Abnormal Psychology
Background
Amanda is a vibrant young, nineteen year old, single mother living in a suburban community. She is unemployed and receiving state issued public assistance. She does not attend school and reported having dropped out in the tenth grade due to her learning disability in comprehension. She presents with severe symptoms of depression and several obsessive compulsive symptoms as well. She is accompanied by her biological mother.
Amanda was raised by her father following a long divorce from her mother. Her father is an alcoholic not in recovery. Amandas mother suffers from panic disorder and post traumatic stress disorder (PTSD). When Amanda was thirteen, she went to live with her mother due to her father overdosing on crack cocaine. Amanda found her father passed out and barely breathing and was reported to have been doing CPR on him when the ambulance arrived. Amandas mother initiated contact with a local mental health organization in order for Amanda to have an outlet for any residual psychological dysfunction due to the traumatic events that she had endured. During her outpatient treatment, Amanda was hospitalized for suicidal ideologies. She spent ten days in the adolescent psychiatric unit. Upon her release, she continued with outpatient therapy, but did not seem to be improving. Her grades suffered immensely, and she became more withdrawn. Her daily activities consisted of sleep. One evening, Amanda woke from a nightmare and ran to her mother sobbing and hyperventilating. Amanda indicated to her mother that she had a dream that her father had died. She continued sobbing and stated emphatically that she wanted to die, over and over. Amandas mother contacted the crisis worker on call, and Amanda was admitted again to the adolescent psychiatric unit.
During her second inpatient stay, the treating psychiatrist performed several pathological tests as well as a psychiatric assessment. It was determined that Amanda had Bipolar Disorder I. She was stabilized with Depekote and Zoloft. Fourteen days later, Amanda was discharged. She continued with outpatient cognitive behavior therapy and prescription regimen for the next year until she chose to move back in with her father.
Amanda reports loss of memory from the time she returned home to her father to the present. She stated that she quit taking her medications within days of moving into her dads house because they were not doing anything. Amanda reports becoming pregnant as a result of a one night encounter. Amanda states that she was drunk and does not have any recollection of the evening. She also states that she drinks frequently because it helps her to relax and think better. Shortly after becoming pregnant, she found out that she had contracted Genital Herpes. Amanda gave birth to a healthy daughter eight months later. She moved back in with her mother within a month of giving birth.
Amandas mother initiated contact with the local mental health agency due to the symptoms that Amanda is presenting. She constantly sleeps, screams at her newborn for wanting a bottle, and refuses to participate in any activity other than sleeping. The newest and most concerning symptom, according to her mother, is of an obsessive compulsive nature. Amanda became angry and verbally outraged at her mother for feeding the baby a bottle with a yellow nipple ring. Amanda stated that it was Tuesday and only the blue nipple rings were to be used. During the
last month of Amanda cohabitating at her mothers home, her mother reports one incident of Amanda getting up and cleaning the entire house and doing a load of laundry. Just as quickly as Amandas energy came, it left and Amanda fell right back into the sleeping all day pattern. The treating psychiatrist reassessed Amanda via tests, both biological and psychological. It was again determined that Amanda had Bipolar Disorder and obsessive compulsive disorder as a secondary condition.
Methodology
Abnormal psychology contains five major theories and perspectives within the discipline. The first theory is the Medical Perspective, also known as the biological or physiological aspect. The second theory is the Psychodynamic Perspective. The next theory is the Behavioral Perspective. The Cognitive Perspective is the next theory to be examined. Finally, the last theory is the Social and Cultural Perspective. Each of these perspectives holds reasoning behind the psychological reasoning of ones behavior. The behaviors and behavior patterns are definitive within each respect as is the treatment and prognosis of each individual being addressed under a specific theory (Corner, 2010).
The Medical, or biological, Perspective focuses on the biological and physiological factors as a course of origin for abnormal behaviors. Genetics has been accredited to some conditions such as Schizophrenia and some mood disorders. Family history of a pre-existing condition is said to pre-dispose an individual and make one vulnerable to the consequences of the same mental disorder. In Amandas case, it can be asserted that her mothers history of panic disorder and PTSD could have had a genetic effect on Amanda developing Bipolar Disorder. It can equally
be asserted that her fathers history of substance abuse could be a form of self-medicating due to an undiagnosed mental illness. Medical testing has proven that some medical conditions can give the impression of an existing mental disorder when in actuality the condition was solely medical in nature (Ware Johnson, 2000). Amanda did present with a determined medical condition, and it should be noted that her medical diagnosis of Genital Herpes could be a contributing factor. Amanda stated that she is being treated for Genital Herpes with the medication Valtrex. Treatments used with regard to the Medical Perspective typically involve temporary hospitalization, medications to enable stability of any condition, and outpatient therapy.
