Neurodevelop-ment Disorders
The patient is an eighteen-year-old Asian male residing in suburban California. At age eight, he presented to a psychiatric outpatient department with a 2-month history of repetitive involuntary eye blinking, shoulder shrugging, and throat clearing. The intensity and duration of these motor and vocal tics varied, with no single episode lasting more than a few seconds, but he was never completely symptom-free. The frequency of his tics ranged from many times a day to once every few days. These tics were more severe when the patient was fatigued or stressed and less severe when the patient was mentally focused. The patient could voluntarily suppress the tics for a few minutes at a time, but such effort induced great stress and restlessness.
What is Tourette's Disorder?
Schizoaffective Disorder involves concurrent symptoms from two other diagnosis for at least 2 weeks without prominent mood symptoms.
What is Schizophrenia and major depressive episode? Manic episode is allowed.
A 22-year-old male in his freshman year of college reports increasing stress at school. Although historically he has done well academically and appears quite extroverted, the transition to college has been difficult and his grades have been suffering. He is afraid of drawing attention to himself in his classes by asking "stupid questions" and has avoided meeting with his professors and teaching assistants. He experiences particular difficulty in seminars and tutorials, where there is less opportunity to hide than in a lecture theater. He feels his mouth getting dry and his heart racing when even thinking about trying to get help. He has become more withdrawn, is starting to feel more depressed, and recently began missing classes.
What is Social Anxiety Disorder?
Carla is a 13 year-old female who presented to the ER with a grand-mal seizure from hyponatremia. She had been binging on water in order to fend off hunger. Carla had always been a happy child and great student, but had recently become obsessed with her schoolwork and isolated from her friends and close-knit family.Carla began losing weight after her PMD told her she was overweight. This coincided with a family trip to parents’ country of origin where Carla didn’t like the food. She lost >40 pounds and stopped getting her period.
What is Anorexia Nervosa?
Involves a husband choosing between stealing a drug to save his wife’s life & obeying the law by not stealing the drug. (Moral Stages)
What is Heinz Dilemma?
A 3-year-old girl presents because her parents are concerned about her language development. She started using single words at age 18 months but still doesn't use 2 words together. She stopped using words she had previously learned between 18 and 24 months, but has now regained most of these words. She does use words to request and she points at objects, but doesn't look at her parents when she does this. She plays with toys but prefers to play alone. She is less interested in other children than expected. She plays with her parents but only does this when they bring toys or books to her. She screams when taken to the supermarket and doesn't like noisy environments. She tends to flap her hands at times and her parents report her staring at the ceiling lights for 10 to 20 minutes at a time. She is a fussy eater and hates being messy.
What is Autism Spectrum Disorder?
A 48-year-old woman becomes convinced that her next door neighbor hates her and wants her to move. She states she has evidence, and when asked to explain, tells the psychiatrist at about every session that the neighbor gives her “looks,” puts excessive junk in her mailbox, and leaves yard clippings on her side of the yard to harass her.
What is delusional disorder?
A 25-year-old female presents to her primary care physician with complaints of muscle tension, especially in her shoulders and neck, contributing to tension headaches. She describes decreased sleep, chronic fatigue and constant restlessness in addition to poor concentration at work, with repeated run-ins with her coworkers. She has been a worrier since childhood, with worsening bouts when under stress. Physical exam reveals a healthy, tense female with normal vital signs and generalized muscular tension. She does not abuse substances, and medical history is unremarkable.
What is General Anxiety Disorder (GAD)?
Ken is a 10-year-old boy who has been referred to a
psychologist because of a recent escalation in his ongoing behavior problems. At preschool age, Ken began
throwing temper tantrums, talking back to his mother,
and acting disobediently. His mother frequently received
calls from his teachers during his early school years for
problem behavior. Ken is frequently sent to the principal’s office for being disruptive in the classroom, talking
back to the teacher, and getting into fist fights with other
children. Ken has few friends and spends a lot of time
playing alone. Recently, Ken was picked up by police
because he was found setting a fire in an abandoned
warehouse. This prompted his mother to seek help by
contacting the school psychologist who referred him to
a specialist in the area of disruptive behavior disorders.
What is Oppositional Defiant Disorder?
Sensorimotor (0-2), Preoperational (2-7), Concrete Operational (7-11), Formal Operational (11+)
What is Piaget's Stages of Development?
A 12-year-old girl presents to the physician's office because of problems with school performance. She attends a large public high school, and her teacher has reported that she has not been turning in her assignments and she is falling behind in math. Her father hired a tutor, and she seems to respond well to individual instruction. In the office, it is noted that she is sitting calmly but is constantly fiddling with her cell phone and is distracted by the toys in the room. She says that she does fine on tests but has difficulty focusing on homework. She still maintains an active social life and reports that her mood is fine.
What is Attention-Deficit/Hyperactivity Disorder (ADHD)?
A 22-year-old unmarried white man presents to the clinic with his mother. He spends most of his time in the house and refuses to go out at night alone. He used to live independently and worked until a few months ago. The patient states he made an error on his taxes and is convinced the Internal Revenue Service (IRS) hired detectives to gather information about his whereabouts. He states that since his mistake he uncovered an essential flaw in the taxation algorithm, which may expose the underpinning of IRS, and is convinced they hired assassins disguised as bikers. After moving in with his mom, he did not see the bikers, but they are trying to trace his "mental activity". Also, he hears them outside of his house talking about how they will kill him; he reported the problem to the police and FBI and is seeking my help "to defeat the IRS". He appears suspicious, avoids eye contact, and his answers to questions are delayed, during which he appears internally preoccupied.
What is Schizophrenia?
A 40-year-old man experiences intense worry several weeks before scheduled airline travel. However, he is required to fly several times each year with his work. His fear developed 2 years ago following an extremely turbulent flight. He has recurring, vivid images of himself dying in a fiery crash while flying. He is hyperaware of any sound and unexpected movement of the plane. Over the past several months he has been drinking alcohol excessively in an attempt to manage his symptoms.
What is Specific Phobia?
"Jason," age 17, currently lives in a residential treatment facility for emotionally troubled teenagers. His "file" indicates that as early as the third grade, Jason was labeled as the class bully and often initiated physical fights with peers. During middle school (age 12) he began skipping school and "roaming the streets" at night while using marijuana and alcohol(. He was once confronted by a store clerk as he tried to steal a pair of sneakers. In retaliation he spray-painted obscenities across the clerk's car and tossed a brick through the windshield.
When he was 15, Jason attacked a woman with a broken bottle and took her car keys. He was subsequently arrested after her car was traced by the police and he was court-ordered into a locked residential treatment facility.
What is Conduct Disorder?
Social (external) Speech (0-3), Egocentric Speech (3-7), Inner Speech (7+)
What is Vygotsky’s Stages in the Development of Speech?