Boundary Between Deranged and Progressive Psychopathology - Report Example

Vignette Analysis Vignette Analysis Differential Diagnosis Malingering and Factitious Disorder Steven seems to have malingering disorder based on the events that have occurred in his life. The fear of failing to take care of his unborn baby and the family has no basis as he is currently doing well as an architect. This means that his financial state is ok but feels he is not in a position to meet the basic needs. He regularly makes sure that all the doors in his home are locked and secured before living despite the fact that there are no signs of risk from break in. As an architect with good pay, he is likely living in a good neighborhood. He left his home for college at the age of 19 meaning he does not want to be associated with neighborhoods of crime and violence. He is most likely living in a neighborhood different from his childhood where gang activities and violence were indifferently rampant. Steven also avoids streets with odd numbers and gives no reason for this. This can be associated with fear of being mugged or robbed. This can also be associated with his past neighborhood and childhood up bring where gangs would wait for people in odd streets. However, to some extend Steven shows minimal signs of factitious disorder. He is exaggerating the idea of him being incapable to take care of his family. As he was growing up, his parents showed no interest to them. He had to take himself to college and live in a new city. There are chances that he wants to subject his children through the same circumstances. The fact that he did spend most of his life taking care of his young brothers means that he is well experienced and conversant with taking responsibilities and needs of family members. He did this in worst circumstances and should be able to do it now that he has a stable source of income (Domino & Baldor, 2014). Substance abuse Etiology Steven shows signs of substance abuse. He says that he has experienced dizziness occasionally while driving and this can be related to use of drugs. He also says that in the recently, he has been experiencing difficulties with breathing while in malls with his wife. Malls are congested areas and this means that he might be having problems with his respiratory system due to inhalation of drugs and other intoxication. Having brought up in a gang-related neighborhood, he might have been influenced by other people into drug abuse. He does not reveal much about his life in the West Coast city and chances are high that due to the difficulties and pressure experienced in that period, he might have gone into drug abuse. This can also be supported by analyzing Steve’s fears of seeing himself as a facade and worries that people may find out who he really is. Questions remain as to why he would say that. He seems to have secrets that if revealed he fears about his reputation from other people. He does not mention any past record of sickness or health problems that can be linked to his dizziness and difficulty with breath and this means that one of the few reasons for these occurrences is drug abuse. According to Domino & Baldor (2014) individuals who abuse drugs are often do it in secrets and it may take even therapists long time to notice. Drug abuse has high potential of developing both physical and psychological harm to the user. Therapists who deal with patients suffering from drug abuse and other addictions recommend medical checkups from physicians as this boosts their chances of recovery. Early medication and referral plays a key role in general recovery from drug addiction. General Medical condition There is a chance that Steven has a medical condition in relation to his respiratory system but this is subject to further diagnosis. Disorder due to medical condition would therefore rule out the disorder due to drub and substance abuse. However, if he is found to have been involved in drug abuse, chances are high that Steven would still have medical condition triggered by drug abuse. According to Buckworth & Buckworth (2013) individuals with cases of drug abuse are likely to have prevalence medical conditions. Drug abuse can affect both psychological and physiological health of the user. Stevens fear of failing to take care of his family might be due to the fact that he might get too twisted and entangled with drugs leading to loss of job or worst get arrested. Specific primary disorder Stevens disorder is based on his social and family background. He was brought up in a dysfunctional family of two different races. His father’s acts of violence have a play in his abnormal behaviour. His community also affected his perception about social life. He is paranoid about his house being robbed as well as being mugged in the streets. His health seems ok but further medical research and diagnosis will help establish this (Buckworth & Buckworth, 2013). High chances are that Steven is involved in drug abuse. There are no indications of medical conditions or any form of threat that can be linked to recent events. He has been referred by the primary physician for psychological therapy. If his condition was more of a health problem, the physician would have easily dealt with it. His condition is related to other factors such as childhood experiences that have affected his overall perception about life and family. He is living in the fear of leading the same lives he saw with his parents. This makes him paranoid about his ability and capability to raise a family. Adjustment Disorders from Residual Other or Unspecified Categories The case with Steve is multi-disorder therefore need more than one procedure. Adjustment disorder is predominant in this case and this is due to his drug abuse. The solution would be to help him recover from drugs and restrain from this acts. The symptoms displayed by the patient are maladaptive response particularly to psychosocial stressor. His background and memories of violence and poor upbringing have played part in worsening his condition. Boundary with No Mental Disorder Stevens case is clearly a psychological disorder. He has reported hallucinations and visions of his parents fighting and shouting. He is also paranoid about attack in his house as well as walking in the streets. This condition is likely to affect his functioning