Guess the Diagnosis:  CASE OF AMANDA SOC4425 Abnormal Psychology   AmandaAmanda S.was 22 years old when she reluctantly agreed to interrupt her college semester and admit herself for the eighth time to a psychiatric hospital. Her psychologist, Dr. Swenson, and her psychiatrist, Dr. Smythe, believed that neither psychotherapy nor medication was controlling her symptoms and that continuing outpatient treatment would be too risky. Amanda was experiencing brief but terrifying episodes in which she felt that her body was not real. She sometimes reacted by cutting herself with a knife in order to feel the pain, so she would feel real. During the first part of the admission interview at the hospital, Amanda angrily denied that she had done anything self-destructive. The anger dissolved, however, and she was soon in tears as she recounted her fears that she would fail her midterm examinations and be expelled from college. The admitting psychiatrist also noted that at times Amanda behaved in a flirtatious manner, asking inappropriately personal questions such as whether any of the psychiatrist’s girlfriends were in the hospital.When she arrived at the inpatient psychiatric unit, Amanda once again became quite angry. She protested loudly, using obscene and abusive language when the nurse searched her luggage for illegal drugs and sharp objects, even though Amanda was very familiar with this routine procedure. These impulsive outbursts of anger were quite characteristic of Amanda. She would often express anger at an intensity level that was out of proportion to the situation. When she became this angry, she would typically do or say something that she later regretted, such as verbally abusing a close friend or breaking a prized possession. In spite of the negative consequences of these actions and Amanda’s ensuing guilt and regret, she was unable to stop losing control of her anger.The same day Amanda filed a “three-day notice,” a written statement expressing an intention a leave the hospital within 72 hours. Dr. Swenson told Amanda that if she did not agree to remain in the hospital voluntarily, he would initiate legal proceedings for her involuntary commitment on the grounds that she was a threat to herself. Two days later, Amanda retracted the three-day notice, and her anger seemed to subside.Over the next two weeks, Amanda appeared to be getting along rather well. Despite some complaints of feeling depressed, she was always well dresses and groomed, in contrast to many of the other patients. Except for occasional episodes when she became verbally abusive and slammed doors, Amanda appeared and acted like a staff member. She began to adopt a “therapist” role with the other patients, listening intently to their problems and suggesting solutions. She would often serve as a spokesperson for the more disgruntled patients, expressing their concerns and complaints to the administrators of the treatment unit. With the help of her therapist, Amanda also wrote a contract stating that she would not hurt herself and that she would notify staff member she began to have thoughts of doing so. Since her safety was no longer as big of a concern, she was allowed a number of passes off the unit with other patients and friends.Amanda became particularly attached to several staff members and arranged one-to-one talks with them as often as possible. She used these talks to flatter and compliment the staff members and tell them that they were one of the few who truly understood her and could help her, and she also complained to them about alleged incompetence and lack of professionalism among other staff members. Some of these staff members Amanda was attached to had trouble confronting Amanda when she broke the rules. For example, when she was late returning from a pass off grounds, it was often overlooked. If she was confronted, especially by someone with whom she felt she had a special relationship, she would feel betrayed and, as if an emotional switch had flipped, would lash out angrily and accuse that person of being “just like the rest of them.”By the end of the third week of hospitalization, Amanda no longer appeared to be in acute distress, and the staff began to plan for her discharge. At about this time, Amanda began to drop hints in her therapy sessions with Dr. Swenson that she had been withholding some kind of secret. Dr. Swenson `addressed this issue in therapy and encouraged her to be more open and direct if there was something she needed to talk about. She then revealed that since here second day in the hospital, she had been receiving illegal street drugs from two friends who visited her. Besides occasionally using the drugs herself, Amanda had been giving them to other patients on the unit. This situation was quickly brought to the attention of all the other patients on the unit in a meeting called by Dr. Swenson. During the meeting, Amanda protested that the other patients had forced her to bring them drugs and that she actually had no choice in the matter. Dr. Swenson didn’t believe Amanda’s explanation and instead thought that Amanda had found it intolerable to be denied approval and found it impossible to say no.Soon after this meeting, Amanda experienced another episode of feeling as if she were unreal and cut herself a number of times across her wrists with a soda can she had broken in half. The cuts were deep enough to draw blood but were not life threatening. In contrast to previous incident, she did not try to hide her injuries and several staff members therefore concluded that Amanda was exaggerating the severity of her problems to avoid discharge from the hospital. The members of Amanda’s treatment team then met to decide the best course of action.Not everyone agreed about Amanda’s motivation for cutting herself. Amanda was undoubtedly self-destructive and possibly suicidal. Therefore, she needed further hospitalization. But she had been sabotaging the treatment of other patients and could not be trusted to refrain from doing so again. With the members of her treatment team split on the question of whether or not Amanda should be allowed to remain in the hospital, designing a coherent treatment program would prove difficult at best.Article Summary Reports  Title Page – Student Name and Title of ReportClient Background:  Describe all of the key background points about the person.Abnormal Behavior:  Describe how and why this behavior is considered abnormal.DSM Classification:  Describe the client’s diagnosis. Go with first choice, then second choice.  Match the symptoms with the diagnosis.Describe Possible Treatment Plans and OutcomesConclusion: What did you learn from this case about abnormal psychology?Report Format – Typed, single-spaced, up to one page, spelling, grammar check. References included in APA style. Remember, psychologists, psychiatrists, mental health counselors, and licensed social workers consider behavior abnormal when it meets some combination of the following criteria:(a) deviant – unusual or statistically infrequent(b) despised socially – socially unacceptable or in violation of social norms (c) delusional – fraught with misperceptions or misinterpretations of reality (d) distressing – associated with states of severe personal distress (e) dysfunctional – self-defeating or maladaptive or(f) dangerous – to self or others
