Question

Peggy, a 17-year-old female, was referred by her pediatrician to a child psychiatry clinic for evaluation of an eating disorder. She had lost 10 pounds in 2 months and her mother was concerned...At the clinic she stated that she was not trying to lose weight, had begun to sleep poorly about 2 months ago unless she had several beers, and that she and friends "got trashed" on weekends. Her relationship with her parents was poor; she had attempted suicide a year previously with aspirin and was briefly hospitalized. The day before this evaluation she had taken a razor to school to try to cut her wrists, but it was taken away by a friend. She admitted being depressed and wanting to commit suicide and finally told of discovering that she was pregnant 4 months earlier. Her boyfriend wanted her to abort, she was ambivalent, and then she miscarried spontaneously about 2 months after her discovery. After that, " It didn't really matter how I felt about anything." (Committee on Adolescence, 1996, pp. 71-72)

Criteria for Diagnosing Abnormal Behavior:

Statistical deviance – Does the person’s behavior fall outside the normal range of behavior? According to this criterion, a mild case of the “blahs” or “blues” would not be diagnosed as clinical depression because it is statistically common, but a more enduring, severe, and persistent case of the "blues" might.

Maladaptiveness – Does the person’s behavior interfere with adaptation or pose a danger to self or others? Psychological disorders disrupt functioning of daily routines and create problems for the individual as well as for other people such as partners or family.

Personal distress – Does he behavior cause personal anguish or discomfort? Many psychological disorders involve personal suffering and are of concern because the person might harm themselves or others.

After reading the story and the criteria for diagnosing abnormal behavior, do you think Peggy's behavior should be considered normal or abnormal? Explain your reasoning by referencing the criteria that helped you make your decision.

What possible mental disorders is Peggy exhibiting by her behavior?

If you were Peggy's doctor, what advice and treatment would you prescribe for her?

Answer 1

Criteria for Diagnosing Abnormal Behavior:

Statistical Deviance; Peggy's "blues" are more enduring, severe and persistent that normal "blues" and "blahs". Hence, she can be diagnosed with clinical depression.

Maladaptiveness: Peggy's behavior indicate a self harming behavior.She has a poor relationship with her parents, has difficulty in sleeping, have to take several beers to have sleep, is loosing weight, is recurrently having suicidal thoughts and even have attempted to it.

Personal Distress: Peggy's depression is causing her self harm. Her disturbed sleep pattern, her substance abuse, her suicidal ideation and attempts are related to her depression, that may triggered after her pregnancy and miscarriage.

The major symptoms of Peggy are :

• Depressed mood since two months of period.
• Significant weight loss, as she has lost about 10 pounds in two months period.
• Has difficulty in sleeping or has insomnia
• Feeling of guilt.
• Substance abuse
• Recurring thoughts of suicide and attempts of suicide.

All these symptoms indicate that Peggy is suffering from Major Depressive Disorder.

Peggy would be adviced for life style behavior changes to deal with her alcoholism. She would be treated with interventions as Psychotherapy that involves talk therapy and would be prescribed antidepressant medications.