology
1
treatment efforts for their patients. As with any resource, it is only as effective as the critical practices that are
embraced when utilizing it.
Within this unit, you will learn about various mental disorders including anxiety, mood, and antisocial
personality. Although you have probably heard about PTSD, panic disorders, and OCD, there exists a
plethora of commonly unknown syndromes that are quite fascinating. According to Enoch and Ball (2000),
Capgras’ delusion is described as a syndrome that occurs when a patient believes that an individual close to
him or her has been exchanged with a twin or exact double. Watch this short video segment to learn more
about this condition:
TED (Producer). (2007). The Capgras delusion (Segment 2 of 13)[Video file]. Retrieved from
https://libraryresources.columbiasouthern.edu/login?auth=CAS&url=http://fod.infobase.com/PortalPla
ylists.aspx?wID=273866&xtid=48098&loid=132941
To view a transcript of this video, click here.
In Ekbom’s syndrome, patients experience delusions in which they believe that various maggots, lice, or other
insects live within their skin. Have you heard about Munchausen syndrome by proxy? This syndrome is
gaining new attention by doctors as a form of child endangerment. In this case, a caregiver persistently
fabricates medical symptoms in the person for which he or she is responsible for basic care. In many
instances, a mother will fabricate her child’s symptoms in order to receive attention. This often leads to
unnecessary, hazardous treatment procedures. What do you think? Have you seen any reports in which a
mother traveled to various clinics and hospitals to pursue care for her child and it was discovered that she had
fabricated every detail of the illness?
A person with OCD typically has compulsions, or
repetitive behaviors. Hand-washing is a common
compulsion seen in people who suffer from this
disorder.
Did I unplug the iron when I left home this morning? Am I
sure? Do I need to go back and check again? Maybe I need
to check it one more time? Taken in isolation, these thoughts
might seem like common reminders for safety purposes.
However, in individuals who suffer from obsessivecompulsive disorder, these plaguing insecurities are a way of
life. Individuals who suffer from OCD often find themselves
repeating tasks over and over again, up to 25 times in one
day. Begley and Biddle (1996) examined a study conducted
by Jeffrey Schwartz and colleagues at UCLA. The PET
scans of patients with OCD revealed that the part of the brain
that serves as an alert system, the orbital cortex, was
seemingly in a constant active state. Schwartz and his
colleagues suggest that behavior modification and cognitive
therapy can assist these individuals with overcoming their
obsessions. For instance, when an obsessive thought floods
one’s mind, these scholars suggest that the individual relabel
the thought as an obsession and begin to focus on a
constructive activity instead, such as paying the bills for 15
minutes. This allows the caudate nucleus time to get
refocused on other thoughts. Do you think you can you alter
your brain to restore your peace of mind?
(James, 2009)
As you further your examination of this chapter, pay close
attention to additional disorders discussed. Take note of the
numerous symptoms and possible treatment options. Begin to notice others around you that possibly might fit
some of the characteristics associated with the various disorders. According to Halgin and Whitbourne (1994),
some individuals lack a notable sense of self-control. For instance, have you ever noticed someone who
obsessively pulls out his or her hair? This is known as trichotillomania. Do you know someone who is overly
obsessed with fires? This person would be classified as a pyromaniac. Further still, do you know someone
who seems to have recurrent bouts of excessive rage? This is a characteristic of intermittent explosive
disorder. Have you ever noticed these abnormal behaviors?
This chapter further discusses the issue of drug abuse and addiction. Wade and Tavris (2017) report that
genetics may play a role in one’s vulnerability to alcohol abuse. Furthermore, cultures possess varying views
PSY 1010, General Psychology
2
on practices and values related to alcohol and drug usage. As you read this section, begin to notice your peer
associations and influences. Is social drinking acceptable in your community? Are you an advocate for the
usage of marijuana for medicinal purposes? What is your stance on alcohol and drug use?
