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Part 1: Make the Diagnosis (20 points)

For this assignment, imagine you are an interning psychiatrist assigned to the state mental hospital. One
of your duties as an intern is to make an initial diagnosis based on a history you take upon a patient’s
arrival. Later, a team of doctors will evaluate your initial assessments to determine your professional
competence.

For each of the five case studies given below, list the symptoms and then state your diagnosis and the
rationale behind it. Consult the DSM website for help.
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Case 1: Kristin, age 20, is a firstyear college student. This is her first time away from home, and she
worries about her family a lot, as her parents are going through a bitter divorce and she has a
little brother at home. Kristin is having trouble concentrating on her studies and has been
complaining about various physical problems. Sometimes she has sudden, unexplained attacks
of fear, and sometimes, for no apparent reason, her heart races, she has chest pains, and she
gets sweaty all over. She sometimes also feels nauseated and dizzy. At first she thought she
might be having a heart attack, but a medical exam found that her heart was fine.

According to the paragraph, Kristin is a first-year college student and she is facing some difficulties now, which
caused some mental health problems. Excessive worrying, difficulty concentrating, sudden attacks of fear, chest
pains, excessive sweating, nausea and dizziness, and heart-racing are all the symptoms that she has.
Regarding those symptoms that Kirstin is displaying, I can diagnose she is suffering from anxiety disorders
because Kirstin shows all the symptoms of anxiety such as difficulty concentrating and excessive worrying. On
the other hand, Kristen also suffers from panic disorder because she has a panic attack that makes her feel
dizzy and nauseous, which are the factors that have made her think she has a heart attack. In addition, she has
also experienced heart and panic attacks, which are also symptoms of panic disorder in anxiety disorders.
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Case 2: Shelby, a 13-year-old girl, is brought in by her mother. The mother is concerned about Shelby's
"unusual" bedtime routine. Before going to bed each night, Shelby spends exactly one hour
writing all the events of her day in minute detail in a special journal. She then picks all of the
hair and lint off her bed and folds her sheets back until they are "just right." She then spends
anywhere from 10 to 30 minutes brushing and flossing her teeth. Finally, after lying down in
bed, she calls out good night to each person in the family. If everyone answers, she can sleep;
otherwise, she gets up and checks on those who didn’t respond. She then goes back to bed
and starts the “call out” ritual again. If she wakes up during the night, she has to "call out" again
before falling back to sleep, which is disruptive to everyone's rest.

Refer to the paragraph, the symptoms that Shelby is displaying are a continual bedtime routine in which
everything she does has to be exact. For example, the time she spent writing the events of the day was exactly
one hour, and she kept folding the sheets until it looked satisfactory. She also called every member of the family
good night and could not fall asleep until each of them responded, then checked and started again if there was
someone who did not respond. Regarding those symptoms, Shelby's diagnosis is that she has an obsessive-
compulsive disorder because she repeats the same routine every night, and everything must be perfect, or she
will start again. A person with obsessive-compulsive disorder will drive them to do something over and over,
which has shown in Shelby’s case. She spends around ten to thirty minutes cleaning her teeth again and again.
In addition, every night she would give good night call-outs to her family and this disrupts their sleep as well
because she does it again if she wakes up in the night. Shelby’s behavior has shown many symptoms of
obsessive-compulsive disorder.
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Case 3: Carl, age 32, is an assistant principal at a local high school. He came to the hospital today
because of some "blackouts" he's been experiencing over the past six months. The first one
occurred after the worst day in his personal life and professional career. That day, his wife
revealed that she’d been having an affair with one of his coworkers and wanted a divorce.
He then left the house to get some space and think, but couldn’t remember what happened
afterward. He "came to" in the parking lot of a movie theater about 100 miles from his home.
He has had four more blackouts since that time, though he's never "come to" as far away
from home as the first time.

As maintained in the paragraph, the symptom that Carl is experiencing is “blackouts” and has no memory of
what has happened during the blackouts. Regarding that, the diagnosis of Carl would be that he suffers from
dissociative amnesia as a result of an emotionally traumatic event which was when he found out his wife was
having an affair with his coworker and wanted a divorce. In addition, the symptoms of dissociative amnesia are
loss of knowledge of what happened during blackouts. Also, this is not normal forgetfulness, even more, severe
than this, and that can't be explained by a medical condition. On the other hand, another possibility is that he
may be diagnosed with dissociative identity disorder, but he has not gotten a new job, new friends, or other
things. Therefore, Carl is diagnosed with dissociative amnesia.
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Case 4: Lyndsi is a 22-year-old woman who was just brought in from the emergency room of the adjacent
hospital. She was reportedly found at a McDonald's trying to cut her wrists with a plastic knife while
rocking back and forth. When the manager approached her and tried to talk to her, she was
unresponsive. A moment later, she screamed that the people in the hamburgers were making her
cut. She remained agitated until the police came, and she kept talking about "them."

