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Summary diffdiagnosis PSY 645 Making a Differential Diagnosis The University of Arizona Global Campus PSY 645 Psychopathology Making a Differential Diagnosis In Case 14 from Case Studies in Abnormal Psychology, a differential diagnosis is made for Jack, a
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diffdiagnosis PSY 645 Making a Differential Diagnosis The University of Arizona Global Campus PSY 645 Psychopathology Making a Differential Diagnosis In Case 14 from Case Studies in Abnormal Psychology, a differential diagnosis is made for Jack, a 22-year-old male admitted to the psychiatric...
diffdiagnosis psy 645 making a differential diagnosis the university of arizona global campus psy 645 psychopathology making a differential diagnosis in case 14 from case studies in abnormal psy
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PSY 645
Making a Differential Diagnosis
The University of Arizona Global Campus
PSY 645 Psychopathology
Making a Differential Diagnosis
In Case 14 from Case Studies in Abnormal Psychology, a differential diagnosis is made
for Jack, a 22-year-old male admitted to the psychiatric unit after a suicide attempt (Gorenstein et
al., 2015).
Recommended Diagnosis
Based on the DSM-5 and tree of personality disorders, the recommended diagnosis for
Jack is cluster B antisocial personality disorder 301.7 (F60.2) (APA, 2013). There are four
diagnostic criteria expressed by features like failure to obey laws and norms by engaging in
behavior that results in a criminal arrest, lying, deception, and manipulation, impulsive behavior,
irritability, and aggression, blatant disregard the safety of self and others, a pattern of
irresponsibility and lack of remorse for actions (APA, 2013). Other diagnostic criteria are the
person is at least 18 years old, conduct disorder was present before age 15, and the antisocial
behavior is not better explained with schizophrenia or bipolar disorder (APA, 2013).
The first step is to rule out malingering and factitious disorder. Jack has a pattern of
dishonesty, deceitfulness, and manipulation, ranging from auto theft to portraying his mother as
seriously ill. His motivation appears to be for personal gain and is considered malingering. The
first question to assess is if Jack's symptoms, behavior, or mood are due to substance use
(Hatchett, 2015). Suspicion was also raised for possible substance use when he proactively asked
for medication. A study found that individuals with ASPD were seven to eight times more likely
to depend on alcohol and 15-17 times more likely to have a substance use issue (Werner et al.,
, 2015). The presentation lacks a casual relationship directly, and the patient only admitted to
marijuana use. Another nonpsychological medical condition was not present either.
Sociocultural Perspective
An antisocial personality disorder is a severe and dysfunctional personality disorder
grounded in social irresponsibility with delinquent, exploitive, or manipulative behavior without
remorse. It is considered the only personality disorder that cannot be diagnosed in childhood
(Fisher & Manassa, 2020). The etiology of ASPD is varied. Heredity accounts for an estimated
38-69% of ASPD diagnoses and adverse childhood experiences like neglect, abuse, and troubled
parenting styles (Fisher & Manassa, 2020). ASPD exists in many cultures with a higher
prevalence in WEIRD countries (Mulder, 2012). The prevalence of ASPD is in 1-4% of the
population and more frequent in men (6%), with a significant correlation to substance abuse.
Intelligence and education show a negative correlation (Fisher & Manassa, 2020). Individuals
with ASPD report increased abuse rates, adversity, and low education attainment (Verona &
Patrick, 2015).
Personality disorders intersect sociocultural and historical personality concepts in
addition to developmental processes and neurobiology. Some view the label of ASPD as
stigmatizing, reinforcing self-indulgent and reckless behavior as a chronic condition with no
hope for recovery (Tuvblad & Beaver, 2013). Others propose that the criminal justice system
better manage ASPD and not disrupt society (Mulder, 2012). Children may be labeled as having
a personality disorder before their personality has developed, yet the ratio of conduct disorder
before age 15 to an ASPD diagnosis ranges from 40-70% (APA, 2010). Other sociocultural
factors include school truancy, suicidal behavior, unemployment, unstable housing,
imprisonment (47% of those with ASPD have arrest records), and dysfunctional adult
relationships (Mulder, 2012).
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