Exercise: Case Study of Natasha
You are a clinical psychologist specializing in the diagnosis and treatment of psychological problems among children. A colleague has sent you information regarding Natasha Reed (see below) in hopes that you will provide a second opinion as to the correct diagnosis for Natasha. Read the case study, make a diagnosis, and then answer the following questions in a report to be written to her family. Be careful to fully explain concepts such that someone outside of the area of abnormal child psychology would understand. (DO NOT assume that you are writing this paper to me.)
1. What is the primary diagnosis for Natasha (be sure to specify the major diagnosis and type if necessary)? Using the criteria in the DSM-V specifically describe why Natasha’s symptoms fit this particular diagnosis. Give specific examples of the symptoms she manifests. While you should describe the disorder, do not just list the symptoms of the disorder according to the DSM. It may help to use direct quotes from the case study. You must get the diagnosis EXACTLY correct. There is enough information given so that you can make the exact diagnosis. The remainder of the paper will be based on the diagnosis you gave, and not the correct diagnosis. In order to help you arrive at the correct diagnosis, try doing this. First list all of the possible diagnoses that you think Natasha has, then using the information available regarding differential diagnoses rule out each diagnosis until you are left with only one. Once you reach this one diagnosis, confirm it with specific examples from the case study. (10 points)
2. With most diagnoses there are differential diagnoses and co-morbid conditions that you need to consider. Discuss differential diagnoses and co-morbid conditions that exist with your primary diagnosis by answering Parts 1, 2, and 3.
a. Part 1: For your primary diagnosis that you gave in question #1, list the common differential diagnoses and co-morbid conditions.
b. Part 2: Next, take one of the differential diagnoses listed in Part 1, and explain how you would make a differential diagnosis between your primary diagnosis and that particular differential diagnosis. What characteristic do you look for to make the differential diagnosis between the two disorders? Next, apply it to Natasha’s case. In other words you are going to explain why Natasha has the primary diagnosis that you gave her and not the common differential diagnosis. For example, if you gave Natasha the primary diagnosis of schizophrenia (she doesn’t have schizophrenia), you would need to list autism as a common differential diagnosis, and then explain how you would make a differential diagnosis between schizophrenia and autism. If there is additional information that you would like to have to help you make a differential diagnosis, you may discuss this here.
c. Part 3: Take one of the common co-morbid conditions listed in part 1, and discuss whether or not Natasha also has this common co-morbid condition in addition to her primary diagnosis. Explain why you think she also has this additional diagnosis by listing the specific symptoms that Natasha displays, or explain why she does not have this additional diagnosis by discussing what symptoms she does not display. If there is additional information that you would like to have to be able to say that she has another diagnosis, you may discuss this here.
3. Based on the known causes of the particular primary diagnosis you gave Natasha, speculate about the cause(s) of her diagnosis. You most likely don’t have enough information to definitively know what caused the problem. Consider the most common cause of the disorder. It would be appropriate to address two or three causes and fully explain at least one of the causes. You want to explain these causes from a technical perspective. Use information from the textbook to explain why this causes the disorder that Natasha has or provide data that supports that this is a true cause of the disorder. Hint: You absolutely need to cite information from the text or another source in this section. (10 points)
4. Based on the known treatments for Natasha’s primary diagnosis, what treatment(s) can you recommend for her and her family? This should be based on the most common and/or most effective treatment for this disorder. Be very specific about the name of the treatment and what is done in the treatment. Explain how this type of treatment conducted? Generic statements like, “Natasha should seek therapy,” are inappropriate. What type of therapy would you recommend? How is this type of therapy conducted? Be careful not to give a laundry list of all the possible treatments. Pick the best treatment for Natasha, and explain this treatment in detail. Hint: You absolutely need to cite information from the text or another source in this section. (10 points)
5. What information can you give Natasha and her family about her prognosis? Base your answer on known information about the prognosis for his particular disorder, and not just what you hope for Natasha and her family. For example, you may discuss what is known about what might make the prognosis better or worse. Avoid generic statements like, “With proper treatment Natasha will get better.” This is true for almost all disorders, and is what we hope for all of our clients. Say something more specific like, “Generally speaking the prognosis for Natasha’s disorder is positive. 75% recover within one year, and only 15% relapse.” Typically there are situations that make the prognosis better or worse. Find out what these are and apply it to Natasha’s case. (10 points)
IMPORTANT NOTE: The information supporting the symptoms of the diagnosis, cause, and treatment, should be taken from another source like your textbook, the DSM, or another source. However, this information should NOT be copied word-for-word from the source, and should be correctly cited within the text and in a reference listing at the end of the paper. APA format should be used for the in-text citation and reference listing. Information on how to use APA format can be found in a document located on Blackboard in the Assignment area titled, “A Primer on Citation” or at http://owl.english.purdue.edu/owl/resource/560/02/ . Severe penalties could result from failure to follow this requirement.
