Write a paper that includes the following information for each of the two vignettes: – Identify any red flags (i.e. crisis/legal/ethical issues)
– List symptoms that concern you and why.
– List questions that you may want to ask to obtain further information.
– Provide a diagnosis using Axis I, III, IV and V
– List the criteria from the vignette that apply to the Axis I diagnosis you gave
– List any other diagnosis that you considered and why you ruled them out. Vignette 1: Sandra
Sandra is a 27 year old single woman who is admitted to a Chicago hospital after running away from a nearby half way house because she saw devils there and was afraid of being killed. When interviewed she is tense, suspicious of the interviewer, and guarded about revealing her symptoms. She does acknowledge that she is still hearing voices and needs to protect herself from people at the halfway house. During the previous years she was hospitalized off and on because of her rituals and was given many medications which did not help. About six years ago she began hearing voices of unknown people ordering her to “fix it” or accusing her of not “fixing it right,” and telling her that she could not go out and face people until she fixed her room perfectly.
Five years previously she lost her job as a secretary because she was behaving in a bizarre way at work, talking to people that weren’t there, and accusing her co-workers of wanting to harm her. She began to believe that her roommate wanted to kill her and kept asking her, “Why do you want to kill me?” She moved back into her parents? house in the suburbs, where she stayed in her room for two months doing nothing until her parents finally hospitalized her. Since that time, she has either been hospitalized or in day-hospital and work programs, but has not been able to support herself. Vignette 2: Paul
Paul is a 24 year old single man who comes to you because he is very upset because he recently lost his job. He states that he is a genius who is constantly coming up with new inventions. He lost his job because he was going to his boss and telling the boss that the company should fund his inventions, and wouldn’t take no for an answer. When you ask about these inventions, Paul gives vague answers and will only say that they will “completely change the world.” He states that he is very angry because people around him don’t give him the credit he deserves and don’t seem to recognize how incredibly smart and special he is. He claims that he is in the process of creating new mathematical processes that will “make Einstein seem stupid.” He further states that he is a “very powerful” influence on those around him, even if they don’t know it. He seems agitated and angry when talking with you, and says things like, “I’ll show them all just how much power I have!” When you talk with his parents, they indicate that Paul was an average student, and to the best of their knowledge he has not invented anything, although he does enjoy “tinkering with electronics in the garage.” They also indicate that he was a C student in math.