The Psychodynamic Perspective believes that behaviors produce anxiety and discord in ones life due to repressed memories, most likely stemming from a past childhood experience. These sometimes unconscious memories could only be resolved through speaking candidly with a well trained therapist (Corner, 2010). Amandas repressed memories of child abuse, neglect, feeling abandoned by her mother, and her fathers overdose is suggested to have attributed to her developing Bipolar Disorder.
The Behavioral Perspective suggests that ineffective learning and conditioning play a major role in the abnormalities of ones behavior and inability to make rational decisions. Phobias and compulsive disorders are distinguished within this perspective. Amanda taking issue over the color of the nipple rings is indicative of this perspective. The main focus of treatment associated with this perspective is identifying and changing the way in which one behaves (Ware Johnson, 2000). This can be accomplished through the use of desensitization strategies.
The Cognitive Perspective teaches a patient to think differently. Abnormal behavior is centered on false reasoning and thought based on ill teaching. These teachings may have come from parents, teachers, and other role models in ones life. Amanda for the greater part of her life has been taught to deal with stress via alcohol or illegal drugs. This erroneous thought process contributed to her engaging in unprotected sexual behavior resulting in an unplanned pregnancy and contracting Genital Herpes. Her compulsive behavior is associated with this perspective as well (American Psychiatric Association, 2000). The use of Cognitive Behavioral Therapy could benefit Amanda in the form of modeling by using a mentor.
The Social and Cultural Perspective or Humanistic approach focuses on the environment and social influences as it relates to abnormal behavior. Mentally ill individuals, including Amanda, have suggested that low self-esteem, anger issues, and every day stressors are contributing factors to her behavior dysfunctions (Ware Johnson, 2000). Amandas abnormal behaviors are associated with her financial burdens, unemployment, poor education, and low standards of living. Cognitive modeling therapy, individualized therapy, group therapy, and medications in some cases have proven to be effective measures to be used when dealing with this perspective of abnormal psychology.
Analysis
In order to make operational determinations in abnormal psychology, the psychological community refers to the Diagnostic and Statistical Manual of Mental Disorders (DSM). This resource manual offers information on diagnostic classifications, criteria required, and descriptions (American Psychiatric Association, 2000). A patient generally is not diagnosed for just one abnormality, but several other contributing factors are taken into account and utilized for a more formative diagnosis. The V Axes are used to diagram and represent the full diagnosis of a patient. There are five levels of diagnosis on the Axis, and each one represents a different perspective. Axis I pertains to Clinical Disorders. Axis II focuses on Personality Disorders and Mental Retardation. Axis III is dedicated to General medical conditions. Axis IV includes the Psychosocial and Environmental factor.
Medications can be attributed to this axis as some medications produce an unwanted behavioral effect on the patient. Lastly, Axis V is dedicated to the Global Assessment and Functioning Scale. This scale is used to determine the level of risk proposed by each patient individually. Amandas V Axes would be defined as follows Axis I- Bipolar Disorder II Axis II- Learning Disabilities, comprehension related Axis III- Genital Herpes Axis IV- Valtrex Axis V- Score of 20 at present.
Conclusion
Abnormal psychology is full of many theories and perspectives based on human behavior and functioning. Psychologists have worked to develop theories over the years and have made great contributions to a better understanding of human patterned behaviors. Biological factors, learned behaviors, environmental changes, thoughts, and memory can have a loitering effect on the way one process thought and behaves. Each individual case involves many different factors that may have had a direct affect on the formulation of a mental illness. Psychologists are especially trained to uncover other behaviors that may suggest another condition that would be treated differently. Patients put much faith into how their psychiatrist diagnoses and treats their emotional issues. Unfortunately, some patients are in denial and believe that they are not ill.
These patients sometimes require hospitalizations in order to stabilize their mental illness and protect the patient from their own destructive behaviors. Abnormal psychology contains patterns of behavior which have been theorized upon and abnormal behaviors which are definitive of many perspectives.
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