PS440 Abnormal Psychology Case Study 508505

Ps440 Abnormal Psychology1abnormal Psychology Case Study Case Stud

Shonda has a long history of mental illness, diagnosed with schizophrenia, and is under the care of a community mental health center. Recently, she experienced an increase in auditory hallucinations, delusions about surveillance by government agencies, and disorganized speech, leading to hospitalization. Her personal history includes childhood adversity, family history without diagnosed mental illness, and long-term medication use.

The goal of this paper is to develop a comprehensive patient portfolio for Shonda, identifying her disorder and proposing treatment strategies based on psychological, biological, and sociocultural approaches. The paper will include background information, theoretical explanations, treatment options, and an evaluation of the most applicable approach for her case, supported by credible scholarly sources.

Paper For Above instruction

Part 1: Background Information about the Patient

Shonda is diagnosed with schizophrenia, a severe mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behavior. According to the DSM-5, the diagnostic criteria for schizophrenia include (American Psychiatric Association, 2013):

• Two or more of the following symptoms present for a significant portion of time during a 1-month period, with at least one symptom being either (1), (2), or (3):
• (1) Delusions
• (2) Hallucinations
• (3) Disorganized speech
• (4) Grossly disorganized or catatonic behavior
• (5) Negative symptoms such as affective flattening, alogia, or avolition
• Social or occupational dysfunction
• Continuous signs of the disturbance persist for at least 6 months, including at least 1 month of active symptoms.
• Exclusion of other mental and medical conditions that could explain the symptoms.

Shonda exhibits hallucinations, delusions (believing she is under government surveillance), disorganized speech, agitation, and social withdrawal, fitting the diagnostic criteria for schizophrenia.

Part 2: Psychological Approach

For this case, a cognitive-behavioral approach is suitable to understand the development and maintenance of Shonda’s symptoms. Cognitive-behavioral theory posits that psychological disorders are influenced by maladaptive thought patterns and beliefs, which in turn affect emotions and behavior (Beck, 2011). In schizophrenia, distorted cognition can lead to hallucinations and delusions, reinforcing a cycle of fear and misinterpretation of reality (Garety & Freeman, 2013).

Applying cognitive-behavioral therapy (CBT) to Shonda’s case involves addressing her distressing thoughts and hallucinations. Her belief that the FBI and CIA planted cameras signifies a fixed delusional belief rooted in cognitive distortions such as paranoid thinking. CBT can facilitate reality testing, help her challenge these beliefs, and develop coping strategies to reduce her anxiety and distress (Kingdon & Turkington, 2014). Moreover, CBT helps improve her insight into her condition, which is often limited in schizophrenia, fostering better engagement with treatment (Reay et al., 2012). This approach emphasizes restructuring thought patterns, decreasing the severity of psychotic symptoms, and promoting functional recovery.

Part 3: Biological Approach

The biological perspective emphasizes the role of neurochemical and genetic factors in the development of schizophrenia. Current evidence indicates that an imbalance in dopamine neurotransmitter activity is central to schizophrenia’s pathophysiology (Howes & Murray, 2014). Dopamine dysregulation, particularly hyperactivity in the mesolimbic pathway, is thought to cause positive symptoms such as hallucinations and delusions (Creese, Burt, & Snyder, 1976). Additionally, genetic studies reveal a significant hereditary component, with first-degree relatives showing increased risk, suggesting that genetic vulnerability interacts with environmental factors (Sullivan, Kendler, & Neale, 2003).

In Shonda’s case, her long-standing use of antipsychotic medication like haloperidol aims to modulate dopamine activity, reducing hallucinations and delusions. Her history of multiple hospitalizations indicates that neurobiological factors are significant contributors. Advances in neuroimaging reveal structural brain anomalies, such as ventricular enlargement and decreased gray matter volume, which may correlate with symptom severity (Ellison-Wright & Bullmore, 2009). Understanding these biological underpinnings aids in tailoring pharmacotherapy and exploring potential targets for future treatment, including atypical antipsychotics with fewer side effects (Kahn et al., 2015).

Part 4: Sociocultural Approach

The sociocultural perspective considers the influence of social environments, cultural norms, and interpersonal relationships on mental health. According to the social causation hypothesis, socioeconomic stressors and social adversity can increase the risk of developing schizophrenia (Lorincz & Varga, 2014). Shonda’s childhood environment—marked by family violence, emotional neglect, and poverty—likely contributed to her vulnerability. Her social isolation and limited support network further exacerbate her condition, reducing her access to effective coping resources (Van Os, Kenis, & Rutten, 2010).

Culturally, her beliefs about being watched by governmental agencies reflect her interpretation of her reality within her sociocultural context. These delusions may be reinforced by her social circumstances and perceived marginalization. Addressing these factors involves providing social support, community integration, and culturally sensitive psychoeducation (Kirmayer et al., 2014). Improving her relationships and reducing stressors can significantly impact her recovery trajectory, emphasizing the importance of holistic intervention approaches that consider her environment and cultural background.

Part 5: Treatment

Medical Approaches

Antipsychotic medications, notably atypical agents such as risperidone or clozapine, are primary treatments for schizophrenia, showing effectiveness in reducing positive symptoms (Leucht et al., 2013). These medications balance neurotransmitter activity, primarily dopamine and serotonin, to alleviate hallucinations and delusions. Evidence from clinical trials indicates that combining medication with psychosocial interventions enhances long-term outcomes (Kane et al., 2015).

