Case Study on Bordeline Personality Disorder

Case:

Mary is a 26-year-old African-American woman who presents with a history of non-suicidal 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.”
When she is stressed, Mary says that she often “zones out,” even in the middle of conversations or while at work. She 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.

Symptoms

• Anger
• Anxiety
• Concentration Difficulties
• Emotion Dysregulation
• Impulsivity
• Mood Cycles
• Risky Behaviors
• Self-Injury
• Suicidal thoughts

Diagnoses and Related Treatments

Borderline Personality Disorder

The following treatments have empirical support for individuals with Borderline Personality Disorder:

• Dialectical Behavior Therapy for Borderline Personality Disorder
• Mentalization-Based Treatment for Borderline Personality Disorder
• Schema-Focused Therapy for Borderline Personality Disorder
• Transference-Focused Therapy for Borderline Personality Disorder

For more information,

Visit: https://mtlhealth.blogspot.com/2019/04/borderline-personality-disorder.html

Case Study on ADHD

Jen: ADHD

Jen is a 29 year-old woman who presents to your clinic in distress. In the interview she fidgets and has a hard time sitting still. She opens up by telling you she is about to be fired from her job. In addition, she tearfully tells you that she is in a major fight with her husband of 1 year because he is ready to have children but she fears that she is “too disorganized to be a good mother.” As you break down some of the processes that have led to her current crises, you learn that she has a hard time with time management and tends to be disorganized. She chronically misplaces everyday objects like her keys and runs late to appointments. Although she wants her work to be perfect, she is prone to making careless mistakes. The struggle for perfection makes starting a new task feel very stressful, leading her to procrastinate starting in the first place. As a consequence, she has recently received a number of warnings from her boss related to missing deadlines for assignments and errors in her work, which has led to her acute fear of being fired. As her performance at work has plummeted and she has grown increasingly anxious and doubting of herself, she has grown more pessimistic about starting a family. You learn that she received extra time for test taking in school as a child but never had any formal neuropsychological testing.  With Jen’s permission, you conduct additional structured assessments, including collecting collateral information from her fiancé, and conclude that she has adult ADHD.

For more information,

visit: https://mtlhealth.blogspot.com/2019/04/attention-deficithyperactivity-disorder.html

Case Study on Bulimia Nervosa

Sage is a 26-year-old doctoral candidate in English literature at the local university. She is in good standing in her program and has plans to enter the job market in the fall. In your intake, she tells you she thinks she is “fat” and has been self-conscious about her body since the sixth grade, at which time she began menstruating and developing breasts earlier than the other girls in her class. She was teased for needing a bra and remembers feeling “chubby, too big, and just wanting to be small like [her] younger sister.” She started dieting in the seventh grade, following strict rules for weeks (e.g., she recalls the grapefruit only diet), then transitioning into what she called “bad” weeks.  During these times, she would stock up on candy bars and other snack foods and eat them, often in her bedroom late at night. Her parents became concerned and tried to strictly limit her dieting.  This led to eating “normal” during the day and binging on those candy bars she kept hidden in her bedroom at night if she felt sad, scared, or mad. She grew into a habit of eating to feel better – relief that was only temporary, as she would feel ashamed about what she had done and resolve to not do it again. In college, her pattern of emotional eating continued, which felt more distressing to her because of the pressure to look “as pretty and thin as the other girls.” In spring of her freshman year she experimented with throwing up after the late-night eating and found that, at least in the minutes that followed, she felt like she had much more control and believed this would help her to prevent the weight gain she so dreaded. She fell into a vicious cycle of late-night binges (typically consuming about 7 candy bars in 15 minutes, during which times Sage described feeling very out of control) followed by making herself throw up. In college, she engaged in these binge-purge episodes about 6 nights/week. At present, she is having a harder time hiding the episodes because she lives with her boyfriend; she estimates that they occur about 4 nights per week. The times when she feels the most compelled to binge and purge are when she has a major presentation coming up in her doctoral program and when she gets in a fight with her boyfriend. Her BMI is in the normal range, but she says she needs to lose weight. She wants to stop binging and purging because she does not want her boyfriend to find out, but she is also afraid that if she stops, she will gain weight.

Symptoms

• Binges and Purging
• Body Image
• Emotion Dysregulation
• Disordered Eating

Diagnoses and Related Treatments

Bulimia Nervosa

The following treatments have empirical support for individuals with Bulimia Nervosa:

• Cognitive Behavioral Therapy for Bulimia Nervosa
• Family-Based Treatment for Bulimia Nervosa
• Healthy-Weight Program for Bulimia Nervosa
• Interpersonal Psychotherapy for Bulimia Nervosa

For more information,

Visit: https://mtlhealth.blogspot.com/2019/04/bulimia-nervosa.html