PS440 Unit 8 Assignment Instructions....

PS440 | Abnormal Psychology

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Abnormal Psychology: Case Study Case Study 5: Shonda: Schizophrenia The Case Shonda has a long history of mental illness and has a caseworker from a local community mental health center that checks on her every few days. Shonda is employed at the mental health center, doing light cleaning and other chores, but she did not show up for work today. Her income at the mental health center is supplemented by social security disability checks, which allow her to maintain her own small apartment under the supervision of the clinic. Her supervisor at the center called Shonda’s caseworker this morning, explaining some of the difficulties that Shonda was having in performing her duties at work recently and that she had not shown up for work that day. The caseworker decided it was time to pay Shonda a visit at her home to determine if she was having a psychotic episode. Upon arriving at Shonda’s apartment, the caseworker found her to be anxious and fidgety frightened of the “voices” she heard. The voices were nothing new to Shonda, as she had experienced hearing voices many times in the 12 years since she was first diagnosed with schizophrenia. She often referred to them as her “counterparts”, as they are constantly with her. Usually, the voices did not interfere with Shonda’s ability to perform her part-time job, doing clean-up work at the health center; however, in the past week, the voices seem to be taking on a more intense direction, becoming increasingly critical, harsh, and loud. Shonda has tried hiding under the bed and in closets in an attempt to get away from the audio hallucinations she hears, but nothing is working. Shonda’s speech pattern seems disjointed and the conversation is difficult to follow; she is clearly agitated and upset. After talking with Shonda for more than an hour, the caseworker learns that Shonda believes that the FBI and CIA planted tiny video cameras in her apartment and at her workplace – she is convinced that she is under surveillance. As she talks about the voices, the cameras, and the FBI and CIA, Shonda becomes increasingly confused and agitated. The caseworker determines that Shonda’s medication might need and adjustment and makes arrangements to take check her into the clinic as an inpatient, where she will undergo a new assessment of her condition and medications to see if any changes should be made in her treatment plan. Childhood Background Shonda grew up in a working class neighborhood in Oklahoma City, with an older brother, her parents, and her maternal grandmother. Several years ago, her older brother married and moved away and Shonda has not seen him or heard from him for several years. Although her parents live in the same place, only twenty miles away, she has not seen them in years also – although she hears from her mother on birthdays and Christmas, where she always sends Shonda a small check. Shonda’s parents have always been emotionally distant from both their children, however, this emotional distance became more pronounced after the time when Shonda was first diagnosed with schizophrenia. Shonda did not have a good childhood; there was constant bickering amongst her parents and her father had a potent temper, often beating his two children and his wife. He would often arrive home late from work, after stopping at the neighborhood bar. Shonda’s family history in the immediate family shows no sign of diagnosed mental illness; however, while she was growing up, she heard of an aunt on her father’s side that was “locked away” in a hospital

PS440 | Abnormal Psychology

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after having a “nervous breakdown.” Her father never spoke of his sister and Shonda had never met her as a child. Shonda has been hospitalized many times during the past twelve years. Her charts include complaints of frequent, almost continuous auditory hallucinations, as well as a number of other delusions. She has been on antipsychotic medications for years, most recently, the neuroleptic haloperidol (Haldol). Due to the increase and intensity in the auditory hallucinations and her inability to perform her hob duties, Shonda will re reassessed by the psychiatrists at the center.