Case Study: Vee

Janys Pelaez
St Thomas University
NUR 530: Psychopathology
Dr. Seraphin, Vardah L.
04/02/2023
Question # 1

According to the instance, one concern that has been showing itself is self-inflicted

harm. The African American man, now 26 years old, has considered inflicting damage on

himself. For example, Vee indulged in the practice of cutting herself on the arms and legs

when she was a teenager. Another concern that has been brought to light is that the patient

has suicidal thoughts and has made two attempts at ending their own life. When Vee was a

teenager, more recently, she took excessive medically necessary drugs. She also describes

having persistent suicidal thoughts, which see death by one's own hand as an escape route. In

addition to these issues, the patient may have difficulties focusing. It has been reported that

she has a tendency to zone out during chats at work. Also, she struggles with anxiety and

emotional dysregulation, leading to her altering how she dresses and the activities she enjoys

while engaging with different social groups.

Another problem that has surfaced is Vee's impulsivity, as seen by the fact that he

sends text messages and makes extravagant purchases for his girlfriend on the spur of the

moment. In addition, the fact that she lashes out, shouts at, and throws objects at her spouse

reveals her mood swings and cycles of rage. Vee also gets anxious when she feels guilt and

terror after lashing out because of the possibility that her spouse will leave her. Last but not

least, one of the patient's presenting problems is hazardous conduct, which occurs when the

patient participates in sexual interactions with several people she does not know.

Question # 2

Vee meets the criteria for Borderline Personality Disorder, which is the primary

diagnosis according to the DSM5 manual (Perrotta, 2020). The presence of a persistent

pattern of unstable self-image, impulsive behavior, and dysfunctional interpersonal

connections is required for this diagnosis. In addition, one of the requirements for a primary
diagnosis of borderline personality disorder in the DSM5 is that the symptoms must first be

seen in early adulthood. Distrust, idealization of self-harm, and apprehensive anxiety about

desertion are common aspects based on the criteria. Other common elements include. These

recurring themes are readily apparent in the challenges that Vee is now facing. The ICD 10

codes suggest that the patient may have an emotionally unstable personality disorder as a

differential diagnosis. It is primarily characterized by a predisposition for impulsive behavior,

emotional outbursts, and unpredictable mood, which occur often. According to the DSM-5,

another differential diagnosis that may be made is dysthymia, which is characterized by a

sensation of emptiness and an increased risk of suicide.

On the other hand, this is not the same as borderline personality disorder since

anger and distrust might come on suddenly. Another differential diagnosis that may be made

is that of bipolar disorder, which is characterized by a pattern of dissociated behavior,

irritability, impulsiveness, and self-injury. On the other hand, mood swings associated with

borderline personality disorder tend to occur in cycles and often occur, in contrast to mood

swings associated with bipolar illness, which are typically triggered by being rejected.

Question # 3

Cluster B refers to the main diagnostic of Borderline Personality Disorder, which

falls under this category. It is said to be the condition that occurs the least often yet might be

difficult to treat. According to the fifth version of the Diagnostic and Statistical Manual of

Mental Disorders, personality disorders may be categorized into three categories (Edition,

2014). One of the four disorders that fall under the cluster B category and are characterized

by unstable interpersonal connections is borderline personality disorder (BPD). Narcissistic

personality disorder and antisocial personality disorder are also examples of other illnesses

that fall under this umbrella. In addition to this, those who have been diagnosed with the
illness have an unstable self-image and a heightened sensitivity to being rejected. The

disorders that belong to this cluster have a characteristic style of thinking that is very

emotional and erratic.

Question # 4

Psychotherapy that incorporates cognitive behavioral therapy and the use of

psychotropic medication are both components of Vee's treatment plan (Sperry, 2016). The

symptoms associated with borderline personality disorders, such as impulsivity and

emotional dysregulation, may be managed with psychotherapy, a treatment backed by

scientific evidence. Mood regulation may be accomplished with the use of psychotropic

medication. Antipsychotic drugs like aripiprazole and antidepressants like fluoxetine are

examples of selective serotonin reuptake inhibitors (SSRIs). It has been shown that SSRIs are

helpful in reducing feelings of anger and anxiety.

On the other hand, it is of the utmost importance to avoid prescribing

antipsychotics for extended periods of time since patients might be susceptible to the effects

of these medications. As a result, the treatment strategy will consist of decreasing the doses

of psychoactive mood stabilizers as well as the number of times they are taken each day.

Also, since it combines interpersonal and psychoanalytic treatment into a single intervention

strategy, Schema Focused Therapy is an excellent method for the management of

maladaptive patterns. It is effective in treating borderline personality disorder since the illness

is characterized by problems with interpersonal connections.

 References

Edition, F. (2014). Diagnostic and statistical manual of mental disorders. Am Psychiatric

Assoc, 21(21), 591-643.

Perrotta, G. (2020). Borderline personality disorder: Definition, differential diagnosis, clinical

contexts, and therapeutic approaches. Annals of Psychiatry and Treatment, 4(1),

043-056. https://dx.doi.org/10.17352/apt

Sperry, L. (2016). Handbook of diagnosis and treatment of DSM-5 personality disorders:

Assessment, case conceptualization, and treatment. Routledge.