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Psychology
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Ms. Neighbors. Case Study. Psychology Research Paper

Essay Instructions:

Assignment:

In each case read the case carefully and note the patient's symptoms, their signs (observable behavior) and their history.  Then align each symptom, behavior, etc. with the actual criteria  in the DSM.  Make sure you indicate in your write-up how each piece of information in the case is an example of the criteria in the DSM so that you can justify your diagnosis.  The next section will require you to offer "rule out" diagnoses.  These are possible diagnoses that "could" be true, but after careful analysis do not meet ALL OF THE CRITERIA necessary to make that diagnosis.  A medical example:  a patient complains of a severe headache, stiff neck and a high temperature.  You may suspect meningitis....that would be a "rule out" that requires further investigation.  Clearly, it is a possible diagnosis, but when a spinal tap is done, it is negative and meningitis is "ruled out."  It was the flu!  When you give me two rule outs for the case make sure each one is plausible.  For instance, if your final diagnosis turns out to be schizophrenia, a rule out of a phobia for elevators is  not even close to the symptoms of schizophrenia and would never be a possibility. You must describe why each of your rule outs DO NOT describe the patient by noting the DSM criteria that are not met.  As you read about disorders you will see that their are clusters of somewhat similar disorders that can be differentiated from one another.  Finally, you will be asked to discuss treatment options for your diagnoses and the prognosis for the patient, that is what is the likely outcome and possibility for improvement or deterioration. Remember, all reports must be at least 1 full page, single spaced 12 point font.

Make sure you read the case study info below very carefully. Most critical is that you line up each symptom, complaint, sign and history with the exact criteria in the DSM 5 that will justify your diagnosis.  Do not generalize, but do a criteria by criteria justification.  For instance, Mr. Q complains of feelings of tiredness and not getting pleasure out of his usual hobbies ( Dx criteria that aligns are" fatigue and anhedonia" to help justify a dx of Major Depression).  You are also required to rule out diagnoses that "could "be possible but not all necessary criteria. are met.  List all criteria that are Not met.  Notice that many diagnoses in a chapter are somewhat similar, but have significant diffrerences. THis exercise is called "differential Diagnosis" for that reason.

 

 

Case Study

Ms. Neighbors,

Ms. Neighbors is a 25-year-old, single, unemployed African American woman who was evaluated in the crisis center after her sister observed that her behavior had become increasingly bizarre and her work habits erratic.  She had no prior psychiatric history.

Ms. Neighbors lost her job 3 months ago and had become increasingly preoccupied with her neighbors who she felt were harassing her by “accessing” her thoughts and then repeating them to her.  She admitted to feeling “stressed” since she lost her job.

She presented as poised, attractive and appeared perfectly normal which surprised her evaluators after they had read her admission complaints.  She had no insight as to why she was being evaluated.  She denied mood disturbance and denied having any psychotic symptoms.  When asked if anyone could read her mind, she replied, “Yes, it happens all the time,” and described how when she was planning her dinner in silence, she heard her neighbors reciting her menu out on the street.  She claimed that everyone developed telepathic powers in childhood and she had just become aware of hers.  She was also upset that her neighbors were critical of her and saying that “You’re no good” and “You have to leave.”  She admitted to thinking about having a “contract” put out to “eliminate” the neighbors.

The patient was medicated and her beliefs about thought broadcasting remitted.  Within 2 months she was employed and feeling well.

 

Questions:

  1. What is her diagnosis?
  2. What are the symptoms that helped you make this diagnosis?  What diagnostic criteria do they relate to?
  3. What are two other possible diagnoses and why did you not choose them?
  4. Discuss the role of genetics in this case.
  5. What is her prognosis?
Essay Sample Content Preview:

CASE STUDY
Name:
Institution:
Case Study
Mrs. Neighbors presents with symptoms and behaviours that are consistent with a DSM-5 diagnosis of Schizophrenia Spectrum and Other Psychotic Disorders, Brief Psychotic Disorder (295.90) “Multiple episodes currently in partial remission”
The symptoms that helped reach this diagnosis include:
* Hallucinations, she could hear her neighbors reciting her menu on the street
* Delusions, her neighbor accessing her thoughts and repeating them to her
* Catatonic behaviour and disorganization, this is described by her sister who says she has increasingly bizarre and her work habits erratic
* Diminished emotional expressional, this is seen when admits to having a contract out to eliminate her neighbors who are disturbing. She is emotionally disconnected.
In DSM-IV two of the five symptoms associated with schizophrenia and one should be either of the first three. The five symptoms are hallucinations, delusions, disorganization and catatonic behaviour, emotional expressions and negative symptoms (Barch, D. M. 2019). Our case has at least three of these symptoms.
The diagnosis could have pointed to a delusional disorder which is characterized with delusions which last either for one month or more. No other psychotic symptoms are required to diagnose with delusions disorder according to American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Being a case with many other psychotic symptoms I choose not use the delusion symptom only to determine that the diagnosis could have been a delusional disorder. The second possible diagnosis could have been Obsessive-Compulsive Disorder (300.3). This is because we can see the patient is obsessed with the thought that her neighbors are the problem in her life to the extent she wants to eliminate them. This obsession with her neighbors is in form of recurrent and persistent thoughts encountered during the process of disturbance. According to DSM-5 this criteria can be used to diagnose one with obsessive compulsive disorder. I did not go for this diagnosis because still the patient had indications of other symptoms which were conspicuous enough to be included in the diagnosis. I feel if I had gone with this diagnosis I would have ignored some of these symptoms.
The role of genetics in this case can be a broad speculation but true, since we do not have any evidence that the patient had the exposure of this disorder due to hereditary factors, there are very high chances that she might have. This is because it was the sister who noticed the behaviour and took her to the crisis evaluation center. For a normal member of a family which might not have dealt with such a case before, it would not have been that easy for them to realize that their family member had a problem. But for Mrs. Neighbor’s sister she realized that the sister had a problem and this raises my speculation that she might have dealt or heard of a similar case especially w...
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