Author:  Michelle Grimes-Hillman, Nancy Meggelin, and Marybeth Brown

For each case: decide what disorder is being reflected. List the symptoms that led to your decision.

Max

42-year-old male prisoner is awaiting final appeal on a death sentence. He was originally imprisoned 15 years ago for rape and burglary. While in prison he strangled his cellmate for “annoying” him. He states he has no remorse for the crimes he was convicted of and states, “I did everyone a favor by getting rid of that little snitch.”

He has been in and out of institutions and jails/prisons since he was 10 years old. As a minor, he was arrested for torturing and killing the neighbor’s cats. At 19 years old he was arrested for arson – he set fire to his ex-girlfriends car. At 27 he was arrested for aggravated assault and attempted rape. He has had no contact with his mother since he was 19 and states he never knew his father who was in prison since he was 3 years old.

Joe

28-year-old male, unemployed since layoffs from his job at the auto assembly factory as a line worker has been receiving unemployment and lives at home with his family.

            His daily routine is fairly constant. He awakes each day at 07:00am, drinks 1 glass of milk and 1 glass of orange juice with 2 slices of white bread toasted & lightly buttered. He then completes his AM grooming. His mother complains that there is never any hot water left for the dishes after he showers.

            He goes to the library each Monday at 1100, walking the same route, avoiding all the cracks in the sidewalks. After walking through the stacks of non-fiction he will choose a new book to read, check it out, read it during that week, and return it the following Monday.

            On his way home he stops at McDonalds for a hamburger, plain and dry with a large fry. When he receives his order he sits in his “usual” spot in the back corner, next to the window. He then empties the fries onto the tray and arranges them in order of smallest to largest.   He says, “otherwise, they just look too uncomfortable.” He always picks up three at a time, starting with the largest, dips twice in the ketchup and then eats them.

            The rest of the week continues in this fashion with a different activity each day: Tuesday – K-mart, Wednesday – grocery store, Thursday – laundry at home, Friday – movie matinee. Lunch at McDonalds follows each activity. Each afternoon is spent reading and writing in his personal journal.

Phillip

19-year-old male college freshman, first time away from home. He was and excellent student in high school and is now struggling with pre-med courses.

            He has begun to socially withdraw from classmates and fraternity brothers. He has begun to wear very dark clothing with a hooded jacket daily. He often appears unkempt and friends are beginning to comment on his hygiene or lack of hygiene and grooming.

            When his professor suggests he seek counseling he responds by questioning the professors motives and withdraws further. Next he drops out of his classes. Friends have seen him on campus talking to the air.

Angela

            20-year-old woman, living at home with parents. She doesn’t work and is not in school. Her parents want her to either “get a job or go to school.” Every time she tries to drive to the local community college her heart begins to pound and she feels hot and cold flashes and is just sure “something will happen” to her. She will then return home without stopping at the campus. She avoids the topic of work or school with her parents until her father comes home and says that his company will hire her as a receptionist. She goes into a panic just thinking about the job and the interview. She instead answers a newspaper ad for telemarketing.

Karen

28-year-old single female with a history of many toxic relationships that have ended in bitter fighting and property damage. Her last relationship was with a female “because I thought she’d understand me.” She is currently hospitalized recovering from a suicide attempt – she swallowed all of her antidepressants and valiums. The E.R. staff notices multiple scarring on both forearms and abdomen. She claims this was from a car accident. She is attempting to manipulate the doctor into letting her go home after having her stomach pumped. She is complaining about the nurse that is being “so mean” to her. She has no insurance at this time because she is “between jobs” and is planning to go to her last boyfriend’s house when she is discharged from the hospital.

Kelly

34 year old married woman who works part-time at a travel agency. She has 2 children in private school making “honors” grades. Her children are active in little league, AYSO, and scouting. Her husband is a loving, executive vice president of an insurance firm. They have just used her agency to arrange for a one-month vacation in the South Pacific.

            She complains to her friend that “I know I should be happy. I’m the richest woman I know, so why do I feel like driving my minivan into the canyon?” She is tearful at times. Occasionally she can’t bring herself to attend her children’s games and feels great regret afterwards. Her husband has said he feels so helpless when he sees her so upset and wishes he could do something to help but she always turns him away.

Ted

            70-year-old man with high blood pressure, heart disease, and adult onset diabetes. His wife of 48 years died one year ago after having a stroke and being hospitalized for two weeks. He is now living alone and having difficulty managing his own health care. His 40-year-old daughter is attempting to help with his health care and household chores. He complains to her that “I can’t sleep in your mom’s bed” and “Nobody can cook like your mom.” It is obvious that he hasn’t been sleeping or eating well. The daughter notices that for the first time she can remember he’s growing a beard and he’s wearing the same clothes everyday.

            Family and neighbors have invited him out for holidays and social activities but he always declines with polite excuses but confesses to his daughter, “It’s just not the same without your mom.”

Diane

            30-year-old female married with 2 children. She and her husband have recently declared bankruptcy due to intermittent excessive shopping sprees. She has redecorated their home 3 times during their 8-year marriage. She owns 2 closets full of clothes and shoes. Her husband says that there has been times where she will cry and won’t get out of bed.

            Her husband just received a phone call from a public health officer because of his wife’s recent treatment for STD’s that he has found out from her was because of a “fling” she had at the local bar three weeks ago. She has never had a “drinking problem” and has always been affectionate towards her husband.

            The neighbors have noticed an extreme change in her dress and make-up during the past month. She has been really irritable with her best friends and has “no time for small talk.” She seems to have lost some weight and is out all hours of the day and night.   Her husbands says he seen this behavior before but she always seems to snap out of it.