at work, in the family among others. There is a display of biological dysfunctional where he finds difficulty breathing in congested places and experiencing dizziness while driving. In general, Stevens case is a clinically significant case and needs to be attended to in order to improve and fix his condition. However, we cannot single out chances of a chronic mental disorder for Steven especially based on events of hallucination. Models of Abnormality The Socio-cultural Model: The Family-Social and Multicultural Perspectives This model states that abnormal behaviors of individuals can be best understood and explained in light of social and cultural forces and factors that influence the individual. By observing the social surrounding of an individual, we are able to understand their abnormal behaviour. This model has focus on social labels and roles of individuals, social networks, family structure and communication. On multicultural perspective, there is sharing of values, attitudes, beliefs, history and behaviors and this contributes largely to an individual’s abnormal behaviour. This models outlines that some people from different ethnicities, races and culture relate with each other and how this can influence an individual’s abnormal behavior (Comer, 2014). Steven is largely affected by his family background. He grew up in an unstable family where parents were fighting and arguing. This affected him and can be associated to his abnormal behaviour. Steven seems to have poor communication link with his family. He does not mention further contact with the family since he left Los Angeles. As a young boy, Steven witnessed the breaking of families and irresponsible parenthood. His parents had no interest in him and are siblings. Despite the presence of the parents, there was no much attention from the parents. The parents were irresponsible and never met the needs of the children. He sees visions of his parents fighting and often wakes up at night with clenched fist. This is a culmination of his parents’ acts of violence or members of his neighborhood. Comer (2014) explains how generalized anxiety disorder is most likely to develop in individuals who are going through societal conditions that are dangerous. Studies show that individuals in highly threatening environments and conditions are indeed more likely to develop feelings of tension, anxiety, and fatigue as well as sleep disturbances. His father was an African-American and his mother a Hispanic-American. This multicultural background might have affected him since he lack of specific culture to relate with or be associated with. In a family of different races, there are chances that he did not get the best in terms of cultural values and models. He grew up confused and could not related to particular culture. The battles between the two parents limited time for the parents to share with them. The Society he grew up in is full of violence and crime. The city was characterized with gangs and this played a role in shaping his behaviour of fear of an attack at anytime. Buckworth & Buckworth (2013) argue that the most effective treatment for Steven would be; family therapy/Community therapy and prevention work. He should also be taken through cultural models. Taking him into sessions with some of the family members will help him get a clear picture of change that has taken place and his progress. By realizing the progress and transformation he has undergone, Steve can live free from attachment of his family’s poor social background. Community therapy will help Steven understand the different social set ups other than having a single perspective of his violent, gang-related community. Behavioral Model Behavioral theories believe that the actions and behaviors of an individual are largely determined by life experiences and environmental factors. The principles of learning are used to explain the behaviors as well as the treatment of these disorders. This model emphasizes that human beings take up certain abnormal behaviors after repeating and learning them over time. Classical conditioning illustrates learning where when individuals are exposed to two events close to each other repeatedly, they slowly learn to respond to both events similarly. According to Comer (2014) many behaviors that have been learned helps individuals to cope with daily challenges and to lead to productive lives. In the same way, abnormal behaviors can also be learned. Behavioral model concentrates on behaviors and the responses an individual makes to its environment. Steven in many ways has had behavioral change because of the surrounding circumstances. The continued witness of violence for his parents might have impacted the same behaviour to him. Steve does not mention that he has been involved in acts of violence but the occurrence of him waking u with a clenched fist shows that he has history of being violent. Chances are high that while living with his parents or after leaving for West Coast city, he was involved in fighting. His abuse of drug might have been caused by presence of gangs in his neighborhood or at college when he left home. With no one to look after him, he might have been involved in drug abuse. His current experiences with a wife and an unborn baby have made Steve become anxious and paranoid for fear of responsibility. He is not sure about his abilities as a husband and as a father. Comparison of his fathers history and his makes him confused. Steven’s wife is his college girlfriend and fears that she might discover his real picture. This shows that his behaviors have been affected over time and there is fear that other people will discover this. The most appropriate treatment for this condition would be; systematic desensitization for phobia, step-by-step procedure, learns relaxation skills, construct a fear hierarchy and confront feared situations. References: Top of Form Domino, F. J., & Baldor, R. A. (2014) the 5-minute clinical consult 2014. Philadelphia, Pa: Wolters Kluwer Health/Lippincott Williams & Wilkins. Bottom of Form Top of Form Buckworth, J., & Buckworth, J. (2013) Exercise psychology Champaign, IL: Human Kinetics. Bottom of Form Top of Form Top of Form Comer, R. J. (2014). Abnormal psychology New York, NY: Worth Publishers: a Macmillan Higher Education CompanyBottom of Form Bottom of Form Read More