Abnormal Psychology - Diagnosis & Treatment

Abnormal Psychology

Paper #2

8/19/2015

Case Summary #1: Diagnosis & Treatment

Diagnosis

The diagnosis for Robin Henderson is Major Depressive Disorder. Robin has been treated with primarily anti-depressant medication for 18 months by her psychiatrist. During this time, she has been hospitalized for treatment of suicidal ideation and one near lethal attempt and several instances of suicidal gestures, including at least 10 instances of drinking Clorox bleach and self-inflicting multiple cuts and burns.  She had recurrent suicidal ideation or a suicidal attempt and continued to display binge-drinking behavior at an intermittent frequency and often engaged in restricted food intake with consequent eating binges.  Also, she dropped out of medical school and became severely depressed and actively suicidal. Even during treatment, she felt worthlessness and unloved by her husband but there was no clear basis for this perception.  She ultimately committed suicide by consuming an overdose of prescription medication and alcohol. After considering all the factors, these are the main criteria that are met for the diagnosis of Major Depressive Disorder.

Another known diagnosis for Robin Henderson is Eating Disorder: Bulimia Nervosa. Beginning at age 14, she began having difficulties with alcohol abuse and bulimia nervosa. She often engaged in restricted food intake with consequent eating binges.  

She could be diagnosed with Post traumatic Stress Disorder (PTSD). She reported that she had experienced severe physical abuse by her mother throughout childhood and her father began sexually abusing her when she was 5. Her father’s sexual abuse became physically abusive when she was about 12 years-old.  Unfortunately, this abuse continued through her first years of high school. So, she was constantly abused throughout her adolescent.  Beginning at age 14, she began having difficulties with alcohol abuse. Robin’s alcohol abusing was maybe caused by her fear/trauma from physical and sexual abuse from her parents in order to cope with the fear and emotional distress due to the abuse she experienced from her parents as a young child.

        Another possible diagnosis could be Borderline Personality Disorder.  She tried to either self-mutilate or kill herself whenever she felt threatened, criticized or unloved which began with an interpersonal encounter, usually with her husband and those preceded Robin’s suicidal behavior.  However, she had behaved appropriately at times, well mannered and reasonable and other time she seemed enraged and irrational to her friends.  Her decisions to self-mutilate or attempt suicide were often done to by attention-seeking.  Her interpersonal behavior was erratic, unstable and very inconsistent.  She would threaten suicide to keep her friends or family from leaving her afterwards she thought she had alienated them.  Many of the patients with Borderline Personality Disorders shows suicidal threats and actions.  Robin had both sexual and physical abuse in childhood.  Sexual and physical abusing in Robin’s childhood may have caused Borderline Personality Disorder to her.  Childhoods of people with Borderline personality Disorder were often marked by multiple parent substitutes, divorce, death, or traumas such as physical or sexual abuse (Comer, 2014).  

Treatment

Therapists may approach with humanistic & existential treatment.  Robin does not know why her husband is leaving her and her worth as a person.  She needs to honestly recognize and accept her weaknesses or problems and find her strength. She needs help to establish satisfying personal values to live by. She needs to bring her true feelings into the surface and see what is making her more difficult. She would be able to know why she wants to commit a suicide and why her husband does not love her.  Robin was able to function well in work and school settings until she completed 2 years of medical school, so humanistic approach may help her to self-actualize to fulfill her potential for goodness and growth.  Robin has not received unconditional positive regards early in life so she was unlikely to develop unconditional self-regard. Thus, she couldn’t come to recognize her worth as person.  She does not know what she is truly feeling, what she desperately needs, or what goals and values would be genuinely meaningful for her.  She is very vulnerable and unstable, so she needs a warm and supportive approach as client-centered therapy in the humanistic-existential model.