Case Study 2 3318

Case Study 2
25 pts
Due 11/21 by 11:59 p.m. via Canvas
Mary is a 26-year-old woman who presents with a history of self-injury, specifically cutting her arms and
legs, since she was a teenager. She has made two suicide attempts by overdosing on prescribed
medications, one as a teenager and one six months ago; she also reports chronic suicidal ideation,
explaining that it gives her relief to think about suicide as a “way out.” Mary doesn’t share much about
her childhood other than her father left when she and her siblings were very young. As a result, her
mother worked 3 jobs to care for her 5 children.
When she is stressed, Mary says that she often “zones out,” even in the middle of conversations or while
at work. When experiencing an episode, she states she has a sense that her body isn’t really hers or that
she’s floating outside of herself. She also states that during these episodes she feels almost like she’s
reading a book about her life or that things aren’t “real”. She shares that she is afraid she will be
terminated from her position soon, due to ongoing conflicts with co-workers and periods of zoning out.
Mary additionally states, “I don’t know who Mary really is,” and describes a longstanding pattern of
changing her hobbies, style of clothing, and sometimes even her job based on who is in her social group.
At times, she thinks that her partner is “the best thing that’s ever happened to me” and will impulsively
buy him lavish gifts, send caring text messages, and the like; however, at other times she admits to
thinking “I can’t stand him,” and will ignore or lash out at him, including yelling or throwing things.
Immediately after doing so, she reports feeling regret and panic at the thought of him leaving her. Mary
reports that before she began dating her current partner she sometimes engaged in sexual activity with
multiple people per week, often with partners whom she did not know.
Address the following questions. Be sure to number each response (1-5).
1. Based on APA 3 criteria for defining and diagnosing abnormal behavior, does Mary show
evidence of abnormal behavior? Addressing each of the 3 criteria, what evidence do you have
that is sufficient for these requirements? Be sure to incorporate specific text evidence.
According to the APA 3 criteria, a behavior is abnormal when It causes distress to yourself or
other people, Impairs your ability to function day to day or It increases the risk of injury, death,
lead problems and punishment for breaking rules or other detrimental consequences.
First Mary causes distress towards herself by the harm that she causes to herself. She cut has a
history of cutting her harms and legs since she was a teenager. A way that she is hurting people
around her is she shows signs that she may be neglecting her partners. Her partners are
unaware that she engages in sexual activities with multiple people per week. Her ability to
function properly is compromised as she zones out often. This can be detrimental to her work.
The rules that she’s breaking which can cause other detrimental consequences to her based on
her actions is going in conflicts with her coworkers.
2. Based on text evidence, what would you diagnose Mary with? Keep in mind comorbidity; if you
feel she meets the criteria for more than one, address both.
Mary can be diagnosed with Depersonalization/Derealization Disorder and borderline

personality disorder. According to the DSM 5, borderline personality disorder “a pervasive
pattern of instability of interpersonal relationships, self-image, and affects, and marked
impulsivity, beginning in early adulthood and present in a variety of contexts.”. and the
definition for depersonalization/derealization is an enduring and inflexible pattern of long
duration leading to significant distress or impairment and is not due to use of substances or
another medical condition.
3. Using the DSM-5, select at least 3 criteria for Mary’s diagnosis (if comorbid, select 3 for each);
give specific examples from the text to illustrate how she meets each criterion.
1) depersonalization/derealization- the part of the text that makes me diagnose Mary with this
is this part of the story “, she states she has a sense that her body isn’t really hers or that
she’s floating outside of herself. She also states that during these episodes she feels almost
like she’s reading a book about her life or that things aren’t “real”.”
The DSM 5 criteria’s that transpire through her actions are: symptoms due to stress or
dysfunction, symptoms not due to substance abuse, and switching between 2 or more
alters.
2) Borderline disorder- the part of the text that makes me diagnose Mary with this is this part
of the story. “Mary reports that before she began dating her current partner she sometimes
engaged in sexual activity with multiple people per week, often with partners whom she did
not know.”
The DSM 5 criteria’s that transpire through her actions are: 1) A pattern of unstable and
intense interpersonal relationships characterized by alternating between extremes of
idealization and devaluation. 2)Identity disturbance: Markedly and persistently unstable
self-image or sense of self. 3) Transient paranoid ideation or severe dissociative symptoms.
3) Dependent personality disorder- the part of the text that makes me diagnose Mary with this
is this part of the story states, “I don’t know who Mary really is,” and describes a
longstanding pattern of changing her hobbies, style of clothing, and sometimes even her job
based on who is in her social group.” This may stem from the fact that she does not share
much with her childhood self.
The DSM 5 criteria’s include: Desperately seeks another relationship when one ends,
constantly preoccupied with fear to take care of herself and goes to extensive care to obtain
nurturance and support from others.
4. Would you consider Mary’s prognosis good or guarded? Why?
I would consider Mary’s prognosis to be guarded as we do not know that steps that Mary has
done to get treatment for her disorders. Unfortunately, we won’t be able to tell Mary’s
predictions as far as her mental health status. From this story, Mary does not recognize that she
has an abnormal behavior.
5. What treatment/s would you recommend for Mary and why? Provide at least 2 examples and
identify specific benefits for each.
A treatment I would recommend for Mary at first is an nonpharmacological method of
Dialectical behavior therapy. This form of therapy requires Mary to talk about her problems to a
licensed counselor. This will help Mary notice that the harmful behavior that she conflicts on
both herself and others. After the dialectal behavior, Mary will undergo antidepressant
medication for short time relief while continuously visiting for dialectal therapy. The
antidepressants will help her when her behavior is impaired while the therapy will help her long
term. The dialectal behavior therapy will help for both borderline disorder and dependent
personality disorder. Lastly, she could use PTSD medication as a treatment for her dissociative
disorder. PTSD medication are used to treat people with dissociative disorder.
Grading rubric:
Criteria Excellent Fair to Good Incomplete

Content The assignment clearly and The assignment partially The assignment does not
comprehensively addresses all addresses some or all adequately address the
questions in the assignment. questions in the questions in the assignment.
assignment.
Organization The assignment presents ideas The assignment presents The assignment does not
and Clarity in a clear manner and with ideas in a mostly clear present ideas in a clear manner
strong organizational structure. manner and with a and with strong organizational
The assignment includes mostly strong structure. The assignment
thorough content and organizational structure. includes some content and
conclusions. Diagnosis is The assignment includes conclusion, and/or diagnosis is
logically related and valid. relatively sufficient not logical or valid.
content and conclusions.
Diagnosis is logically
related and valid.
Command of Claims are clearly supported by Claims are somewhat Claims are not supported by text
Evidence text evidence. Evidence is supported by text evidence. Evidence is not
consistent and sustained evidence. Evidence is adequate and/or sustained
through entire analysis. Claims inconsistent or not through analysis. Claims do not
illustrate insightful sustained through entire illustrate comprehension of
comprehension of topics. analysis. Claims illustrate topic.
adequate comprehension
of topics.
Grammar and The assignment has two or The assignment has three The assignment is incomplete or
Spelling fewer grammatical and spelling to five grammatical and unintelligible.
errors. spelling errors.

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Case Study 2

Address the following questions. Be sure to number each response (1-5).

Mary can be diagnosed with Depersonalization/Derealization Disorder and borderline

4. Would you consider Mary’s prognosis good or guarded? Why?

Criteria Excellent Fair to Good Incomplete

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