Schizophrenia is a severe psychotic disorder with a large variety of subtypes and correlated complications. The current case study describes the appointment with Jasmine Mack, an African American 18-years old college student who has recently experienced several symptoms associated with schizophrenia. Therefore, it is essential to thoroughly examine the negative, positive, and disorganized symptoms of the patient to propose an ultimate diagnosis and a corresponding treatment plan. Nevertheless, the visible signs of delusions and auditory hallucinations indicate a high likelihood of schizophrenia development.
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Diagnosis and Symptoms
The initial proposed diagnosis for Jasmine Mack is schizophrenia. Based on the diagnostic manual, the primary criteria for schizophrenia include the persistence of positive symptoms, e.g. delusions or hallucinations, for at least six months (Barlow et al., 2017). In the case study, Jasmine mentions that the first delusions started about six months prior, “No, and it didn’t start until a little more than 6 months ago” which transparently designates the time period.
According to Jasmine, everyone at the dormitory was envious of her academic success and decided to spy on her, “I think they wanted to be like me.” For this purpose, they installed cameras and communication systems both in her room in the dormitory and her parent’s house, “They had cameras everywhere.” The odd beliefs and presuppositions transparently indicate the positive symptom of delusion or a disorder of thought content (Barlow et al., 2017). One of the most frequent delusion types concerns the sense that everyone is trying to sabotage or hurt the individual in some manner. This complication is called the delusion of persecution and is highly notable in Jasmine’s behavior (Barlow et al., 2017). Therefore, the first assumption that supports the diagnosis is the persistence of delusional beliefs for more than a six-month period.
The second positive symptom of Jasmine Mack concerns auditory hallucinations. A hallucination is a sensory experience without environmental input and is another frequent positive symptom associated with schizophrenia (Barlow et al., 2017). Auditory hallucinations occur most commonly, and even healthy people might experience them occasionally (Barlow et al., 2017). Nevertheless, people affected by schizophrenia have regular and transparently expressed auditory hallucinations (Barlow et al., 2017). The case study demonstrates that Jasmine has severe hallucinations on a regular basis, “then they got the voice machine going/different voices saying stupid things.” Similar to delusions, auditory hallucinations first appeared about six months prior to the appointment, which suggests one strong stimulus for both positive symptoms. Overall, auditory hallucinations for more than six months support the proposed diagnosis.
Lastly, negative and disorganized symptoms also uphold the initial examination. The negative symptoms of Jasmine include avolition, a mild degree of alogia, and affective flattening. Jasmine does not display transparent disorganized symptoms; however, mood deviations could designate a mild degree of disorganized behavior (Barlow et al., 2017). The evident negative symptoms are avolition and affective flattening. The former refers to decreased motivation in various areas of life, “I couldn’t do anything. I just stayed in my room” (Corell & Schooler, 2020). Affective flattening generally concerns unexpressive speech and mannerisms, “Jasmine is shaking her head and speaking in a monotone” (Barlow et al., 2017). Similar to positive symptoms, negative symptoms support the initial diagnosis.
As a result, the diagnosis for Jasmine Mack is most likely schizophrenia. The patient could potentially suffer from schizoaffective disorder due to the mild manifestations of a mood disorder, “She’d just get angry and stop speaking to us.” However, additional information concerning the emotional state of the patient is required to establish an accurate diagnosis. Ultimately, the positive and negative symptoms are transparent, and the treatment plan should focus on these aspects.
Treatment and Strengths
Due to the strong manifestations of positive symptoms, the core treatment should revolve around biological intervention. However, the research shows that drugs have different levels of effectiveness depending on the individual; therefore, a trial-and-error process is frequently needed (Barlow et al., 2017). The standard medications for schizophrenia are first-generation antipsychotics – Haldol and Thorazine (Barlow et al., 2017). In case these drugs prove to be ineffective, newer medications are being continually developed, and the second-generation antipsychotics might be more useful.
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Nevertheless, biological intervention might not suffice in certain cases, and a collaborative approach is required. Keepers et al. (2020) recommend ten guidelines for additional psychosocial intervention, including cognitive-behavioral therapy, family support, and self-management. The one particular strength in the current case that could be integrated into the treatment plan is family support. Jasmine’s mother seems highly concerned about her daughter’s well-being and should be able to assist her in the recovery process after the psychoeducation briefing (Keepers et al., 2020). Ultimately, close interaction with family members might significantly enhance Jasmine’s rehabilitation.
Summing up, the proposed diagnosis for Jasmine Mack is schizophrenia. The initial examination reveals the persistence of positive symptoms, delusions and auditory hallucinations, and negative symptoms, avolition and affective flattening, for more than six months. The diagnosis could potentially be schizoaffective disorder; however, the evidence from the case study is not sufficient, and the mood fluctuations could be a sign of disorganized behavior. The treatment of the disorder should focus on biological intervention with the additional support of psychosocial intervention. Jasmine’s parents seem motivated to support their daughter, and the family’s care is one of the transparent strengths present in the case study.
Barlow, D. H., Durand, V. M., & Hofmann, S. G. (2017). Abnormal psychology: An integrative approach (8th edition). Cengage Learning.
Corell, C. U., & Schooler, N. R. (2020). Negative symptoms in schizophrenia: A review and clinical guide for recognition, assessment, and treatment. Neuropsychiatric Disease and Treatment, 16, 519-534. Web.
Keepers, G. A., Fochtmann, L. J., Anzia, J. M., Benjamin, S., Lyness, J. M., Mojtabai, R., Servis, M., Walaszek, A., Buckley, P., Lenzenweger, M. F., Young, A. S., Degenhardt, A., & Hong, S. (2020). The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia. American Journal of Psychiatry, 177(9), 868-872. Web.