Clinical Case Scenarios

Homework questions for abnormal psychology. Please look at the uploaded documents below and answer the questions on a separate document.
vignettes.docx

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Please answer the following 5 questions for Vignette # 1 and Vignette # 2 on a separate document
VIGNETTE #1:
Trina is a 28-year-old accountant who recently started her first job after graduating with good marks
and high performance evaluations. She lives with her 2 cats and her best friend. Trina has always been
an anxious person. She describes herself as a “worry bug” and her friends and family often tell her she
worries too much. During high school she found it very difficult to control her worry about being on
time for class or appointments, her grades, losing her friends, getting her parents angry, her
appearance, whether her teachers liked her, and which university she would attend. Since then she
also has worried excessively about whether her current boyfriend will leave her, she worries about
her cats, her work performance, her weight, and having enough time in the day to get everything
done. Trina has great difficulty controlling these worries and they often intrude when she is trying to
relax alone at the end of each day, during down time at work, and when out with friends. She feels
exhausted all the time with constant muscle tension and body aches. She notices that she is
frequently irritable (e.g., snaps at her roommate and boyfriend inappropriately). Trina can’t
remember when she last felt relaxed as she always feels jumpy, tense, and on guard for something
bad to happen. For the past 6 months she hasn’t been sleeping very well. She often lies in bed
worrying for several hours, wakes frequently during the night, or wakes up too early and can’t fall
back asleep. On days when her worrying is really problematic she has difficulty concentrating at work
and several friends have commented that she often seems distracted. Trina also checks her work
excessively even though it means she often has to work late. She also asks her friends or family what
they think about her appearance or other worries until they get frustrated with her. Trina knows her
worry is a problem but she is concerned that without her worrying everything would fall apart or get
worse.
Given this information, please provide the following:
1) A working diagnosis (i.e. main diagnosis you would consider)
2) Possible differential diagnosis
3) Clinical concerns
4) Possible treatment options
5) Any additional information you would like to obtain to assist you with treatment & diagnosis.
VIGNETTE #2:
Josh is a 27-year-old male who recently moved back in with his parents after his fiancée was killed by
a drunk driver 3 months ago. His fiancée, a beautiful young woman he’d been dating for the past 4
years, was walking across a busy intersection to meet him for lunch one day. He still vividly
remembers the horrific scene as the drunk driver ran the red light, plowing down his fiancée right
before his eyes. He raced to her side, embracing her crumpled, bloody body as she died in his arms in
the middle of the crosswalk. No matter how hard he tries to forget, he frequently finds himself
reliving the entire incident as if it was happening all over.
Since the accident, Josh has been plagued with nightmares about the accident almost every night. He
had to quit his job because his office was located in the building right next to the little café where he
was meeting his fiancée for lunch the day she died. The few times he attempted to return to work
were unbearable for him. He has since avoided that entire area of town.
Normally an outgoing, fun-loving guy, Josh has become increasingly withdrawn, “jumpy”, and irritable
since his fiancé’s death. He’s stopped working out, playing his guitar, or playing basketball with his
friends – all activities he once really enjoyed. His parents worry about how detached and emotionally
flat he’s become.
Given this information, please provide the following:
1) A working diagnosis (i.e. main diagnosis you would consider)
2) Possible differential diagnosis
3) Clinical concerns
4) Possible treatment options
5) Any additional information you would like to obtain to assist you with treatment & diagnosis.
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