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Personaliity Disorders Cases 1

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Psychology
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Pepperdine University
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Diagnostic Cases
Leon
A 45-year-old postal employee reveals that he cannot ever remember feeling comfortable socially. Even
before kindergarten, if he was asked to speak in front of a group of his parents' friends, his mind would
"go blank." He could only answer questions in class if he wrote down the answers in advance; even then,
he frequently mumbled and couldn't get the answer out. He was worried that he would be rejected
because of how he responded. He thought that everyone around him viewed him as "dumb" or "a jerk."
He believes that he is inferior and unlikeable. As a teenager, he was anxious about talking to girls. To this
day, he has never gone on a date or even asked a girl for a date because he is afraid he will not be
accepted. He has a late-night postal job, which he selected because it involves little contact with others.
He was offered but refused promotions because he feared social pressures and criticism.
Leon has a paranoid personality disorder. According to the case provided, he has expressed the anxiety
of scenarios that he is exposed to. First, given an opportunity to speak to his parents' friends, he was
unable to as he would automatically go blank and lack something to tell them. He had developed some
characteristics that resemble social anxiety disorder. Given an opportunity to participate in a class in the
company of colleagues, he would go further to write down the answers. It is only in exceptional
circumstances that Leon’s nature would allow him to mumble words. According to Leon, he feels that
people are against him and refer to him with funny terms such as jerk and dumb. Due to the low self-
esteem that has resulted, Leon is unable to communicate with peer ladies positively. He cannot effectively
work in the day and has resorted to working during the hours when he cannot easily interact with others.
With the addition of positive symptoms such as hallucinations and delusions plus common negative
symptoms such as social withdrawal, Leon is likely to have a diagnosis of paranoid schizophrenia.
Tom
Tom, a 21-year-old man, wants to meet with a therapist to get a diagnosis that will allow him to avoid a
jail sentence for stealing. In Tom's earlier years, he was often truant from school, stole jewelry and
silverware from his family so he could sell them to get money, set things on fire, threw rocks at animals,
and perpetrated small thefts or swindles. At 14 or 15, having learned to drive, Tom began to steal cars.
He also forged his father's name on checks and stole money, pocketknives, textbooks, etc., at school. He
was constantly getting into physical fights with others. When questioned, Tom seemed not to care about
any of the people he has hurt. Tom has never formed any substantial attachment to another person.
Tom has developed an antisocial personality disorder. This personality disorder is commonly associated
with a disregard for the rights of others. Activities that are likely to make Tom end in jail, such as
stealing, are everyday activities that he readily engages in. He steals cars from others ever since he
learned to drive a car. He even went a further mile of taking jewelry and silverware from the family
without also considering that these are members of his inner circle. Perpetration of small theft swindles
and theft of family property to sell are some of the immoral behaviors that are likely to make him end up
in jail. Tom's antisocial behavior has reached an extent where he readily throws rocks at animals to hurt
them. He has even made use of more significant criminal activities, such as impersonation. Tom has
impersonated the father and reached a point that he signs cheques on his own. Getting into physical fights
with others, including friends, clearly depicted that the victim was not ready to establish any physical
relationship. If Tom’s current behaviors and conduct commenced in his early childhood, then his mental
condition can be oppositional defiant disorder.
Jill

