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AP Psychology Homework: Diagnostic II Name: ___________________________________ Read the following descriptions and provide a diagnosis.
To earn all possible points you need to (1) provide the general category
(e.g., affective disorder, anxiety disorder, dissociative disorder, etc.) and
(2) provide the specific diagnosis (e.g., panic disorder, bipolar I, antisocial
personality disorder, etc.) 1. A 28-year-old woman was walking through her local shopping mall when she began to feel intensely anxious. The anxiety was accompanied by sensations of choking, smothering, and a sudden sense that the people and stores around her were unreal. She began to fear that she was going crazy and the more she worried about this the more anxious she became. A guard, seeing that she was in distress, brought her to the mall office where she was able to lie down. A few minutes later the symptoms began to subside. She went home after leaving the mall but she did not tell her husband what had happened. A week later she had a similar attack while she was walking down the street. She was able to reach her house where she lay down until the attack ended. In the following 3 weeks she had two more attacks. Between attacks she was constantly worried about having another attack. The patient was finally forced to tell her husband about the problem because she was so fearful of not being able to get help if an attack occurred that she would not leave her house alone or travel on public transportation. Diagnostic Group: ________________________________________________ Specific Diagnosis: _______________________________________________ 2. A 67-year-old widow was brought to the hospital by her family. They were concerned about her for several weeks because she seemed unhappy and cried much of the day. The patient's appetite decreased and she has lost some weight. While she spends much of the day lying on the bed in her room, she has difficulty sleeping and complains of feeling tired all of the time. The family has tried to cheer her up but she doesn't seem to respond. She has little interest in her usual day-to-day activities with her friends and grandchildren. The patient is often agitated and constantly complains that she is destitute despite the fact that her husband left her with a reasonable amount of money. She feels very guilty about "wasting" her dead husband's money and thinks she has nothing left to leave to her grandchildren. In an attempt to correct her mother's misconceptions about her financial status, the daughter confronted the patient with her bank book that showed a balance of several thousand dollars. The patient looked at the book and said, "I don't have any money. What am I going to do?" Diagnostic Group: _____________________________________________________ Specific Diagnosis: ____________________________________________________ 3. A 26-year-old man was brought to a hospital emergency room for evaluation. He was mute, immobile, and lying on his back with his arms extended in a bizarre posture. His arms could be moved with some force and stayed in the position in which they were placed. The patient would not follow any instructions from the staff. Two hours after he was given antipsychotic medications, the patient began repeating the words the staff spoke to him. He still refused to answer questions or follow instructions. Diagnostic Group: _____________________________________________________ Specific Diagnosis: _____________________________________________________ 4. Spencer is a 51-year-old man who is the chairman of a medical department in a small medical school. Spencer enjoys inviting faculty member to his house for dinner where he has an extensive wine collection. The discussions at dinner cover a range of topics but inevitably settle on Spencer and his experiences, achievements, goals, and aspirations. His wife sits next to her husband smiling and nodding as he talks, periodically emphasizing the importance of his achievements. Other faculty members add their appreciative comments. The chairman accepts their accolades without embarrassment. In reality, Spencer is an inconsistent and ineffective administrator. He is intolerant of any criticism or opposition to his decisions. When criticized, he becomes enraged but covers his anger with superficial pleasantries and then makes plans to punish the offender. Spencer expects complete compliance with his wishes and active recognition of his achievements. His is involved in many national activities and is frequently away from the hospital at meetings and conventions. After returning, he drops the names of important people he has met and emphasizes his powerful political contacts. Diagnostic Group: _______________________________________________________ Specific Diagnosis: _______________________________________________________ 5. A 33-year-old woman attorney confided to a friend that she is upset about breaking up with her boyfriend. The two had been going together for 5 years and she thought that they would get married. The patient blamed herself for the breakup. she explained that the boyfriend complained about constantly needing to reassure her that he still cared for her. Despite her accomplishments she still felt inadequate, especially in relationships with men. The patient admitted that she had been chronically depressed for several years and often felt hopeless about the future. She