An old version of the diagnostic section of the exam

Does this behavior qualify for any of the diagnoses we've discussed? If it doesn't, why? Which diagnosis fits this case best? Briefly justify your diagnosis. (4 pts each.)

1. Aaron, an accountant, has been hearing "voices" lately (no one else hears them) and for several years he has been increasingly thinking that he has been "chosen" to do "The Master's" work. More and more frequently he's feeling that others are talking about him at work. He no longer drinks coffee at work (or eats anything that doesn't come in a can, and even then he must boil it first) because he believes that others want to hurt him to prevent him from carrying out "The Plan." His employer is seriously considering firing him because he has been acting so strangely.

2. Miriam's parents are concerned as they have recently discovered that she throws up several times a week after eating. Since then they began monitoring food that entered and left the house and discovered that there are several episodes a week where she appears to "binge," that is, eat about 800 calories at a sitting of ice cream, cake, or donuts. They've noticed that Miriam, an honor student, talented violinist, and cheerleader, ha. She does aerobics or dances at least six hours a day. Since losing an audition, she has lost over 30 lbs in the last several months, and is now at 95lbs (at 5'6"). She continues to believe that "if only she lost a few more pounds" she would look better and get some of the parts she tries to get.

3. Alex, age 9, is clearly a bright and charming child, but his performance in school is very confusing. On one day he will be restless and miss more than half of the questions on homework assignments. On another, apparently no different day, he received a 100% on a very difficult assignment the first day it was presented. Generally, however, he is described as "always moving and touching things." He frustrates his teacher (who prefers order) by always blurting out the answers, wiggling in his seat, and needing to sit next to her desk in order to concentrate for more than four minutes at a time.

4. Belle, aged 12, has run into minor problems in school over the last several years. As a result, she was referred for an intellectual assessment by her school psychologist who reported that her Full Scale IQ was 66, with Verbal IQ 67 and Performance IQ 65. Her psychologist noted that Belle was tired and distractible and discovered that she had been up most of the night before with her sick father, caring for him. He also noted that, despite Belle's problems in school, Belle is capable of reading at grade level and especially enjoys Tolkien's trilogy The lord of the rings. Belle is responsible for most of the cooking and cleaning for the family, and is even helping market her father's inventions.

5. Madison reports an early history of child abuse. Her favorite uncle molested her from age five to 12 when she finally told her best friend who told her parents. Her relationships with others have always been rocky and short; people frequently complain that a relationship with her is overly intense and idealizing up until the point at which she turns, complaining that he "has never loved her." She often reports feeling "empty" inside, and has engaged in a variety of self-destructive behaviors including driving fast on country roads while drinking, cutting on her wrists, shoplifting, and engaging with sex with strangers in the park. She has attempted suicide seven times.

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   Last modified October 8, 2001