Case History for Chapter 6 Application Response

Gina
Gina, an only child, was raised in a prosperous family. Her father was the chief executive officer of a major charitable organization, and much of his work involved the hosting of fund-raising events to support charitable projects. Through these events, Gina’s family acquired a wide array of prominent people as family friends and acquaintances.
Gina attended an exclusive private school for girls, where she was an above-average student. She did not seem to experience any unusual psychological problems during childhood and early adolescence. A popular girl who got along well with others she had many friends. At about age 17, however, there was an incident that, as it turned out, foreshadowed the problems to follow.
In her senior year of high school, Gina became very involved in a school play production, in which she had a minor acting role. As the production progressed, she became more and more absorbed in the work. Her presentation on stage during rehearsals became increasingly theatrical, and she became more involved in her costuming and makeup. The other students initially were in awe of the increased level of creativity, energy, and comfort on stage. However, with time, her behavior became bizarre. Once, for example, in the soda shop where students would gather after rehearsals, Gina became so giddy and talkative that she approached strangers for rambling conversations, telling some that she was a famous actress. Once, she actually burst out in song, reveling in the attention she got, which was actually not admiring.
Soon the other cast members were distancing themselves from the high school senior. As matters progressed, Gina’s joy shifted into a state of paranoia. She became convinced that the other students were plotting against her, trying to undermine her road to fame and glory. She became increasingly guarded and, ultimately, withdrawn. Soon she became very sad, crying all the time, and refusing to go to school; she believed that everyone hated her and she wished she were dead. Unable to cope with this dramatic shift in mood, her parents sought professional help. In fact Gina’s experience was so extreme that she was hospitalized for treatment.
After treatment, Gina stabilized, graduated from high school and entered into a local university. Things were going pretty well for Gina through her freshman year as an astronomy major, but during her sophomore year more problems began to arise. Gina became increasingly absorbed into her course work in astronomy, to the point of neglecting her other studies. She would spend large amounts of time at the library, reading astronomy materials and becoming extremely excited about the idea of interplanetary travel. Eventually, she spent 3 days in her dorm room almost without sleeping, plotting different voyages across the heavens and developing grandiose plans for colonizing the solar system.
The resident advisor (RA) of her dorm eventually became aware that Gina had stopped attending her classes and was up at all hours of the night. When the RA asked her about her activities, Gina offered a frenzied explanation of the benefits of space travel. Realizing something was amiss, the RA urged Gina to visit the student health center, telling her that she looked exhausted. In response, Gina got annoyed and stalked off. After Gina left the RA called Gina’s parents and they realized that there may be another incident like the one that occurred in high school. It was not long before Gina found herself in a psychiatric hospital for the second time.
Gina was treated again and put on a strict regimen of medication. While she was taking the meds her symptoms were under control. The problem was that Gina felt incapable of staying on medications consistently. Although recognizing the benefits, she often felt “straightjacketed” by the drugs she was taking. When medicated her symptoms would not appear, but at the same time she felt that she had lost her spark; her emotions felt dulled, and she sometimes longed for a few mild “highs” in her emotional life, a feeling of excitement, or of “just being alive” as she put it. When the longing became intense, Gina would stop taking her medications, often without immediate consequences, but she found that the symptoms would often return with new incidents occurring throughout her life.
The result, over the years, was a life greatly hampered by her psychological symptoms. Because of several further hospitalizations during the next few years and other disruptions caused by more minor symptoms of her disorder, Gina was unable to complete her bachelor’s degree on time. She moved back into her parent’s home and lived there for several years taking classes part-time at a local community college and finally earned her bachelor’s degree, finding work, ironically, as a sales representative for a pharmaceutical company.
Unfortunately, Gina continued to be lax on her drug taking and experienced several symptoms of her disorder. Often her episodes would begin with a feeling of happiness which gradually grew to a glorious outlook on life. At this early stage Gina would feel immensely pleased, considering herself the smartest, sexiest, most talented woman alive. These feelings would be in sharp contrast to other episodes where she would consider herself the most miserable failure who ever existed. Even when she was not so down on herself, she often would hold herself in somewhat low regard, unhappy with her work, love life, and her appearance, which actually was attractive.
The feelings that would come up for Gina were hard to resist when she felt these “highs.” Gina would go shopping for new clothes, often spending large amounts of money, which forced her parents to provide her with financial assistance. Gina also became almost unbearably outgoing and friendly, chatting with strangers on the bus or subway and calling up friends, in search of stimulating conversation, late at night.
As these euphoric feeling progressed, her behavior crossed any acceptable boundaries. Of particular concern were her sexual impulses. Due to her family’s social connections Gina often attended society charity balls and other gala social events. Gina used these events as a way to pick up men and have sex with them the same evening. She would dress in a very short red dress and apply lavish make-up, which when finished would present a very striking figure. Although this was very different from the typical presentation Gina would have. These episodes continued over several years, with Gina having sex with at least 100 men during about a ten year period.
At other times Gina would experience very different moods. She would sometimes experience a loss of all interest in normal activities, often calling in sick at work. She also experienced a big shift in her sleeping patterns during these time periods, sleeping 16 hours a day. These periods would often last upwards of three or four weeks at a time, sometimes longer. Even when she was awake, she could barely leave her bed. Instead she spent most of her time staring at a flickering television, sobbing and thinking she was a miserable failure in all aspects of her life. During these time periods she would show no concern for her appearance and would barely eat any food, just enough to keep her going.
In between these abnormal experiences, Gina was intelligent, responsible, serious about her work, and considered a capable sales representative by her employer. However, even then, she was not completely free of difficulties. She suffered from low self-esteem. Although perfectly capable in her work, for example, she often doubted her abilities; and after organizing successful meetings she would spend considerable amounts of time and energy analyzing flaws or faults. Similarly, any considerable amounts of criticism had a way of overshadowing the praise that she generally received in her work.