Are you a gamer? Could you go one day without playing your favorite video game for hours on end? New
research is emerging that suggests that a person can become addicted to playing videogames. According to
Wood (2008), in extreme cases, many individuals have become so fixated on games that they neglect major
aspects of their lives: job, school, and relationships, just to name a few. Although excessive playing can
produce negative consequences, videogame abuse does not normally elicit illegal actions and debt,
behaviors that are often present with other addictions. Could excessive playing, however, be a symptom of
additional psychological issues? More research is still needed in this area. Video gaming addiction is
examined in this short video segment.
Russell, G. (Producer). (2015). Addiction to video games (Segment 9 of 15)[Video file]. Retrieved from
https://libraryresources.columbiasouthern.edu/login?auth=CAS&url=http://fod.infobase.com/PortalPla
ylists.aspx?wID=273866&xtid=124990&loid=442191
To view a transcript of this video, click here.
As you conclude your studies for this section, examine the psychotic disorder of schizophrenia. Research has
discovered that many schizophrenics are heavy cigarette smokers. Neergaard (1997) reported that by taking
a long drag, one can receive temporary relief to information overload. Schizophrenics often find it difficult to
filter out various forms of stimulation. Researchers discovered a gene that was linked to a brain receptor site
that is stimulated by the nicotine drug. In essence, when the nicotine is ingested, this can trigger a short
increase in one’s ability to filter information. This seemingly helps the schizophrenic reduce the stimulation
received from the outside world and achieve momentary selective focus. So what do you think? Can smoking
a hazardous drug actually have beneficial side effects?
PSY 1010, General Psychology
3
Chapter 16: Approaches to Treatment and Therapy
After a person has been diagnosed with a mental disorder,
how does he or she deal with it? In this chapter, Wade and
Tavris (2017) confront the issue of various approaches to
treatment and therapy. During this section, you will learn
about various biological treatment techniques used with
varying results. Antipsychotic drugs, antidepressants, and
tranquilizers are often prescribed to treat the various
disorders. However, have you ever considered the usage of a
service dog? For instance, in a growing number of cases,
service dogs are assisting individuals who suffer from anxiety.
They are trained to lick or nudge the owner if it senses that he
or she is experiencing an anxiety attack. This has a two-fold
purpose. It distracts the owner and reminds him or her to
relax. The dogs are also trained to fetch the owner’s
medications when needed as well. Some organizations have
even begun to provide service dogs to veterans who suffer
from PTSD. The dogs provide emotional support,
companionship, and encourage positive behaviors (Wellman,
2009). This information provides a whole new perspective on
man’s best friend.
As you continue your examination of this chapter, you will be
introduced to the major schools of psychotherapy. For
example, some proponents argue that evidence-based
therapy (EBT) should be the foundation for therapeutic
decisions. In essence, if research purports that a certain
therapy has proven effective to treat a certain disorder, this
form of therapy should be used as the preferential form of
treatment. Although this may seem like common sense, some
This PTSD service dog stands behind his owner
clinicians argue that this will limit their ability to exercise their
and serves as a companion for the soldier.
personal judgment and force them to use EBT. Should
(Reguyla, 2016).
therapists be allowed to continue to use outdated therapies
when new research indicates more effective treatment options?
How do you define success? Although many therapeutic efforts have proven beneficial, there are still
challenges that warrant further examination. For example, many complex issues must be evaluated to
effectively measure outcomes. People can experience depression and anxiety for numerous reasons.
Additionally, it is quite easy for a patient to become attached to his or her therapist due to all of the time and
effort that is extended. Further still, many individuals embrace a false sense of improvement because we
naturally edit our memories in order to believe we have changed for the better. Keeping the above factors in
mind, how would you measure success in therapy?