suffered from insomnia since she was in college and often has little appetite. The patient has no previous history of a major Depressive Episode or a Manic Episode. Diagnostic Group: _______________________________________________________ Specific Diagnosis: _______________________________________________________ 6. A 28-year-old woman is a rising junior executive in her investment company. Her increasing duties require her to make periodic formal presentations to the senior management of the company. However, she becomes intensely anxious at the thought of speaking in public. When she is forced to give a presentation she begins to feel anxious days in advance of the talk and the anxiety increases as the time for the talk approaches. She is concerned that her anxiety will become noticeable during the talk or that she will do something to embarrass herself. Diagnostic Group: _________________________________________________________ Specific Diagnosis: ________________________________________________________ 7. Walt is a 46-year-old man who has been chronically worried about his health for several years. When he visited his internist for a general physical examination last year, his blood pressure was mildly elevated at 145/93 and his electrocardiogram (EEG) was normal. His physician suggested that he have his blood pressure taken every few months, but decided not to start him on any medication. Despite the reassurance Walt became convinced that he had severe hypertension. One night he awoke to feel his pulse throbbing in his forehead and some discomfort in his chest. He became convinced that he was having an episode of acute hypertension and a possible heart attack. He became so agitated that his wife drove him to the emergency room. The nurse took his blood pressure and found it to be mildly elevated at 155/95. An EEG was normal. The next day Walt made an appointment with his physician. The examination in the doctor's office again showed a mildly elevated blood pressure of 145/90. The physician reassured Walt again, prescribed a mild diuretic, and sent him home after telling him that his chest discomfort was not an indication of a heart attack. Walt felt somewhat better but began to worry again later in the evening when he became aware of his heart beat while lying quietly in bed. It has now been 8 months since his first "attack" and Walt has been to the hospital six times. Each time he is told that he is not having a heart attack. Diagnostic Group: ________________________________________________________ Specific Diagnosis: ________________________________________________________ 8. A 31-year-old man has been unemployed for 10 years and lives on the streets. He is periodically hospitalized in a state hospital, moved into a halfway house, and eventually left to wander the streets. His speech is generally incoherent and his behavior is odd and peculiar. He displays little affect, except some agitation and periodic outbursts of angry yelling that seems inappropriate and bizarre. The patient spends most of his time picking through the garbage and adorning himself with various bits and pieces of clothes he finds. He responds to antipsychotic medication with a decrease in agitation but his strange speech and loose associations persist and he continues to wander aimlessly. Diagnostic Group: ________________________________________________________ Specific Diagnosis: ________________________________________________________ 9. Brad is a 33-year-old man who always liked rats and computers. As a boy he had a small collection of snakes, spiders, and mice in his bedroom. When he was age 10, he bought his first white rat. He was so fascinated with the rat that he soon got rid of his other animals and began breeding rats in the basement. His parents were not happy. His father complained to a friend, "What kind of kid spends all his time in the basement with rats?" As a teenager Brad rarely went out with his classmates and never had a date with a girl. In school he was considered a loner; aloof and detached but harmless. He did not participate in school activities and seemed unconcerned about what others thought of him. Brad's interactions with his peers were usually uncomfortable and his occasional attempts at humor seemed strained and off target. After high school Brad went to college where he majored in computer sciences. The only negative incident in college occurred when the dormitory authorities discovered his rat colony and insisted that he remove it. Brad responded by moving into his own apartment so he could keep his rats. After college he took a job in a large company as a computer programmer and systems analyst. He did well, working the night shift. He remained detached, had few friends, and spent little time with his family. Diagnostic Group: _______________________________________________________ Specific Diagnosis: ______________________________________________________ 10. Graham is a 34-year-old man who complains of intrusive thoughts of exposing himself to women that he passes on the street. He has developed an elaborate mental ritual, taking several minutes, that involves counting the number of cars on the street and the number of cracks in the pavement when he has these impulses. Diagnostic Group: _______________________________________________________ Specific Diagnosis: ______________________________________________________
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