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Writing Assignment 2: Case Vignettes
Due Date: Wednesday November 29, 2023 at 11:59pm
Submission: Upload via SafeAssign in Blackboard
Academic Integrity: All graded work must be completed in accordance with The George
Washington University Code of Academic Integrity
(https://studentconduct.gwu.edu/code-academic-integrity)
• Do NOT copy text from articles, the textbook, or other sources without
proper citation
• Do NOT copy work (in part or in whole) from other students
• Do NOT use AI to complete this assignment
• This assignment should be completed individually with no conversation,
consultation, or editing from another person.
• Please talk to the instructor or TA if you have questions about plagiarism,
paraphrasing, using quotations, or collaborating with others on this writing
assignment
Formatting: 5-7 pages of text (no cover page), typed, double-spaced, one-inch margins, and 12point Times New Roman font.
• Number your responses as follows:
Case 1:
1A.
1B.
2A.
2B.
Etc.
Case 2
1A.
1B.
2A.
2B.
Etc.
• Cite your textbook as follows (if necessary):
o The biological model for anxiety disorders is … (Sue et al., 2017).
o According to Sue et al. (2017), the most effective treatment for schizophrenia is…
• Save and upload papers as a Microsoft Word document (not a PDF, Notepad, or Pages).
Grading: Review the rubric for breakdown of points and make sure you have all of the
components in your paper.
Case 1
35 points
Case 2
35 points
Writing style, grammar, spelling, organization of paper
5 points
Total:
75 points
PSYC2011 – Writing Assignment 2 – Spring 2023
Case 1: Jasper
Jasper Dubey is a 14-year-old first-generation American young man whose parents
immigrated to the United States from India six years ago. His family, consisting of his mother,
father, and two older sisters, resides in Washington, D.C. Jasper started high school at Duke
Ellington School of the Arts two months ago and his sister recently handed over her
neighborhood dog-walking business to him so he could start earning money. Three weeks into
the school year, Jasper’s parents were called to pick-up Jasper from the nurse’s office due to
their concerns for Jasper’s safety as he was wandering around the hallways, muttering to himself,
irritable, and not responding to others’ attempts to engage him in conversation. His parents took
him to the emergency department who then referred Jasper to your inpatient adolescent
psychiatric unit for evaluation that same day.
You (clinical psychologist) first meet with Jasper’s parents who describe Jasper as a
distractible and “high strung kid,” as they often have enrolled him in sports to use up his energy.
In elementary school teachers often sent emails to his parents about Jasper’s distractibility at
school, constantly needing to give redirection, and frequently asking him to remain seated during
class. However, Jasper’s parents claimed to not see these same behaviors at home as he was
often outside playing with the neighborhood kids after school and on the weekends he had sports
games and tournaments. His parents believed that the school was simply not paying enough close
attention to Jasper and if he was better monitored he would’ve focused better. Jasper’s father
stated that a teacher suggested having Jasper tested and placed on medication to manage his
difficulty concentrating and regulating his behaviors but Jasper’s father believed that there was
nothing that needed to be medicated, he just worked with Jasper to “try harder.” Since starting
high school, Jasper’s disruptive behavior in class has decreased, though teachers have
commented that he has a hard time remaining focused and has forgotten to turn in several
assignments since school started.
When meeting with Jasper individually, he agreed that he has had challenges remaining
focused at school but he believes this fluctuates from week to week. For example, earlier this
week he was very busy with his sports practices after school as well as trying to schedule all of
his sister’s former dog walking clients. Towards the end of the week he was feeling extremely
productive, going to practice, coming home and walking dogs, cranking out his homework until
3am, and then sleeping for a couple hours before going to school and doing it all over again. He
reported feeling like his mind was quickly jumping from one topic to the next and his friends
told him that he “had to chill,” given how intense he came across. However, Jasper also reflected
on a time about a month ago when he was feeling much more distracted at school, feeling
unmotivated to pay attention in class, sleeping in late and missing first period, and skipping
practice after school because he did not feel he had enough energy to participate or socialize with
his teammates. He also endorsed several somatic complaints during this time including body
pain, frequent headaches, and stomach cramps. Jasper indicated he avoided his parents during
PSYC2011 – Writing Assignment 2 – Spring 2023
this time because he was worried he would disappoint them or they would become upset with his
inability to fulfill commitments. At times, Jasper reported having thoughts such as “I wish I
didn’t wake up tomorrow,” feeling hopeless about returning to a state of feeling good about
himself and his abilities. According to Jasper, he has experienced both periods of feeling down
and low for up to 3 weeks and periods of feeling energized, active, and productive for a week at
a time. Jasper expressed discomfort with sharing this information with his parents as he believed
they would not take him seriously and, ultimately, he wants to make them proud given their
“sacrifice” to move to the US to provide him with greater opportunity.