Which is more important, quality of life or maintaining control over the disorder? Many researchers argue that
the focus has been primarily on treating the symptoms of various disorders while ignoring the patient’s
happiness and quality of life. Should a patient’s level of happiness and ability to function as a viable member
of his or her community be notable points as well? Some psychologists have begun to embrace the Recovery
Model. According to Gottlieb (2009), many therapists now place less emphasis on treating the symptoms of
the disorder and focus more on helping the patient to recover a happy, healthy, fulfilling life. This will often
mean that some patients will choose not to take certain drugs and participate in specific treatments. Ponder
this. If one is suffering from a mental disorder, is he or she actually capable of making rational decisions in
regard to his or her treatment options?
As you conclude your examination of the material, continue to reflect upon evaluating the need for effective
psychotherapy. Does one therapist have a better fit with certain clients than others? Could one’s cultural
background matter when choosing a therapist? How long should therapy actually last? Although therapy
should elicit productive results, can it ever produce more harm than good? It is inherently important that one
PSY 1010, General Psychology
4
remain cognizant of realistic goals when seeking to treat any disorder. Consumers beware; all therapeutic
methods are not created equally.
References
Begley, S., & Biddle, N. A. (1996, February 26). For the obsessed, the mind can fix the brain. Newsweek, 60.
Enoch, M. D., & Ball, H. N. (2000). Uncommon psychiatric syndromes (4th ed.). London: Edward Arnold.
Gottlieb, D. (2009, December 14). Recovery and mental health. Voices in the Family. Philadelphia, PA:
WHYY.
Halgin, R. P., & Whitbourne, S. K. (1994). Abnormal psychology: The human experience of psychological
disorders. Fort Worth, TX: Harcourt Brace.
James, D. (2009, December 12). OCD handwash [Image]. Retrieved from
https://commons.wikimedia.org/wiki/File:OCD_handwash.jpg
Neergaard, L. (1997, January 21). Scientists find link between schizophrenia gene, nicotine. Austin AmericanStatesman, A2.
Reguyla. (2016, November 28). Man’s best friend helps NC guardsman with PTSD [Image]. Retrieved from
https://commons.wikimedia.org/wiki/File:Man%E2%80%99s_best_friend_helps_NC_Guardsman_with
_PTSD_(Image_1_of_8)_(12002105586).jpg
Wade, C., & Tavris, C. (2017). Psychology (12th ed.)[VitalSource Bookshelf version]. Retrieved from
https://bookshelf.vitalsource.com/#/books/9781323598269/
Wellman, E. (2009, December 7). Demand grows for psychiatric service dogs. Cleveland, OH: WCPN.
Wood, R. (2008). Problems with the concept of video game “addiction”: Some case study examples.
International Journal of Mental Health and Addiction, 6, 169-178.
Suggested Reading
The links below will direct you to both a PowerPoint and PDF view of the Chapter 15 and 16 Presentations,
which will summarize and reinforce the information from these chapters in your textbook.
Click here to access the Chapter 15 PowerPoint Presentation. (Click here to access a PDF version of the
presentation.)
Click here to access the Chapter 16 PowerPoint Presentation. (Click here to access a PDF version of the
presentation.)
In order to access the following resources, click the links below:
In this unit, you have read about various disorders. For further enrichment about two of these disorders,
browse the following websites to learn more.
American Psychological Association. (n.d.). Answers to your questions about panic disorder. Retrieved from
http://www.apa.org/pubinfo/panic.html
The website of the International OCD Foundation explains the symptoms of OCD and effective treatments,
and offers resources for support.
International OCD Foundation. (n.d.). Retrieved from http://www.ocfoundation.org/
PSY 1010, General Psychology
5
Learning Activities (Non-Graded)
Non-graded Learning Activities are provided to aid students in their course of study. You do not have to
submit them. If you have questions, contact your instructor for further guidance and information.
Knowledge check!
The short quizzes below are a great way to self-test your knowledge of the concepts learned in this unit. Take
a few minutes to complete these quizzes to check your understanding. They are located in the textbook on
the page(s) given. The answers are provided in the document below the quizzes, but try to answer the
questions before checking the answers.
