ABNORMAL PSYCHOLOGY

Case Conceptualization

What is the presenting concern/problem?

Betty's parents, who were worried about their daughter seeming irrationally agitated and
paranoid, brought her to the neighborhood emergency department. They noticed that she was
no longer communicating with them, was threatening them with a knife, and was spending a lot
of time by herself in her bedroom. She hadn't gone to the local community college for classes in
over a month. When stressed, Betty admitted that she frequently "zones out" and that every
aspect of who she is depends on who is in her social circle. She also has a boyfriend, who she
sometimes loves very much but who she also sometimes despises and wants to leave the
relationship with. She had sex with several different people each week, generally total strangers,
before she met her boyfriend.

What is the background information of Betty’s case? Identify the Predisposing,

Precipitating, Perpetuating, factors causing the symptoms.

BIOLOGICAL PSYCHOLOGICAL SOCIAL

PREDISPOSING Diagnosed with Became Betty’s parents are

attention-deficit uncharacteristically always away due to
hyperactive disorder irritable and paranoid work
(ADHD)
During childhood she She spent the rest of
never felt genuine her childhood living
love and care from with her grandparents
her parents by herself.

PRECIPITATING History of “Zones out” in the Spent most of her

non-suicidal middle of time alone in her
self-injury (cutting conversations or bedroom after
arms and legs) since while at work ceasing to interact
she was a teenager with her family
Isolated herself and
abandoned her She has a tendency
studies. to alter her interests,
appearance, and
employment
according to her
social circle.

PERPETUATING Withdrawal Factors of her Various emotions

symptoms from her stressors could be about her relationship
prescription calming family, school, and with her lover.
medicine for her work
ADHD She admitted that
Twice tried to kill she have different
herself by overdosing sexual relationships
on prescription drugs, with people before
once as a teenager every week
and once six months
ago. Scared when she
thought that her
boyfriend might leave
her
What is your theoretical foundation explaining the case of Betty?

According to Freud, a person's incapacity to accept reality often leads to mental

diseases. Early experiences have a significant impact on how our personalities and behaviors
develop, according to Freud. We are biological organisms in our natural state. Instincts are what
propel us most of the time. However, as we learn to control our instincts and adapt them into
socially acceptable behaviors during childhood, we start to become social beings. The sort of
parenting the child experiences has a significant influence on how their personality develops.
Furthermore, according to psychodynamic theory, our personalities are greatly shaped by the
events of our childhood and how they affect our adult life. Childhood trauma can persist in the
unconscious and produce issues in adulthood. As the drives are altered by various conflicts at
various points in childhood, the personality is formed. The absence of Betty's parents
significantly affects her behavior in the context of this instance. She was struggling to express
her feelings at the time and tended to believe that she needed to change for other people in
order for them to accept her.

What is your diagnosis? (the case is a combination of a psychosis and a Personality

Disorder)

Apparently Betty has a psychotic condition brought on by medication. Drug- or

substance-induced psychosis would be the most acceptable diagnosis, despite the fact that she
had no prior psychotic symptoms, a family history of psychosis, and a sudden start of symptoms
after increasing her stimulant dosage. She was additionally taking stimulating medicines, which
have a high likelihood of producing symptoms of psychosis. Antipsychotic medications that will
assist manage and treat her disease are one possible kind of treatment.

Borderline personality disorder is another condition that she might have. She is suicidal
based on her prior efforts, which include overdose and self-harming by cutting, as indicated in
the case, and her unstable emotions and relationships. The main causes of this are most likely
chronic dread or distress from her early years and parental neglect. She exhibits frantic
attempts to fend off actual or imagined abandonment, impulsivity with regard to sex activity and
drug use that could be self-destructive, inappropriate, intense anger or difficulty controlling
anger, and transient, stress-related paranoid ideation or severe dissociative symptoms. The
following criteria below seems to be applicable to Betty:

Clinical criteria (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5])
For a diagnosis of borderline personality disorder, patients must have

● A persistent pattern of unstable relationships, self-image, and emotions (ie,

emotional dysregulation) and pronounced impulsivity
This persistent pattern is shown by ≥ 5 of the following:

● Desperate efforts to avoid abandonment (actual or imagined)

 ● Unstable, intense relationships that alternate between idealizing and devaluing the
other person
● An unstable self-image or sense of self
● Impulsivity in ≥ 2 areas that could harm themselves (eg, unsafe sex, binge eating,
reckless driving)
● Repeated suicidal behavior and/or gestures or threats or self-mutilation
● Rapid changes in mood, lasting usually only a few hours and rarely more than a
few days
● Persistent feelings of emptiness
● Inappropriately intense anger or problems controlling anger
● Temporary paranoid thoughts or severe dissociative symptoms triggered by stress
Also, symptoms must have begun by early adulthood but can occur during adolescence.