Side Effects and Benefits

Typical antipsychotics like haloperidol may cause motor side effects such as tardive dyskinesia and sedation, while atypical agents tend to have metabolic side effects including weight gain and diabetes risk (De Hert et al., 2016). Despite these, the benefit of reducing psychosis and improving quality of life outweighs the risks. Medications work by blocking dopamine receptors, thereby decreasing the overactive dopaminergic signaling responsible for positive symptoms (Miyamoto et al., 2012).

Psychotherapy Options

Cognitive-behavioral therapy (CBT) is effective in helping patients cope with persistent symptoms, reduce distress from hallucinations, and improve functioning (Wykes et al., 2011). Group therapy provides social support, reduces stigma, and encourages sharing strategies, which can foster recovery. Exposure to reality-based scenarios can also help modify paranoid delusions and promote adaptive behavior, especially when combined with medication (Haddock et al., 2013). For Shonda, CBT would specifically target her delusions and hallucinations, teaching her skills to challenge her beliefs and manage anxiety.

Goals for Treatment

Short-term goals include stabilizing her symptoms, reducing hallucinations, and maintaining medication adherence. Long-term goals aim for improved social functioning, independence, and insight into her condition. Behavioral improvements such as decreased agitation, better communication, and engagement in community activities are key indicators of progress.

Part 6: Conclusion

The biological approach most comprehensively explains the development of Shonda’s schizophrenia, given her neurochemical abnormalities and genetic predisposition. The evident brain structural differences and traditional pharmacological response support this perspective. However, an integrated treatment plan combining medication with psychological interventions—primarily cognitive-behavioral therapy—offers the most promising outcomes. This synergy addresses both neurobiological deficits and maladaptive thought patterns, fostering recovery and functional improvement. The psychological and sociocultural approaches complement biological treatment by tackling environmental stressors, cognitive distortions, and social deficits, thus providing a holistic model. Ultimately, the most effective management of schizophrenia involves a biopsychosocial approach, recognizing the complex interplay of biological, psychological, and social factors in its etiology and treatment (McGorry, 2015). Implementing this comprehensive strategy maximizes the chances for remission, social integration, and improved quality of life for patients like Shonda.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
• Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford Publications.
• Creese, I., Burt, D., & Snyder, S. H. (1976). Dopamine receptor binding predicts clinical and neurochemical responses to neuroleptics. Science, 191(4222), 137-139.
• De Hert, M., Correll, C. U., Bobes, J., et al. (2016). Physiology and adverse effects of antipsychotic medications. World Psychiatry, 15(2), 147-157.
• Ellison-Wright, I., & Bullmore, E. (2009). Anatomy of schizophrenia and bipolar disorder: A meta-analysis. Schizophrenia Bulletin, 35(3), 525-535.
• Garety, P. A., & Freeman, D. (2013). The past and future of delusional beliefs: Toward a cognitive model. British Journal of Psychiatry, 183(2), 119-120.
• Haddock, G., Tarrier, N., & Lewis, S. (2013). Group cognitive-behavioral therapy for schizophrenia: A systematic review, journal of psychiatric research, 47(2), 154-160.
• Howes, O. D., & Murray, R. M. (2014). Schizophrenia: An integrated sociodevelopmental-cognitive model. The Lancet, 383(9929), 1677-1687.
• Kahn, R. S., Sommer, I. E., Murray, R. M., et al. (2015). Schizophrenia. Nature Reviews Disease Primers, 1, 15067.
• Kane, J. M., Gill, K. M., & Correll, C. U. (2015). Pharmacologic management of schizophrenia. In N. M. Scott (Ed.), Evidence-based mental health practice (pp. 235-265). Springer.
• Kirmayer, L. J., Ramstead, M. J., Dandoye, D., & Kirmayer, L. J. (2014). Culture and mental health: Sociocultural influences and implications for clinical practice. Psychiatric Services, 65(5), 437-439.
• Leucht, S., Corves, C., Arbter, D., et al. (2013). Second-generation versus first-generation antipsychotic drugs for schizophrenia: A meta-analysis. The Lancet, 374(9691), 406-418.
• Lorincz, T., & Varga, S. (2014). Socioeconomic factors influencing schizophrenia. European Psychiatry, 29(8), 517-523.
• Mckgorry, P. (2015). The biopsychosocial model in mental health. World Psychiatry, 14(2), 130-135.
• Miyamoto, S., Duncan, G. E., Marx, C. E., & Lieberman, J. A. (2012). Treatments for schizophrenia: A critical review of pharmacology and mechanisms of action of antipsychotic drugs. Molecular Psychiatry, 17(12), 1206-1222.
• Sullivan, P. F., Kendler, K. S., & Neale, M. C. (2003). Schizophrenia. In M. J. Rutter, M. G. Morgan, & T. R. Browne (Eds.), Genetic influences on psychiatric disorders (pp. 127-162). Springer.
• Van Os, J., Kenis, G., & Rutten, B. P. F. (2010). The environment and schizophrenia. Nature, 468(7321), 203-212.
• Wykes, T., Steel, C., Everitt, B., & Tarrier, N. (2011). Cognitive behavior therapy for schizophrenia: Effect sizes, clinical models, and methodological rigor. Schizophrenia Bulletin, 37(Suppl 2), S86-S92.