Chapter 15
Quiz for Module 15.1 (page 546)
Quiz for Module 15.2 (page 547)
Quiz for Module 15.3 (page 552)
Quiz for Module 15.4 (pages 555-556)
Quiz for Module 15.5 (page 560)
Quiz for Module 15.6 (page 566)
Quiz for Module 15.7 (pages 568-569)
Quiz for Module 15.8 (page 574)
Chapter 15 Quiz (pages 578-580)
Chapter 16
Quiz for Module 16.1 (page 590)
Quiz for Module 16.2 (pages 598-599)
Quiz for Module 16.3 (pages 607-608)
Chapter 16 Quiz (pages 611-613)
Answer Keys
Click here for the Chapter 15 answer keys.
Click here for the Chapter 16 answer keys.
Movies for Enrichment Review
Various movies exist that illustrate aspects of psychological disorders. Some of the movies listed below even
relate to the therapeutic process as well. For additional enrichment, take a couple of hours to review one or
more of these movies.
?
?
?
?
?
David and Lisa (1962)
Henry: Portrait of a Serial Killer (1990)
Clean, Shaven (1995)
Nuts (1987)
As Good as it Gets (1997)
Films on Demand
Within this unit, you have learned that multiple treatment approaches to assist with various psychological
disorders exist. One such approach involves the family. For additional enrichment, view the video from Films
on Demand and reflect upon how a “team approach” could best assist the patient with his or her recovery
efforts.
Yu, J. (Producer), & West, S. (Co-producer). (2006). Getting an addict into treatment: The CRAFT approach
[Video file]. Retrieved from
https://libraryresources.columbiasouthern.edu/login?auth=CAS&url=https://fod.infobase.com/PortalPl
aylists.aspx?wID=273866&xtid=39801
PSY 1010, General Psychology
6
15
PSYCHOLOGICAL DISORDERS
15.1
Diagnosing Mental
Disorders
15.5
Personality Disorders
15.2
Anxiety Disorders
15.6
Drug Abuse and Addiction
15.3
Trauma and Obsessive–
Compulsive Disorders
15.7
Dissociative Identity Disorder
15.4
Depressive and Bipolar
Disorders
15.8
Schizophrenia
PSYCHOLOGY, Twelfth Edition | Carole Wade • Carol Tavris
Copyright © 2017, 2014, 2011 Pearson Education Inc. All rights reserved.
15.1
Diagnosing
Mental
Disorders
Copyright © 2017, 2014, 2011 Pearson Education Inc. All rights reserved.
15.1
Module Learning Objectives
15.1.
A
Consider why it is difficult to obtain a universally agreed-upon
definition of “mental disorder.”
15.1.
B
Describe four dangers associated with using the DSM for
diagnosis of mental disorders, and give an example of each.
15.1.
C
Explain the theoretical basis of projective tests, and identify
the problems associated with these techniques.
Copyright © 2017, 2014, 2011 Pearson Education Inc. All rights reserved.
Dilemmas of Definition
Mental disorder:
Any behavior or emotional state
that:
•
•
•
•
Causes an individual great
suffering
Is self-destructive
Seriously impairs the person’s
ability to work or get along with
others
Makes a person unable to control
the impulse to endanger others
Copyright © 2017, 2014, 2011 Pearson Education Inc. All rights reserved.
Dilemmas of Diagnosis
Diagnostic and Statistical
Manual of Mental Disorders
(DSM): APA’s standard
reference manual used to
diagnose mental disorders
Copyright © 2017, 2014, 2011 Pearson Education Inc. All rights reserved.
Classifying Disorders: The DSM
Critics:
Inherent problems in
DSM:
• The danger of
overdiagnosis
• The power of
diagnostic labels
• Confusion of serious
mental disorders with
normal problems
• The illusion of
objectivity
Supporters:
It is important to help
clinician …
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