Abnormal Psychology

 

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Choose a case study and propose an approach to treatment that a psychologist might use. You will need to conduct some outside research for this project. Keep your answer between 500-1,000 words.

Case 1

The boy is 5 years old. When someone speaks to him, he turns his head away, and sometimes he mumbles unintelligibly. He dislikes sounds and does not communicate. In addition, he cannot relate to others and avoids looking anyone in the eye. He cannot use the toilet nor feed himself, and he actively resists others touching him. He often engages in routine manipulative activities, such as dropping an object, picking it up, and dropping it again. He repetitively plays with the same toys for months, lining items in rows; collecting objects such as bottle tops; and insisting on having two of all items, one in each hand. He shows a pathological need for sameness. While seated, he often rocks back and forth in a rhythmic motion for hours. Any change in routine greatly upsets him.

Case 2

A 73-year-old widow comes in with her daughter for an examination. The mother lives alone in another part of the city, 40 minutes from her daughter, and she continues to drive. The daughter reports that her mother has become more disoriented during telephone conversations. In addition, discussions with the mother’s friends reveal memory lapses and inappropriate decisions. Upon examination, the patient appears alert and cooperative, and she does not seem depressed. She denies any problems and minimizes wrong answers and memory lapses. The patient’s hypertension is treated with an ACE inhibitor. Her neurological examination comes back normal, and her gait appears normal as well. She shows no precipitous or stepwise decline in her mental function. Her symptoms have developed slowly, with memory, orientation, and drawing (construction) difficulties.

Case 3

The staff at a local hospital admitted the patient to the nursing home 3 weeks earlier, after she had sustained a fall and developed a urinary tract infection. On the ward, those who worked with her noted that she seemed confused. After admission to the nursing home, the patient became restless and combative with staff. She acted with particular hostility toward one male resident, the one whom she attacked. At night, she kept shouting, “Keep him away.” In addition, she often refused her meals and had lost 5 kg in weight. A visiting community psychiatric nurse performed the Mini-Mental State Examination (MMSE) [1] on which the patient scored 16 out of 30 (normal score is 24 and above), but the nurse also noted she seemed distractible and distressed. The patient’s family became upset because their mother’s behavior did not match her usual character. They described her as “calm and always seeing the best in people.” The patient has a history of hypertension and probably neglected her treatment prior to hospitalization.

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