Jerome's Case: A 28-Year-Old African American Male

Jeromes Casejerome Is A 28 Year Old African American Male Who Lives A

Jerome, a 28-year-old African American male, presents with a complex psychiatric profile characterized by pervasive deception, grandiose fantasies, impulsivity, and behavioral disinhibition. His lifestyle reveals a pattern of engaging in false self-presentation, particularly claiming careers as a rapper and male model despite lacking any actual evidence or professional experience in these domains. His repeated failures to maintain employment, driven by absenteeism and possible impulsive behaviors, contribute to his socioeconomic instability. Furthermore, Jerome’s frequent involvement in nightlife, coupled with reckless behavior such as fighting and being unruly in social settings, underscores his impulsivity and inability to regulate aggression.

Jerome’s refusal or inability to acknowledge reality is evidenced by his denial of his unemployment and his fabricated claims of fame. His distorted perception of self-identity appears to be reinforced by an external facade of success, which he maintains through the distribution of business cards and self-promotion. His conduct during a recent American Idol audition, where he reacted with aggression and unruly behavior when criticized, exemplifies his difficulty in coping with negative feedback and external stressors. His confrontations with law enforcement, often claiming jealousy from others, suggest a paranoid component or a tendency to externalize blame for his problems, which could be indicative of paranoid features.

Clinically, Jerome’s presentation aligns with traits observed in individuals with narcissistic and histrionic personality features, including a need for admiration, sensitivity to criticism, and attention-seeking behaviors. His manipulative and grandiose self-image, combined with temper outbursts and possible antisocial tendencies such as fighting and conduct violations, warrant a comprehensive psychological evaluation to explore underlying personality disorders or other psychiatric conditions.

Analysis of Possible Diagnoses and Therapeutic Considerations

Given Jerome's symptoms, a differential diagnosis may include Narcissistic Personality Disorder (NPD), Antisocial Personality Disorder (ASPD), and features of Bipolar Disorder or Conduct Disorder. His grandiosity, fantasies of fame, need for admiration, and lack of empathy align with NPD, while his impulsive aggression, disregard for social norms, and repeated arrests suggest ASPD (American Psychiatric Association, 2013). His failure to maintain employment, impulsive behaviors, and manipulative tendencies indicate significant antisocial traits, possibly exacerbated by underlying mood instability or substance use, although no substance use is explicitly reported in the case.

Therapeutic intervention for Jerome must address his entrenched maladaptive patterns and personality features. Psychotherapy, particularly approaches like Dialectical Behavior Therapy (DBT) or Schema Therapy, can help improve impulse control and emotional regulation (Linehan, 2014; Young et al., 2003). Addressing underlying narcissistic needs through psychoeducation and fostering empathy may assist in reducing maladaptive interpersonal behaviors. In some cases, pharmacotherapy, such as mood stabilizers or antipsychotics, could be considered if mood swings or agitation are prominent (McClure et al., 2020). Moreover, interventions might include social skills training and anger management techniques to reduce aggressive outbursts and improve social functioning.

It is crucial to approach Jerome with a non-judgmental stance, emphasizing building rapport to encourage engagement in treatment. Given his current presentation, multidisciplinary efforts involving mental health professionals, social workers, and possibly substance abuse counselors are essential for comprehensive care. Early intervention could prevent further legal issues and improve his quality of life by fostering adaptive behaviors and realistic self-perception.

Conclusion

Jerome’s case exemplifies the complexities of personality pathology intertwined with behavioral and social challenges. His grandiosity, impulsivity, and conduct issues align with features of personality disorders, notably narcissistic and antisocial types. A tailored, multidisciplinary treatment plan focusing on emotional regulation, empathy development, and social skills is vital. Recognizing the importance of early and consistent intervention can potentially alter his maladaptive trajectory, promote healthier functioning, and reduce his propensity for legal and occupational problems. Further assessment is essential to clarify his diagnosis and optimize therapeutic strategies.

References

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