Mini Case Studies: Identifying Psychological Disorders

Malcolm: Social Anxiety Disorder

For three mini-case studies (there are thirteen in total), you will write a short paragraph that includes this information: What psychological disorder do you think is depicted in the mini-case study? Explain why you think your answer is right. Please number each paragraph, so it is clear which case study numbers you are responding to. Mini Case-Studies Read all of the following mini case-studies carefully and choose three (3) to write about. Malcolm was a computer expert who worked for a large software firm. One of the things he hated to do most was ride the elevator at the building where he worked when other people were on it. He felt that everyone was watching him, commenting silently on his ruffled clothes and noticing every time he moved his body. He held his breath for almost the entire elevator ride, afraid that he might say something or make a sound that would embarrass him. Often, he walked up the eight flights of stairs to his office, rather than take the risk that someone would get on the elevator with him. Malcolm rarely went anywhere except to work and home. He hated even to go to the grocery store for fear he would run his car into someone else or say something stupid to a grocery store clerk. He found a grocery store and several restaurants that took orders online and delivered. He liked this service, because he could use it to avoid even talking to someone over the phone to place the order. In the past, Malcolm’s job had allowed him to remain quietly in his office all day, without interacting with other people. Recently, however, his company was reorganized, and it took on a number of new projects. Malcolm’s supervisor said that everyone in Malcolm’s group needed to begin to work together more closely to develop these new products. Malcolm was supposed to make a presentation to his group on some software he was developing, but he called in sick the day of the presentation, because he could not face it. Malcolm was thinking that he had to change jobs and that perhaps he would go into private consulting, so that he could work from his home, rather than having to work with anyone else. (Nolen-Hoeksema & Rector, 2nd Canadian Ed.). When her son, José, was born, Irene decided to quit her job and become a full-time mother. She enjoyed José’s infancy tremendously. He was a happy baby and was hardly ill for the first two years of his life. Now that he was a toddler, however, José was beginning to get the usual skinned knees and bumps and bruises that small children do. Irene had always been squeamish about blood, but she thought she could overcome this when it came to caring for her son. The first time José scraped his knee seriously enough for it to bleed, however, Irene became dizzy on seeing it and fainted. José screamed and cried in terror at seeing his mother faint. Fortunately, a neighbour saw what happened and quickly went over to comfort José and to see that Irene was okay. Since then, Irene has fainted three more times on seeing José Injured. She has begun to think that she will not be able to care for José by herself any longer. (Nolen-Hoeksema & Rector, 2nd Canadian Ed.). For me, a panic attack is almost a violent experience…My heart pounds really hard. I feel like I can’t get my breath and there’s an overwhelming feeling that things are crashing in on me. In between attacks, there is this dread and anxiety that it’s going to happen again. I’m afraid to go back to places where I’ve had an attack. Unless I get help, there soon won’t be any place where I can go and feel safe from panic. (Sue, Sue, Sue & Sue, 3rd ed.). Mrs A. is a 32-year-old married mother of two who spends at least 4 hours each day cleaning and making sure everything in her house is in its perfect place. If Mrs A sees or hears words pertaining to death, she immediately begins to repeat the Lord’s Prayer in her mind 100 times. She believes that failure to perform this ritual will lead to the untimely death of her children. (Sue, Sue, Sue & Sue, 3rd ed.). Gina is a 32-year-old single mother of two children seeking professional help for her long-standing feelings of anxiety. Despite the fact that her life is relatively stable in terms of financial and interpersonal matters, she worries most of the time that she will develop financial problems, that her children will become ill, and that the political situation in the country will make life for her and her children more difficult. Although she tries to dismiss these concerns as excessive, she finds it virtually impossible to control her worrying. Most of the time, she feels uncomfortable and tense, and sometimes her tension becomes so extreme that she begins to tremble and sweat. She finds it difficult to sleep at night. During the day she is restless, keyed up, and tense. She has consulted a variety of medical specialists, each of whom has been unable to diagnose a physical problem. (Whitbourne & Halgin, 7th ed.). Joshua is a 43-year-old man who stands daily near the steps of a local bank on a busy street corner. Every day, he wears a Red Sox baseball cap, a yellow T-shirt, worn-out hiking shorts, and orange sneakers. Rain or shine, day in and day out. Joshua maintains his post at the bank. Sometimes he is conversing with imaginary people. Without provocation, he sobs miserably. Sometimes he explodes in shrieks of laughter. Police and social workers keep taking him to shelters for the homeless, but Joshua manages to get back on the street before he can receive treatment. He has repeatedly insisted that these people have no right to keep bothering him. (Whitbourne & Halgin, 7th ed.). Jonathan is a 37-year-old construction worker whose wife took him to a psychiatric facility. Although Jonathan has been functioning normally for the past several years, he