Case Study #3 Instructions: Please read the following case study. After consulti

Case Study #3
Instructions: Please read the following case study. After consulting your DSM-V, submit your diagnosis following the required format (see Case Study link in Blackboard for further details):
* Please note that you do not need to see this movie to complete the assignment. Just go by the information provided here when completing your case study.
Name: Based on the character Nick (Nicolas) from “The Deer Hunter”
Source: The Deer Hunter (movie, 1976 )
Background Information
Nicolas (Nick) is a white male who seems to be in his late twenties. He lives in a small town where he has two long time friends, Michael and Steven. The United States (U.S.) is still at war with Vietnam, and Nick and his two friends plan to go to enlist and protect their country. Steven is engaged and decides to get married before his departure to Vietnam. Nick and Michael go to Steven’s marriage ceremony and seem very happy and do not seem to have any physical or psychological complications; they dance, laugh, drink and enjoy the entire night. Nick’s behavior and attitude is normal and there are no observable signs of physical or mental illness associated with him.
Michael is scared of going to Vietnam and very hopeless about returning back alive, but Nick talks to Michael on several occasions and calms him down, promising that everything will be fine. Nick seems to be a very helpful individual in the community as he lends a hand to people. Nick has a girlfriend and would like to propose to her before going to Vietnam, doing so at the end of the marriage ceremony. Both decide to get married after Nick comes back from the War. After Nick’s plan for marriage, he also feels bad about going to Vietnam; he is emotionally connected to his fiancée and finds it hard for him to leave.
Before Nick and his friends depart to Vietnam, they decide to go for their last deer hunt, up in the mountains close to their town. “One shot” deer hunting is Michael’s favorite slang, meaning that he always wanted to shoot a deer with only one shot. Michael successfully hunts a deer with only one shot and everybody enjoys the hunting that day. On the next day, they depart to Vietnam and face an unexpected battle with the Vietnamese army. It is not hard to see that they are all shocked in battle. Vietnamese soldiers attack them from all directions. After a couple of days, all three of them are taken captive in Vietnam. While captive, Nick, Michael and Steven are forced to play Russian roulette, their captors gambling on who will, or will not, blow out his brain. Russian roulette is a lethal game in which one bullet is placed in a revolver and participants (captives here) spin the cylinder, place the muzzle against their head and pull the trigger. This is a horrifying moment for Nick and his friends. Steven, who is a newly married groom, shows extreme symptoms of stress and anxiety. Nick visibly disintegrates under the abuse and torture of their captors, while Michael refuses to capitulate. Michael plans to free himself and his two other friends by requesting a three bullet Russian roulette game from his captors. He manages to kill the captors and runs away with Nick and Steven. An American helicopter shows up and transports Nick to the army hospital, while Michael and Steven wait for the next helicopter.
Descriiption of the Problem
While Nick is in the U.S. army hospital inside Vietnam, he displays mild symptoms of anxiety; insomnia, lack of appetite and anxiety, are among the major symptoms he displays. When a nurse comes and talks to him, he keeps staring at people who are brought to the hospital and does not talk to anyone. After about a month, he leaves the hospital and starts to have more severe symptoms of anger, especially when he is reminded of his time in Vietnam. He completely forgets that he has a fiancée or friends; he does not call his friends to see if they are still alive and seems detached from his social environment. He has a sense of a foreshortened future because he does not have a plan to go back home or do anything while he is in the U.S. camp in Vietnam. Nick is very busy with his thoughts and does not communicate with his surroundings; social impairment is vivid at this point.
He accidentally visits a bar in that town where people gamble on playing Russian roulette. As soon as he enters the bar, he starts to have intrusive distressing recollections of the time when he was captive and forced to play this game. He experiences a high level of anxiety and anger. As he is watching a candidate place a revolver to his head, Nick grabs the revolver and passionately places it to his head and pulls the trigger. He disrupts the game and the gamblers kick him out. However, the next day as he is walking down a street he reaches the same bar. He goes inside and sits in one of the empty seats designated for a Russian roulette player. When loved ones search for him, Nick shows little emotional response, continuing to play Russian roulette in that same bar.
(End of Case Study # 3)
Use your past experience with Case Studies # 1 and # 2, along with the Eeyore example provided in the “Guidance for the case study assignments” section to successfully complete this case study.
The DSM information you will need to look at is located inside the section entitled, “DSM Notes- Trauma & Stressor Related Disorders”
VERY IMPORTANT TO FOLLOW THIS LINK FOR THE CASE STUDY INTRUCTIONS PER MY PROFESSOR
Case Study Assignments (Overview) – Your first assignment that involves the use of a case study will be given the week of 8/21 – 8/27
Some of the assignments in this class will be case studies. These case studies will provide detailed information about a client, sometimes real, sometimes fictitious. Your first assignment that involves the use of a case study will be given the week of 8/21 – 8/27.
If you scroll down inside this module, you will see the following:
Sample Case Study (This is just an example)
Case Study Response Example
Video guidance with completing case study assignments
NOTE: Case studies of fictitious characters may contain spoilers for your favorite TV shows, movies, and/or books. You’ve been warned.