As shown in the report, Lyndsi tried to cut her wrist and kept saying that someone wanted her to do it. With
regard to that, the symptoms that Lyndsi is experiencing are hallucinations, such as hearing people in the
hamburgers talk, catatonia, and abnormal behavior. Considering that, the diagnosis of Lyndsi would be that she
suffers from schizophrenia. In addition, the symptom of schizophrenia is catatonia, which Lydnsi has shown the
symptoms of catatonia by rocking back and forth. She also has hallucinations and delusions about people in the
hamburgers trying to make her cut her wrist. Moreover, the meaning of hallucinations is seeing or hearing things
that don't exist and delusions are having beliefs that are not based on reality. These two are the two main
symptoms of schizophrenia. Therefore, a diagnosis for Lyndsi would be that she suffers from Schizophrenia.
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Case 5: Becky, age 42, was brought in by local law enforcement after she was found running naked
through the town park. When asked what she was doing, she said that it "felt good to be free."
When the police asked her to come with them, she became combative and had to be
handcuffed. She continued to hiss and spit at the officers until arriving at the hospital, where
she smiled broadly and yelled, "Home sweet home!" During your interview with her, she seems
very excitable but pleasant. She mentions that her run through the park was a celebration.
When you ask what she is celebrating, she says that she has been feeling rather down for the
past two weeks, but that today she felt great and decided to celebrate with a run.

Based on the paragraph, Becky was running naked through the town park and having a big shift in mood. With
regard to that, the symptoms that Becky is showing are exaggerated emotions such as extreme happiness and
extreme actions that she will do to gain attention. With that being said, Becky may be suffering from a histrionic
personality disorder. In addition, Becky felt great so she decided to run at the park naked to let everyone know
first, but when the police tried to take her she realized that people would not see her celebration, so she became
hostile towards the policemen. However, upon arrival at the hospital, she yelled, “Home sweet home!” so that
everyone would hear and notice her presence. Consequently, she wanted everyone to know how she felt and
wanted to celebrate. Therefore, the diagnosis for her would be that she is suffering from histrionic personality
disorder. Moreover, for people with histrionic personality disorder, their self-esteem depends on the approval of
others, which has been shown in Becky's case.
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Part 2: Short Answers (10 points)

1. What are the benefits and drawbacks of using diagnostic labels? (3 points)

The advantage of using diagnostic labels is that the doctor will know the symptoms that the
patient may have and give them the right treatment before the onset of symptoms. In addition, people
can also look at the diagnostic label to understand why the patient is behaving abnormally. However, the
disadvantage of using a diagnostic label is that calling the patient through the diagnostic label may
increase the likelihood that they will continue to act in this way, because they will think that they are
indeed sick, regardless of the fact, since the doctor just made such an assumption. For another, once a
patient has a diagnostic label, their friends may start interpreting everything he or she does negatively,
because of the diagnostic label. 

2. Use the biopsychosocial perspective to explain the development of depression. (3 points)

Before using the biopsychosocial perspective to explain the development of depression, I would
like to talk about the biopsychosocial perspective first. The biopsychosocial perspective is a broad view
that believes the intricate interaction between biological factors, psychological factors, and social factors
is the reason for the occurrence of diseases. In other words, whether it is psychological or physical, all
diseases that occur in our body may be related to biological, psychological, and social functions.
Regarding that, by using the biopsychosocial perspective, the development of depression is the lack of
serotonin and dopamine. The lack of serotonin and dopamine can cause people to feel sad and
unmotivated. With that in mind, dysfunctional neurotransmitters would be the real cause of the problem. 

3. List four specific factors thought to be involved in the development of schizophrenia. (4 points)

1. Genetic factors- family member or genes with schizophrenia.

2. Chemical changes in the brain- having abnormalities in levels of dopamine and glutamate in the brain.

3. Pregnancy or birth complications- virus infection during the second trimester of pregnancy.

4. Childhood trauma- experienced the death or permanent separation of one or both parents.