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Jill, a 23-year-old, was admitted for her first psychiatric hospitalization. Three months before admission,
Jill began drinking heavily, ostensibly to sleep nights. While drinking, she became involved in a series of
"one-night stands." Recently she was stopped by the police while wandering on a bridge late at night
when she was contemplating jumping off. The next day, her supervisor, seeing her distraught and noting
scars from a recent wrist cutting, referred her to a psychiatrist. She acknowledged that she had feelings of
loneliness and brief periods of depressed mood and anxiety since adolescence. She reports that she is just
an empty shell of a person. Her relationships with men usually end abruptly. She tends to develop
relationships quickly when she is enamored with a guy, but she becomes furious when they are not
immediately available. At these times, she anticipates that these men will leave her, which has happened
several times.
Jill has a case of bipolar mood disorder. She has a series of episodes that alternate from mania or
hypomania to depression. During manic episodes, she engages in ‘one-night stands’ and sometimes
develops a feeling of love for men in an abrupt fashion. It is also noteworthy that she develops brief
depressive episodes, whereby she feels worthless and anxious. From her recent encounter with the
authorities, Jill was contemplating jumping off a bridge as an act of suicide. She furthered her plan later
on by harming herself as a scar of a cut is evident on her wrist. The change in episodes is also
characterized by her interaction with men in relationships that end abruptly one of the classic signs of
bipolar patients. They stop after her depressed symptoms, whereby she feels they would leave her. Her
visit to the psychiatrist made her confirm that she has been having symptoms of bipolar mood disorder.
Jack
Jack, a 45-year-old lawyer, seeks treatment at his wife's insistence. She is fed up with their marriage, but
the patient feels no particular distress in the marriage. Jack admits to feeling troubled by problems at
work. Lately, he finds himself increasingly unable to keep up. He is too proud to turn down a new case
and too much of a perfectionist to be satisfied with his assistants' quality of work. People at work
complain that his attention to detail and inability to delegate responsibility is reducing his efficiency. He
has had two or three secretaries a year for 15 years. No one can tolerate working for him for very long
because he is so critical of others' mistakes. Jack describes his wife as a "suitable mate" and has trouble
understanding why she is dissatisfied with their relationship. He has difficulty relaxing on vacations,
develops elaborate schedules for every family member, and becomes impatient and frustrated if they
refuse to follow his plans.
Jack has OCPD since he is far much obsessed with issues going on work. He has developed the nature of
perfectionism, whereby he feels that he is the best at addressing problems. It is effortless for him to
identify the mistakes made by others. Perhaps, this is why he frequently employs new secretaries who
currently consider being less potent. Jack has also come up with a routine whereby he develops big tasks
for their parents and siblings to make them perform activities that he considers to be part of attaining
perfection. Since Jack is highly focused on achieving exemplarily well in his tasks, he fails to rest on
vacations. These activities exude that he has developed OCPD and is likely to develop stubbornness and
nuisance if not treated in good time. It would be recommended to manage his condition initially from an
admission setting. If the symptoms are modified to an extent whereby Jack is compelled to participate in
these behaviors without having flexibility to new ideas, then the condition could have been obsessive
compulsive disorder.
Matt
Matt, a 34-year-old single man, lives with his mother and works as an accountant. He is seeking
treatment because he is unhappy after having just broken up with his girlfriend. His mother had
disapproved of his marriage plans, and Matt felt trapped and forced to choose between his mother and his

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Diagnostic Cases Leon A 45-year-old postal employee reveals that he cannot ever remember feeling comfortable socially. Even before kindergarten, if he was asked to speak in front of a group of his parents' friends, his mind would "go blank." He could only answer questions in class if he wrote down the answers in advance; even then, he frequently mumbled and couldn't get the answer out. He was worried that he would be rejected because of how he responded. He thought that everyone around him viewed him as "dumb" or "a jerk." He believes that he is inferior and unlikeable. As a teenager, he was anxious about talking to girls. To this day, he has never gone on a date or even asked a girl for a date because he is afraid he will not be accepted. He has a late-night postal job, which he selected because it involves little contact with others. He was offered but refused promotions because he feared social pressures and criticism. Leon has a paranoid personality disorder. According to the case provided, he has expressed the anxiety of scenarios that he is exposed to. First, given an opportunity to speak to his parents' friends, he was unable to as he would automatically go blank and lack something to tell them. He had developed some characteristics that resemble social anxiety disorder. Given an opportunity to participate in a class in the company of colleagues, he would go further to write down the answers. It is only in exceptional circumstances that Leon’s nature would allow him ...
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