Many of the characters in the case studies will be based on movies, tv shows, and books. Please note that you will not need to watch the movies, tv shows, or read the books in order to complete the case studies.
* An example of a case study (one on Eeeyore from Winnie The Pooh) is available inside this module, along with an example of a successfully completed case study.
The task of your case study assignments will be to determine the correct diagnosis for the client, and support your reasoning using the checklists in the DSM-V. The correct format for this is as follows:
Student Name: (Your name)
Diagnosis: (List the disorder as it is labeled in the DSM-V)
Diagnostic Criteria: (List all diagnostic criteria in the checklist for this disorder, and bold any/all symptoms that apply to the client in the case study)
Rationale: (Explain your reasoning in 1 – 2 paragraphs, citing specific instances from the case study itself. For every symptom that you have in bold above, there should be an explanation with specific examples from the case study cited)
Parameters: All submissions must be 1 – 2 pages in length, Times New Roman, 12 pt font. Submit each assignment as a Word document (.doc or .dox; I will not accept any other format).
FAILURE TO WRITE YOUR CASE STUDIES IN THE ABOVE FORMAT WILL RESULT IN A LOSS OF POINTS FOR THE ASSIGNMENT
Case Study #0 on Eeyore is provided inside this module. It is located just below these instructions.
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Sample Case Study (This is just an example)Sample Case Study (This is just an example)
The following is an example of what your case studies will look like. Just below the “Case Study #0” inside this module is an example of a successfully completed analysis of the case study. It is entitled, “Case Study Response Example.”
Case Study #0
Instructions: Please read the following case study. After consulting your DSM-V, submit your diagnosis following the required format (see Case Study link in Blackboard for further details).
Name: Eeyore
Source: Winnie the Pooh (TV Show, 1966)
Background Information
Eeyore is an older gray donkey. There are no documents indicating the exact age or specified background information, and he chooses not to share this information. Eeyore does not have an occupation. His health compared to other donkeys is slightly underweight, but slender. He chooses not to share his family background. One main difficulty Eeyore has elaborated on is his detachable tail, which seems to cause him several problems. He has indicated that his goals are to remain strong for his friends despite his lack of confidence within himself, and as a result he often feels lonely without support from others that he is close to. Some forms of coping mechanisms include trying to feel useful in the presence of others and also trying his best to find pleasure in life.
Descriiption of the Problem
Eeyore constantly insists that his tail falls off rather frequently. Eeyore’s posture typically involves a slumped head, droopy eyes, and commonly says “thanks for noticing me.” Sluggish movement is also apparent, without any physical cause for movement delay. He seems to step on his tail often and fall down. Eeyore indicates that sometimes it seems that even his close friends do not need him. Around friends, he typically makes comments about his relative unimportance and travels near the back of the pack. He also stated that although he tries to force a smile, a real smile has not existed in a long time, even though others try to cheer him up. He often feels empty even when accompanied by friends. Eeyore also seems to experience a loss of energy throughout the day, although sleeping habits are not explicitly expressed.
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Case Study Response ExampleCase Study Response Example
Case Study #0
Student Name: John Doe
Diagnosis: Major Depressive Disorder
Diagnostic Criteria:
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly attributable to another medical condition.
Depressed mood most of the day, nearly every day, as indicated by either subjective report (feels sad, emply, hopeless) or observation made by others (appears tearful). Note: In children in adolescents, can be irritable mood.)
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
Insomnia or hypersomnia nearly every day.
Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or inappropriate guild (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The episode is not attributable to the physiological effects of a substance or to another medical condition.
D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specific and unspecified schizophrenia spectrum and other psychotic disorders.
E. There has never been a manic episode or a hypomanic episode.
Rationale:
A. Eeyore exhibits five symptoms of a major depressive episode, and has also experienced these for several years, therefore meeting full criteria. Criteria met include:
Depressed mood most of the day: Eeyore stated that although he tries to force a smile, a real smile has not existed in a long time, even though others try to cheer him up. He often feels empty even when accompanied by friends.
Markedly diminished interest or pleasure in activities: Eeyore often travels near the back of the pack when with his friends, but struggles to find pleasure in life.
Psychomotor retardation nearly every day: Eeyore’s movements are often sluggish, even though there is no physical cause for movement delay.
Fatigue or loss of energy nearly every day: While sleeping habits are not explicitly expressed, Eeyore seems to experience a loss of energy throughout the day.
Feelings of worthlessness: Eeyore expressed a lack of confidence in himself, though he is trying to remain strong for his friends. He often says, “thanks for noticing me,” indicating that he does not think he is worth noticing. Eeyore also stated that sometimes it “feels as if his close friends do not need him.” When around friends he often makes comments about his relative unimportance.
B. These symptoms often cause Eeyore significant distress in social situations, as his friends try to cheer him up regularly with little success.
C. While Eeyore struggles with his tail, these symptoms can not be attributed to said physical condition. Eeyore did not report the use of any substances.
D. Eeyore does not meet the requirements for any other psychotic disorders that might better explain the source of his depression.
E. No manic or hypomanic episode was reported.
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