Guess the Diagnosis: CASE OF AMANDA SOC4425 Abnormal Psychology Amanda Amanda S.was 22 years old when she reluctantly agreed to interrupt her college semester and admit herself for the eighth time
Introduction  Opioids are a class of pain-relieving drugs that interacts with the opioid receptors in the brain to produce several effects. These drugs help relieve pain; however, they can have analgesic effects, negative implications on the central nervous systems, and the potential to cause euphoria. Opioid use disorder (OUD) is a disorder caused by the continuous use of opioid drugs (Blanco & Volkow, 2019). It can involve overdose consumption of drugs as prescribed by the doctor, using the drugs for other purposes, not for treatment, or illicitly consuming heroin. In addition, opioid use disorder often causes patients to have series of illnesses as it is chronic. Therefore, patients with this disorder are often treated to prevent relapse of illness. Client Background This case is about a 27-year-old woman with Opioid Use Disorder and Suicidal Ideation. The woman was admitted because she attempted to commit suicide. Weeks before this admission, the woman began to use intranasal heroin daily to relieve her from the depression and stress of being homeless. She also consumed clonazepam to control her panic and anxiety but felt tired of life and wanted to kill herself. That same day after admission, this woman smashed her phone and ate glass shards to try and commit suicide. She vomited two teaspoons of blood and told the hospital’s emergency department how badly she regrated trying to commit suicide; she requested help with her substance use and suicidality. In her previous medical history, the patient had no records of suicide attempts. However, she had impaired sleep, fatigue, mood lability, nightmares, and flashbacks. She had never undergone psychiatric treatment and took no medication. She, however, smoked and drank daily for the past ten years. Upon examination, this woman appeared tearful and anxious; her body temperature was 36.8°C with a pulse of 70 beats per minute. Client Abnormal Behavior. The opioid disorder has many unique features that make it different from other substance addictions. Consumption of Opioids is chronic and can cause the patients to have abnormal behaviors (Connery, 2015). Patients with Opioid use disorders always have generalized pain, cramps, diarrhea, chills, intense vomiting, and many other symptoms. These symptoms are severe and cause patients to continue using opioids. It is these symptoms that cause the patients to have unique and abnormal behaviors. In this case study, the woman consistently showed abnormal behaviors. She gets the information about her transfers from the hospital to an inpatient facility and goes to the washroom to bang her hand against the wall, after which she reports pains. The patient engages in the repeated act of self-harm until she got discovered, where she described each new injury as unintentional with each incident. She repeats this as she reports clinically significant pain where she is administered an opioid drug. Finally, she tries to dislocate her arm as a trick to try and get an Opioid, and this is an abnormal behavior because we expected her to stay calm and recover. DSM Classification People who suffer from Opioid use disorder try to switch from prescription pain killers to heroin, where this disorder is easily found. To diagnose OUD, the patient must have taken opioids in large amounts or over a longer period than was expected. Patients show persistent desire and strong craving to continue using opioids (Larochelle et al.,2018). These patients continue to consume the opioids despite the interpersonal problems caused and their knowledge of the psychological problem they are likely to cause. In this case study, the woman showed cravings for opioids even after admission to the hospital. She tried all tricks to get the hospital to administer her opioids. She also reported continued abnormal behaviors that showed that she developed a menial problem in the courses. Treatment Treating an opioid disorder requires Medication-assisted treatment. This type of treatment puts the patient under medication, counseling, and guidance at the same time. It involves behavioral therapies and medications to modify the patient’s brain chemistry (Strang et al.2020). Treating Opioid disorder also involves cognitive-behavioral approaches such as advising the patient to change her behaviors and to take the treatment positively by the medical officers. Patients suffering from Opioid use disorder are often put on a steady, balanced diet and advised not to take any other medications and alcoholic foods. The three approved medications for people with this disorder are Methadone, Buprenorphine, and Naltrexone (Larochelle et al.,2018). Methadone lowers the cravings for opioid drugs and removes the withdrawal symptoms. Buprenorphine, on the other hand, is used to combat the effects of other opioid drugs administered and is only provided by special and trained medical officers. Naltrexone provides a defense to the effect of the other opioids and prevents euphoria.   Conclusion. In conclusion, Opioid use disorder is a very serious problem in our society today. It starts from simple consumption of drugs to addiction and more severe effects. Patients with opioid use disorder have abnormal behaviors resulting from the effects of their mental problems. Large consumption of Opioids affects the brain cells and can lead to death if not treated in its initial stages. Therefore, patients who suffer from drug addictions should visit hospitals for checkups and treatments. Treating the effects of opioid use disorder requires behavioral therapies and the use of FDA-approved medications. References Blanco, C., & Volkow, N. D. (2019). Management of opioid use disorder in the USA: present status and future directions. The Lancet, 393(10182), 1760-1772. Connery, H. S. (2015). Medication-assisted treatment of opioid use disorder: a review of the evidence and future directions. Harvard review of psychiatry, 23(2), 63-75. Larochelle, M. R., Bernson, D., Land, T., Stopka, T. J., Wang, N., Xuan, Z., … & Walley, A. Y. (2018). Medication for opioid use disorder after nonfatal opioid overdose and association with mortality: a cohort study. Annals of internal medicine, 169(3), 137-145. Strang, J., Volkow, N. D., Degenhardt, L., Hickman, M., Johnson, K., Koob, G. F., … & Walsh, S. L. (2020). Opioid use disorder. Nature reviews Disease primers, 6(1), 1-28.




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