Chapter 6 Application Response

(25 Points)

Make sure that you read the \”Case History Chapter 6 Application Response Gina PSY 281 Online\” also attached to this assignment. As you read about Gina make sure that you are noting any evidence/symptoms that would lead you to suspect a specific disorder.

Tell me the specific disorder that you would diagnose given the evidence from the case history. Use the ACTUAL DIAGNOSIS FROM THE DSM-5.
Next, you are going to explain your rationale for giving the diagnosis you have decided best represents Gina’s experiences. This is the part of your paper where you will be VERY SPECIFIC in taking evidence from the case history and applying it to the actual criteria of your diagnosis. This will show me that you understand how the criteria for the disorder were met, and subsequently could actually then make the diagnosis. Even if you think you are being too redundant, or too specific, or too boring, explain your rationale for each criterion being met. Go into great depth proving each criterion with as much evidence as you have noted from the case history.
Write this paper as if your audience is someone who has never even heard of the disorder you are writing about. Many students tend to leave out important detail because they believe I (Mr. Schulte a trained counselor) am their audience. Sometimes thinking, “oh, well that is obvious to Mr. Schulte, I don’t need to go into that much detail.” Don’t do that in your paper. Go step by step explaining your reasons/evidence for why each criterion has been met.
Make sure you are covering all aspects of the disorder’s diagnostic criteria, if there are other criteria from other parts of the DSM that are necessary, you should add those.

SAMPLE SOLUTION

Chapter 6 Application Response

Disorder

Gina is suffering from Bipolar disorder. This mood disorder is defined by alternating episodes of mood changes swinging from mania (hyperactivity) to depression. Bipolar is a major psychotic disorder besides schizophrenia. Most Bipolar patients live a normal life since the disorder is easy to control.

Rationale Gina’s clinical history demonstrates manic episodes in various ways. First, she is very aggressive in her acting hobby and is envied by the peers. Second, she experiences delusions of grandiosity as illustrated by her belief that she is the best actress. On the other hand, the patient becomes very talkative and her speech has flight of ideas and sounds to be under pressure to speak. She is also noted to have loosening of association hence it becomes hard to communicate with others. Gina’s sexual drive gets out of control leading her to dangerous multi-sexual relations. Moreover, the patient becomes paranoid in that she…