Read the following case study and decide which TWO personality disorders could a
ID: 3462100 • Letter: R
Question
Read the following case study and decide which TWO personality disorders could apply to the situation. List the symptoms/behaviors that led you to these TWO diagnoses.
Mary was twenty-six years old at the time of her first admission to a psychiatric hospital. She had been in outpatient treatment with a psychologist for several months when her persistent thoughts of suicide led her therapist to conclude that she could no longer be managed as an outpatient.
Mary’s first experience with some form of psychological therapy occurred when she was an adolescent. Her grades had declined sharply in the eleventh grade, and her parents suspected she was using drugs. She began to miss curfews and even failed to come home at all on a few occasions. She was frequently truant. Family therapy was undertaken, and it seemed to go well at first. Mary was enthusiastic about her therapist and asked for additional, private sessions with him.
During the family sessions her parents’ fears were confirmed as Mary revealed an extensive history of drug use, including “everything I can get my hands on.” She has been promiscuous and had prostituted herself several times to get drug money. Her relationships with her peers were changeable, to say the least. The pattern was a constant parade of new friends, at first thought to be “the greatest ever,” but who soon disappointed Mary somehow and were cast aside, often in a very unpleasant way. Except for the one person with whom she was currently enamored, Mary had no friends. She reported that she stayed away from others for fear they would harm her in some way.
After several weeks of therapy, Mary’s parents noticed that her relationship with the therapist had cooled. The sessions were marked by Mary’s angry and abusive outbursts toward the therapist. After several more weeks had passed, Mary refused to attend any more sessions. In a subsequent conversation with the therapist, Mary’s father learned that she had behaved seductively toward him during their private sessions and that her changed attitude coincided with the rejection of her advances, despite the therapist’s attempt to mix firmness with warmth and empathy.
Mary managed to graduate from high school and enrolled in a local community college, but the old patterns returned. Poor grades, cutting classes, continuing drug use, and lack of interest in her studies finally led her to quit in the middle of the first semester of her second year. After leaving school, Mary held a series of clerical jobs. Most of them did not last long, as her relationships with co-workers paralleled her relationship with her peers in high school. When Mary started a new job she would find someone she really liked, but something would come between them and the relationship would end angrily. She was frequently suspicious of her co-workers and reported that she often heard them talking about her, plotting how to prevent her from getting ahead on the job. She was quick to find hidden meanings in their behavior, as when she interpreted being the last person asked to sign a birthday card to mean that she was the least liked person in the office. She indicated that she “received vibrations” from others and could tell when they really didn’t like her even in the absence of any direct evidence.
Explanation / Answer
First Diagnosis: The first diagnosis is Borderline personality disorder.
Symptoms:
Second Diagnosis:
Paranoid Personality disorder
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