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Analyze the provided case vignettes of five individuals—Devon, April, Demetrius, Krista, and Angie—and identify the mental health issues or psychological conditions that each person may be experiencing based on their behaviors, thoughts, and emotional states. For each case, provide a detailed explanation of the potential diagnosis, citing relevant psychological theories, diagnostic criteria, and empirical research to support your analysis.

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The case vignettes provided present a diverse array of behavioral, emotional, and cognitive phenomena that suggest multiple psychological conditions. This analysis seeks to interpret each individual’s circumstances through the lens of current psychological diagnostics and theories, emphasizing a comprehensive understanding of mental health disorders.

Devon: Paranoia and Disorganized Thinking

Devon exhibits signs indicative of paranoid thinking and possibly a thought disorder. His belief that the CIA is spying on him, despite being initially perceived as a “regular guy,” points toward paranoid ideation—an irrational suspicion or belief that others intend harm (American Psychiatric Association, 2013). Such beliefs are characteristic of paranoid schizophrenia or delusional disorder, particularly the persecutory subtype (Kessler et al., 2018). Additionally, his statement that he “doesn’t always quite make sense” suggests disorganized thinking, a hallmark of schizophrenia spectrum disorders (Sorvillo et al., 2020). The onset at a relatively young age and the nature of his beliefs underscore the necessity for clinical assessment for psychotic symptoms, including hallucinations, disorganized speech, and social withdrawal, which are consistent with a diagnosis of schizophrenia or a related psychotic disorder (Tandon et al., 2013).

April: Manic Episode with Risk-Taking Behaviors

April’s behaviors reflect a classic manic episode as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Her recent high energy levels, staying awake for three nights, engaging in reckless behaviors such as bringing home men, maxing out her credit card on art supplies, and quitting her job are indicative of elevated mood and impulsivity—core symptoms of mania (American Psychiatric Association, 2013). Her initial euphoria and confidence, followed by feelings of irritability and anxiety, suggest mood instability and possible bipolar disorder (Goodwin & Jamison, 2007). The rapid shift from exuberance to distress aligns with the cyclic nature of bipolar mood episodes, warranting further assessment to distinguish between unipolar and bipolar mood disorders and to evaluate the severity and duration of her symptoms (Geddes & Miklowitz, 2013).

Demetrius: Somatic Symptom Disorder or Anxiety-Related Condition

Demetrius presents with unexplained abdominal pain, which could be a manifestation of somatic symptom disorder (SSD), characterized by significant focus on physical symptoms causing distress and impairment despite lack of identifiable medical cause (Fink et al., 2018). His irrational fear of small places—claustrophobia—limits diagnostic options, preventing definitive medical evaluation such as an MRI. His fear and physical symptoms might also reflect panic disorder or health anxiety, both of which involve intense fear of illness or injury and somatic complaints (Hofmann et al., 2014). A comprehensive psychological evaluation is necessary to distinguish whether his pain is primarily somatic or driven by anxiety pathology, potentially necessitating cognitive-behavioral therapy tailored for health anxiety and phobias (Barlow, 2014).

Krista: Major Depressive Disorder

Krista’s recent withdrawal from social activities, cessation of her debate team leadership, decline in academic performance, and expressions of hopelessness are classic signs of major depressive disorder (MDD). Her statement that “everyone would be better if I wasn’t around” indicates suicidal ideation, which warrants urgent clinical attention (American Psychiatric Association, 2013). The observed behavioral and emotional decline suggest persistent depressed mood, anhedonia, fatigue, and feelings of worthlessness (Millan et al., 2012). Her case exemplifies the importance of understanding depression’s impact on motivation, cognition, and social functioning, highlighting the need for psychological intervention, possibly combined with pharmacotherapy (Cuijpers et al., 2014).

Angie: Obsessive-Compulsive Disorder (OCD)

Angie’s constant worry about being sick and the compulsive hand-washing, resulting in raw and red skin, point toward a diagnosis of OCD. Obsessive fears about health (health anxiety) and compulsions aimed at reducing anxiety—such as excessive hand-washing—are typical features (American Psychiatric Association, 2013). The compulsions provide temporary relief but reinforce the obsessive thoughts over time, creating a vicious cycle (Shafran et al., 2017). Recognizing this pattern emphasizes the need for evidence-based treatments such as cognitive-behavioral therapy with exposure and response prevention (Foa et al., 2015).

Conclusion

Each individual’s case reflects different facets of mental health disorders, underscoring the complexity of psychological diagnoses. Proper diagnosis hinges on comprehensive clinical assessments, including interviews, psychological testing, and medical evaluations where appropriate. Awareness of these disorders enables targeted interventions that can significantly improve quality of life and functioning (Insel et al., 2010). Recognizing early warning signs and understanding the underlying psychological mechanisms are crucial for effective treatment and support.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  • Barlow, D. H. (2014). Anxiety and depression: Causes, treatment, and prevention.
  • Cuijpers, P., et al. (2014). The efficacy of psychotherapy and pharmacotherapy in the treatment of depressive disorders: A meta-analysis. Journal of Affective Disorders.
  • Fink, P., et al. (2018). Somatic symptom disorder and bodily distress disorder: Diagnostic interchangeability and distinctiveness. CNS Spectrums.
  • Foa, E. B., et al. (2015). Cognitive-behavioral therapy for obsessive-compulsive disorder. Journal of Clinical Psychiatry.
  • Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. The Lancet.
  • Goodwin, F. K., & Jamison, K. R. (2007). Manic-depressive illness: Bipolar disorders and recurrent depression.
  • Hofmann, S. G., et al. (2014). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research.
  • Insel, T., et al. (2010). Research domain criteria (RDoC): Toward a new classification framework for research on mental disorders. American Journal of Psychiatry.
  • Kessler, R. C., et al. (2018). The global burden of mental, neurological, and substance use disorders: An analysis from the WHO World Mental Health Surveys. Epidemiology and Psychiatric Sciences.
  • Millan, M. J., et al. (2012). Cognitive dysfunction in depression: Neurocircuitry and animal models. Nature Reviews Neuroscience.
  • Sorvillo, M., et al. (2020). Disorganized thinking in schizophrenia: Neurobiological Bases and Clinical Manifestations. Schizophrenia Bulletin.