The diagnosis that this client has is F50. 8, Binge-Eating Disorder, which is, “recurrent episodes of binge eating” (DSM-5, 2013, p. 350). The reason why this specific diagnosis would apply would be that Andrea meets the diagnostic criteria for this disorder. This disorder is characterized by, one, “eating, in a discrete period of time (e. g. , within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under normal circumstances” (DSM-5, 2013, P. 50). Andrea applies to these specific criteria because when her binge eating began in college, she would eat a big breakfast, and then afterwards take large quantities of food to her dorm room, which she would consume over the new few hours.
The second criteria, which is “a sense of lack of control over eating during the episode (e. g. , a feeling that one cannot stop eating or control what or how much one is eating)” (DSM-5, 2013, P. 50); Andrea would say that she did not feel control during her binge eating because she always believed that she would stop when she had finished whatever piece of food that she was eating, although this did not happen. According to the other criteria, Andrea would also eat until she felt uncomfortably full, she ate until she had stomach pains, and never felt hungry because she was always eating so much; and she felt very ashamed and did most of her eating in private because of this.
For this disorder, the binge eating needs to occur, one average, at least once a week for 3 months, and in Andrea’s case, it lasted for several weeks to several months, her longest binge eating episode lasting 10 months. In an assessment to this particular client, the biological, family, and cultural considerations that would need to be seen to justify this diagnosis would be that “binge-eating disorder appears to run in families, which may reflect additive genetic influences; 2:33
Binge Eating Case Study Essay binge-eating disorder occurs in most industrialized countries, including, the United States, Canada, etc. , and this disorder appears comparable among non-Latino whites, Latinos, Asians, and African Americans” (DSM-5, 2013, P. 352). All of these considerations would need to be assessed in Andrea’s case, to see if these apply to her specifically. As for ethical considerations in this case, Andrea has tried many different types of diets and therapy to help with her binge eating.
She tried Weight Watchers several times, diets in magazines, used prescribed and illicit amphetamines, and spoke to internists about her weight and even tried the diets that they gave her. She also tried to discuss her weight and eating problems with a therapist, but it was ineffective since the therapist’s interventions were only limited to suggesting diets. It seems that Andrea has tried everything and that no form of treatment seems to be working for her, so it would be unwise to suggest that this client try another diet, or medication, as well as sit in an office talking to a therapist about her issues.
One form a therapy that could work for Andrea is referred to as, “walk and talk therapy”. This is when therapists take their clients out of the office and essentially walk and talk during their sessions. One consideration for this may be, since they are out in public, confidentiality is limited, and the client may run into people that they know. All of these considerations would have to be discussed in depth with the client before performing this type of therapy.
More available treatments according to WebMD, Binge Eating Disorder (2017), include “individual counseling, nutrition counseling, and/or group/family therapy”. Cultural considerations for these treatment options could be that many different types of cultures see a therapist as an authority figure, in which they do not want to go against their suggestions, even though they disagree or do not conform to them. A client may also not like opening up to their therapist, and can see talk therapy as an unsuccessful way to deal with their issues.
Another treatment consideration could be that certain cultures are against prescribed medications or other holistic treatment options. All of these considerations would have to be assessed in the beginning of the session so the therapist is aware of what the client is comfortable with concerning their treatment and what they are not. Overall, within this case study, it is clear to see that Andrea suffers from Binge-Eating Disorder and has tried many types of diets and treatment options to help with her weight and eating problems.
It is unsure without going into more depth if Andrea’s mother suffers from this disorder as well, since they had frequent arguments throughout her childhood and adolescence about her excessive eating and weight gain. When assessing this client, it is important to take all of this background into consideration when looking for and discussing different types of treatment options. Although Andrea has tried many types of “fixes” to her disorder, none of them have had a long-lasting effect. This is where the therapist has to look outside the box to find the most effective longlasting form on treatment.
In the case of Martin, his diagnosis would be, F20. 9, Schizophrenia. According to the AMCH (2017), “Schizophrenia is a brain disease that interferes with normal brain functioning. It causes affected people to exhibit odd and often highly irrational or disorganized behavior. Because the brain is the organ in the body where thinking, feeling and understanding of the world takes place (where consciousness exists), a brain disease like schizophrenia alters thinking, feeling, understanding and consciousness itself in affected persons, changing their lives for the worse”.