Also remember that papers containing more than three direct quotes (sentences and phrases) from sources other than the case study will receive a grade of 0.
Natasha Reed’s name was placed on the list of children in need of evaluation by her third-grade teacher. In the Greene County educational system, teachers could recommend children for intellectual and emotional evaluations if they had any concerns. As a result, Natasha would be evaluated by a psychologist employed by the school. Natasha was brought to the testing center by her parents.
Natasha was a nine-year, six-month-old Caucasian female with short brown hair who was of average height and weight. Natasha was the youngest child from an intact family of four children. Her oldest brother (age fifteen) as well as her two older sisters (ages thirteen and eleven), were described by the mother as good students, typically earning A’s and B’s in school. The mother reported no pregnancy or birth complications with Natasha. Natasha had a been a healthy and happy child who was easy to care for and manage, although she seemed to lag consistently a year or more behind her brother and sisters in language acquisition, toilet training, self-help, and play activities. As an example, Natasha did not learn to dress herself until she was five, and at nine, she was still unable to tie her own shoes.
The parents appeared to be open and honest with each other and strongly committed to family-type activities such as church and sports. Both a parents have completed college and are employed. Mr. Reed is employed as a computer programmer at the local university, where he has been employed for the past eighteen years. Mrs. Reed returned to work when Natasha was three and has been employed as a social worker by the local Department of Child Welfare.
Natasha began preschool when she was three. The parents reported that Natasha had attended preschool with no difficulties. Natasha liked other children and played well with both girls and boys. Natasha had remained at the same preschool for three years on the advice of the teacher. Natasha had a birthday in late August which would have made her the youngest child in kindergarten. Therefore, given her birthday and her general slowness to develop, Natasha had stayed in preschool. At six, Natasha began kindergarten. Kindergarten was a pleasant, stimulating experience for Natasha. School records suggested that Natasha was cooperative, friendly, and willing to share with other children. It was noted, however, that since Natasha scored low on a reading readiness test, she might have difficulty with reading in first grade. As predicted, Natasha could sound out only a few words. Despite daily tutoring sessions in the second grade, Natasha continued to lag behind her classmates in reading. Now, in the third grade, Natasha could read only the most simply books (approximately a first-grade reading level), while her classmates were reading chapter books. According to Natasha’s teacher, many of the other children were beginning to make fun of Natasha and call her names.
Natasha was administered the Wechsler Intelligence Scale for Children-Revised (WISC-R), the Wide-Range Achievement Test (WRAT), the Bender-Gestalt, and the Adaptive Behavior Inventory for Children. On the WISC-R, Natasha earned a Full-Scale score of 65. ON the WRAT, Natasha scored in the 6th percentile in Reading and the 4th percentile in Arithmetic. Results of the Bender-Gestalt were in the 6th percentile, Koppitz score. The Adaptive Behavior Inventory for Children confirm the more general comments of Natasha’s parents and teachers. Natasha was able to score well on those items reflecting cooperation with others but scored two years younger than her chronological age on items reflecting physical skills.
Adapted From: Morgan, R. K. (1999). Case Studies in Child and Adolescent Psychopathology. Upper Saddle River, New Jersey: Prentice Hall.