1. Based on the available data above, please answer the following questions: (35 points)
a. What is Jasper’s primary diagnosis? (2 points)
b. What specific diagnostic criteria do you think are met? (4 points)
c. What specific diagnostic criteria are not met? (4 points)
*Provide the basis for your decisions using evidence from the case vignette (note: do not just
copy and paste the DSM-5 criteria. You can summarize the criteria and include the evidence
from the case.)
d. Describe one comorbid or competing diagnosis you would consider for Jasper. Justify
your reasoning by comparing and contrasting the relevant DSM-5 diagnostic criteria (i.e.,
what symptoms overlap). Why did you rule out this diagnosis in favor of the one you
proposed in Part A? (6 points)
e. What additional questions would you like to ask Jasper to clarify your diagnosis? What
additional questions would you like to ask Jasper’s parents? (4 points)
f. What role does Jasper’s culture play in his discomfort to speak with his parents about his
symptoms? As the clinician, how would you navigate this dynamic between Jasper and
his parents? How does Jasper’s culture influence the manifestation of his symptoms? (5
points)
g. What is one risk and one protective factor that might predispose Jasper to developing (or
not) this disorder? (4 points)
h. What treatment options would you recommend based on your primary diagnosis in Part
A? What treatment options would you recommend based on your competing diagnosis in
Part B? (6 points)
PSYC2011 – Writing Assignment 2 – Spring 2023
Case 2: Marena
Marena Hernandez is a 29-year-old Mexican American female living in Los Angeles,
CA. Marena grew up in LA her whole life and lives with her girlfriend of 6 years in a onebedroom apartment with their dog, Rusty. Marena works as an accountant in a medium sized
firm in downtown LA where she commutes to and from the west side of LA, often taking over an
hour each way with traffic. Marena loves her job but often works long hours, especially during
tax season. One Friday night in April 2019, Marena pulled a double shift and ended up driving
home at 11pm at night. Extremely fatigued, Marena fell asleep at the wheel and crashed into a
median on highway 10. Bystanders called 911 and an ambulance rushed Marena to the hospital,
where she was treated for a broken arm, several broken ribs, and a severe concussion from the
impact. Following this, Marena had to take medical leave from work due to her inability to drive.
She began physical therapy and was prescribed several medications, including opioids to manage
her pain.
About 2 months after the incident, Marena made significant progress in regaining her
functional mobility. Her girlfriend Sam was pleased with her progress, however, began to worry
over other issues Marena was experiencing. Specifically, Sam noticed that Marena had become
increasingly irritable lately. Seemingly little things would anger her out of nowhere, such as the
dishes not being clean, the TV being too loud, or anyone making noise when she was trying to
sleep. Sam often felt like she was walking on eggshells with her since her outburst would come
out of nowhere. Marena had also stopped sleeping, getting around 1-2 hours of sleep a night.
Despite taking the sleep meds prescribed to her, Marena noticed no effect, and often took far
more than the recommended amount in an effort to “shut her brain off”. Due to these concerns,
Marena was referred to an outpatient clinical psychologist by her doctor.
During your first session with Marena, you (clinical psychologist) make several
concerning behavioral observations. Marena is noticeably fidgety and agitated, shaking and
showing external signs of insomnia (i.e., dark circles and bloodshot eyes). Marena voiced several
problems during the intake, including the inability to fall or stay asleep despite medication,
severe mood swings and irritability, lack of appetite and significant weight loss, and feeling like
her thoughts were “out of control”. Upon further questioning, Marena states all of these issues
began after the car accident. More specifically, she reports feeling constantly on edge, often
reliving the memories of the accident. Marena has not been able to step into a car since that day
due to an extreme fear something will happen again. She reports drinking excessively in an
attempt to calm down her uncontrollable thoughts and memories of the event, often drinking
over 7 beers every day for the past 30+ days. Although her doctor told her not to drink while on
medication, Marena explains that the opioids are not working like they should be. When
prompted further, Marena states that if she does not keep taking her pain meds, she will start
experiencing horrible shakes, tremors, and withdrawal symptoms, often feeling like she’s dying.
Her doctor has told her repeatedly to reduce her dosage, but Marena states doing so would be too
PSYC2011 – Writing Assignment 2 – Spring 2023
painful to bear. Marena reports feeling very stuck. Additionally, she reports a significant loss in
pleasure over things she normally enjoys (e.g., spending time with her girlfriend and dog) and
feeling a severe lack of energy in being able to do simple life tasks or even going back to work.
Marena is afraid to admit just how severe these symptoms have become, because she doesn’t
want Sam to worry about her. Therefore, she wants an “easy fix” from you as she does not
believe in traditional therapy.
2. Based on the available data above, please answer the following questions: (35 points)
a. Is Marena abnormal? Specify which definition of abnormality you are using to make this
determination, and why Marena’s case does or does not meet this definition. (4 points)
b. What is Marena’s primary diagnosis? (2 points)
c. What specific diagnostic criteria do you think are met? (4 points)
d. What specific diagnostic criteria are not met? (4 points)
Provide the basis for your decisions using evidence from the case vignette (note: do not just copy
and paste)
e. Does Marena meet criteria for a comorbid disorder? Why or why not? If you said yes,
briefly describe this diagnosis as evidenced from the case. Justify your reasoning. (4
points)
f. Using the multipath model, what are two possible etiological models for Marena’s
behavior (primary diagnosis)? Be specific and use the models described in the chapters of
the specific disorders. Refer to specific examples from the case, how the disorder might
be explained from a particular etiological model. (6 points)
g. Given Marena’s aversion to therapy, how would you go about treating her in this
situation? Would you recommend therapy or another treatment? Why or why not? Justify
your reasoning. (5 points)
h. Describe one differential diagnosis you would consider for Marena. Justify your
reasoning by comparing and contrasting the relevant DSM-5 diagnostic criteria (i.e., what
symptoms overlap). Why did you rule out this diagnosis in favor of the one you proposed
in Part A? (6 points)
PSYC2011 – Writing Assignment 2 – Spring 2023
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