This disorder requires at least two of the five criteria to be present for a significant period of time during a 1-month period, and at least one must include the first three criteria: “delusions, hallucinations, disorganized speech (e. g. , frequent derailment or incoherence), grossly disorganized or catatonic behavior, and negative symptoms, (i. e. , diminished emotional expression or avolition)” (DSM-5, 2013, P. 99). According to the case study, Martin is showing signs of delusions and hallucinations.
In Schizophrenia, there are five different types of delusions; one, persecutory, in which one believes that they are being followed; two, delusions of reference, in which one believes that the newspaper or TV is specifically talking to them; three, grandiote delusions, in which one believes that they have a lot of power; four, erotomanic delusions, in which one person believes to be romantically involved with someone (usually famous); and five, bizarre or non-bizarre delusions, in which one believes aliens replaced their brain (bizarre) or that they are being followed by the FBI (non-bizarre).
Martin is suffering from bizarre delusions, in which he believes that if he answers or makes calls on his cell phone, that it will activate a deadly chip that was implanted in his brain by evil aliens. He also has accused his parents on several occasions of conspiring with the aliens to have him killed so that they can remove his brain and put it inside one of their own. Because of this, Martin has stopped attending his college classes altogether, making him very behind on his coursework, which could been seen as a persecutory delusions, because he is not leaving his dorm room in order to protect himself.
This also applies to Criteria B, which states that “for a significant portion of time since the onset of disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset” (DSM-5, 2013, P. 99). The five different types of hallucinations in Schizophrenia include, one, auditory, hearing voices; two, visual, seeing clear, vague, and/or distorted shadows; three, olfactory, sense of unpleasant smells; four, tactile, feeling insects and/or fingers touching them; and five, gustatory, horrible/unpleasant taste.
In the case of Martin, his family and friends have noticed him whispering in an agitated voice, even though there is no one nearby, which suggests that he is suffering from auditory hallucinations, in which he is hearing someone talking to him, er it be commentary, commands, and/or conversational. In Criteria C, continuous signs of disturbance need to persist for at least 6 months, but this 6-month period must include 1 month of symptoms.
Since Martin has had these symptoms for the past few weeks, and this disorder requires at least 1 month of symptoms, one could conclude that Martin is suffering from Schizophrenia. But, since these signs need to persist for at least 6 months, he should also be further monitored since a 6-month period has not passed yet. As for the other criteria stated, it cannot be another disorder or physiological effects of a substance, which does not apply to Martin’s case because even though he occasionally has a few beers with friends, he has never been known to abuse alcohol or use drugs.
In an assessment for this particular client, the biological, family, and cultural considerations of their background that would need to be seen to justify this diagnosis would be that there is a strong contribution for genetic factors in determining the risk for schizophrenia, although most individuals, who have been diagnosed with it, do not have any family history of it. One could have a risk that is associated with other mental disorders, such as bipolar disorder, depression, and autism. Pregnancy and birth complications with hypoxia and greater parental age are also associated with a higher risk of developing schizophrenia in the fetus.
Cultural considerations could include ideas that are held to be delusional in one culture, may be accepted in another; visual and/or auditory hallucinations could be seen as part of a religious experience; and the “emotional expression of these hallucinations could be normative to the patient’s subgroup” (DSM-5, 2013, p. 103). As for ethical considerations, Martin has refused to go to any type of psychiatrist for an evaluation, so it is unknown what type of therapy he would consider and/or benefit from successfully.
He might be against taking medication, since he believes that aliens have implanted a chip in his brain, but he might be willing to do talk therapy, in which he can discuss his concerns and reasons for why he is feeling and acting the way that he is. It is also important to consider cultural and socioeconomic factors, particularly when the individual and the therapist do not share the same cultural and socioeconomic background. Overall, in Martin’s case, he is showing signs of schizophrenia.
Since the onset of this disorder is late teens to mid 30’s, Martin should be further evaluated to see if these signs continue. He also has an estranged aunt who has been in and out of psychiatric hospitals over the years due to erratic and bizarre behavior. Even though schizophrenia often times has no family history, it would be important for the clinician to take this into consideration and also have a look into this family member’s mental health background. This could provide specific answers as to why Martin is feeling and acting the way that he is.