suddenly became severely disturbed and depressed. At the time of admission, Jonathan was agitated, dysphoric, and suicidal, even going as far as to purchase a gun to kill himself. He has lost his appetite and had developed insomnia during the preceding 3 weeks. As each day went by, he found himself feeling more and more exhausted, less able to think clearly or to concentrate, and uninterested in anything or anyone. He had become hypersensitive in his dealings with neighbours, co-workers, and family, insisting that others were being too critical of him. This was the second such episode in Jonathan’s history, the first having occurred 5 years earlier following the loss of his job due to a massive layoff in his business. (Whitbourne & Halgin, 7th ed.). Larry is a 32-year-old bank cashier who has sought treatment for his mood variations, which date back to age 26. For several years, co-workers, family, and friends have repeatedly told him that he is very moody. He acknowledges that his mood never feels quite stable, although at times others tell him he seems more calm and pleasant than usual. Unfortunately, these intervals are quite brief, lasting for a few week and usually ending abruptly. Without warning, he may experience either a somewhat depressed mood or a period of elation. During his depressive periods his confidence, energy, and motivation are very low. During his hypomanic periods, he willingly volunteers to extend his workday and to undertake unrealistic challenges at work. On weekend, he acts in promiscuous and provocative ways, often sitting outside his apartment building making seductive comments and gestures to women walking by. Larry disregards the urging of his family members to get professional help, insisting that it is his nature to be a bit unpredictable. He also states that he doesn’t want some “shrink” to steal away the periods during which he feels fantastic. (Whitbourne & Halgin, 7th ed.). Myra is a young single woman who works as a clerk in a large bookstore. She lives by herself, never goes out socially except to see her relatives, and dresses in a conservative manner, which her associates ridicule as prudish. In her early teens, she was involved in an intimate relationship with a middle-aged man who was quite abusive toward her. Although others remind her of this troubled relationship. Myra claims that she has no recollection of that person, and she was even wondered at times whether others have made up the story to annoy her. At age 25, Myra says that she is saving herself sexually for marriage, yet she seems totally uninterested in pursuing any close relationships with men. So far, this describes Myra as her work acquaintances and family know her. However, alters reside within Myra’s body and they go by other names and behave in ways that are totally incongruous with “Myra’s” personality. “Rita” is flamboyant, outgoing, and uninhibited in her sexual passions. She has engaged in numerous love affairs with a variety of unsavory characters she picked up in nightclubs and discotheques. “Rita” is aware of “Myra” and regards her with extreme disdain. A third personality, “Joe,” occasionally emerges from Myra’s apartment dressed in a man’s three-piece business suit. “Joe” goes downtown to do some shopping. According to “Joe,” “Rita” is nothing but a “slut” who is heading for “big trouble someday.” Myra’s alters are oblivious to the details of her life. (Whitbourne & Halgin, 7th ed.). A 41-year-old woman, Linda, reported having a history of concerns about cancer, especially stomach or bowel cancer. Her grandmother had bowel cancer when Linda was 22. Media stories of illness, medical documentaries, or reading about people who are ill all trigger her worries: “I notice a feeling of discomfort and bloating in my abdomen. I wonder if this could be an early sign of cancer. Cancer is something that can happen at my age. People can have very few symptoms and then suddenly it is there and a few months later they are gone”. (Sue, Sue, Sue & Sue, 3rd ed.) Tiffany, a 32-year-old banker, thought she had already suffered more stress than one person could handle. She had always thought of herself as a person to whom weird things usually happened, and she commonly made more out of the situations than was warranted. Driving down a snowy road one night, she accidentally hit an elderly man who was walking on the side of the road, causing a near-fatal injury. In the months that followed, she became caught up in lengthy legal proceedings, which distracted her from her work and caused tremendous emotional stress in her life. On awakening on Monday morning, she found herself staggering around the bedroom, unable to see anything other than shadows of objects in the room. At first, she thought she was just having a hard time waking up. As the morning progressed, however, she realized that she was losing her vision. She waited two days before consulting a physician. When she did go for her medical appointment, she had an odd lack of concern about what seemed like such a serious physical condition. (Whitbourne & Halgin, 7th ed.). An 18-year-old woman who survived a dramatic fire claimed not to remember it or the death of her child and husband in the fire. She claimed her relatives were lying about the fire. She became extremely agitated and emotional several hours later, when her memory abruptly returned. (Sue, Sue, Sue & Sue, 3rd ed.). When she awoke, Joan looked around and realized that she did not know her own name, where she was, or how she got there. She did not recognize herself in the mirror. She figured out that she was in a motel room in Albuquerque, New Mexico…She then took a bus downtown in hopes of finding something familiar. She felt disoriented, and became anxious, afraid and paranoid…For Joan, her life began when she awoke in the motel room. (Sue, Sue, Sue & Sue, 3rd ed.)