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OCTOBER 7, 2017





Mr. G is a 68 year old widowed. He lives independently in an apartment

that he and his wife shared for 30 years. He had a good marriage and has two

children. Both children are grown and live in another state. He used to be an

outgoing, social person, active in community affairs and a devoted member of

his church prior to his retirement.

Mr. Gs persistent complaint about tension headache, poor attention span,

and hypersomnia are well known primary presentations of depression in the

elderly. Poor eyesight and memory lapse are the common indicator of senility.



Mrs. S is a 32 year old scientist. She is married and currently works for a

large pharmaceutical company. She has never been hospitalized for a psychiatric

disorder and hasnt had any previous contact with a therapist. She is in good

physical health and has no history of drug or alcohol abuse. She feels

comfortable in crowds, and shows no evidence of agoraphobia or social phobia.

Mrs. S looked sloppy and unkempt. She is unable to sit still and fidgets

throughout the entire interview. She has pressured speech and finds difficulty in

answering questions. She exhibits anxiousness for finding a cure for AIDS.


Jessica is a 28 year-old married female. She has a very demanding, high stress

job as a second year medical resident in a large hospital. Jessica has always

been a high achiever. She graduated with top honors in both college and medical

school. She has very high standards for herself and can be very self-critical when

she fails to meet them. Lately, she has struggled with significant feelings of

worthlessness and shame due to her inability to perform as well as she always

has in the past.

For the past few weeks Jessica has felt unusually fatigued and found it

increasingly difficult to concentrate at work. Her coworkers have noticed that she

is often irritable and withdrawn, which is quite different from her typically upbeat

and friendly disposition. She has called in sick on several occasions, which is

completely unlike her. On those days she stays in bed all day, watching TV or


At home, Jessicas husband has noticed changes as well. Shes shown little

interest in sex and has had difficulties falling asleep at night. Her insomnia has

been keeping him awake as she tosses and turns for an hour or two after they

go to bed. Hes overheard her having frequent tearful phone conversations with

her closest friend, which have him worried. When he tries to get her to open up

about whats bothering her, she pushes him away with an abrupt everythings


Although she hasnt ever considered suicide, Jessica has found herself

increasingly dissatisfied with her life. Shes been having frequent thoughts of
wishing she was dead. She gets frustrated with herself because she feels like she

has every reason to be happy, yet cant seem to shake the sense of doom and

gloom that has been clouding each day as of late.



Kristen is a 38 year-old divorced mother of two teenagers. She has had a

successful, well-paying career for the past several years in upper-level

management. Even though she has worked for the same, thriving company for

over 6 years, shes found herself worrying constantly about losing her job and

being unable to provide for her children. This worry has been troubling her for

the past 8 months. Despite her best efforts, she hasnt been able to shake the

negative thoughts.

Ever since the worry started, Kristen has found herself feeling restless, tired, and

tense. She often paces in her office when shes there alone. Shes had several

embarrassing moments in meetings where she has lost track of what she was

trying to say. When she goes to bed at night, its as if her brain wont shut off.

She finds herself mentally rehearsing all the worse-case scenarios regarding

losing her job, including ending up homeless.



Josh is a 27 year-old male who recently moved back in with his parents after his

fiance was killed by a drunk driver 3 months ago. His fiance, a beautiful young

woman hed 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 fiance 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


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 caf where he was meeting his fiance 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 fiancs death. Hes 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 hes




Martin is a 21 year-old business major at a large university. Over the past few

weeks his family and friends have noticed increasingly bizarre behaviors. On

many occasions theyve overheard him whispering in an agitated voice, even

though there is no one nearby. Lately, he has refused to answer or make calls on

his cell phone, claiming that if he does it will activate a deadly chip that was

implanted in his brain by evil aliens.

His parents have tried to get him to go with them to a psychiatrist for an

evaluation, but he refuses. He has accused them on several occasions of

conspiring with the aliens to have him killed so they can remove his brain and

put it inside one of their own. He has stopped attended classes altogether. He is

now so far behind in his coursework that he will fail if something doesnt change

very soon.

Although Martin occasionally has a few beers with his friends, hes never been

known to abuse alcohol or use drugs. He does, however, have an estranged aunt

who has been in and out of psychiatric hospitals over the years due to erratic

and bizarre behavior.


Background Information

Anthony Soprano, Jr., referred to as A.J., is a male born on July 15, 1986 to

Anthony and Carmela Soprano. The family is of Italian decent and they live in

New Jersey. From a very young age, A. J. had disciplinary problems in school

and a possible learning disability. After extensive testing and meeting with school

counselors, he was deemed to be suffering from Attention-Deficit Hyperactivity


It was very obvious throughout the various seasons that A. J. had a strong family

history of multiple psychiatric disorders. His father was diagnosed with

depression from the beginning of the series. He was on medication and would

see a therapist regularly. In addition, his father had antisocial personality

disorder and panic disorder without agoraphobia. His father was involved in

organized crime, which caused strains on his parents relationship. Due to these
marital issues between his parents, A. J. would often act out during their period

of separation and possible divorce. As A. J. got older, his father insisted on him

becoming more responsible and not a failure in life. As a way to make A. J. more

productive, his father got him a job at a construction site. A. J. started the job

and was doing well. He met a Puerto Rican girl named Blanca at the construction

site and they started dating.

The two became really close, and A. J. eventually proposed to Blanca. After

some reconsideration, she decided that A. J. was not right for her and broke up

with him. This is when he became depressed. A. J. continued to work at the

construction site for some time, but the site of Blanca talking to other men

became too much for him, so he eventually quit. Just as things seemed like they

would never improve, A. J. met some childhood friends whose fathers were also

in the Mafia with his father.

He started hanging out with them and seemed to be improving. He also began

seeing a therapist and was prescribed Prozac. He improved to the point that he

even began to take some college courses. However, these new friends turned

out to be a bad influence. They were running some illegal gambling on campus

and would use violence to collect money. A. J. did not seem to be affected by

this, but when they badly beat up an African American student, this sent A. J.

spiraling down once again.

Description of the Problem

After the breakup with Blanca, A. J. started sleeping all the time and would not

come out of his room. He had a decreased appetite and anhedonia. He seemed

to lack energy for quite some time. There were no suicidal ideations initially.
After the African-American student incident, he again confined himself to his

room and developed similar symptoms to what he was displaying after his break

up with Blanca. It progressed to the point that he attempted to kill himself by

tying a plastic bag around his face, wrapping a cinder block around his leg, and

jumping in the pool while his parents were out of the house. Luckily, his father

came home and saved him prior to there being any significant damage. A. J. was

admitted to an inpatient psychiatric facility and received the therapy he needed.


Background Information

Jenna Marony is a forty-three year old woman, who was born Ystrepa Grokovitz

on February 24, 1969. She grew up in Bakersfield, CA. Her father, was a burger

server in suburban Santa Barbara. He dumped Jenna's mother, a dental

hygienist, for another woman. Jenna still says she will "always be his little girl."

After being spurned, Jenna's mother made her sit on every mall Santa's lap in

Bakersfield in an attempt to find him. Jenna has a sister who urinated in one of

Jenna's eyes when she was little, which causes it to not open all the way.

Another sister is deceased. She did not get along with her half-sister, Courtney,

who is now deceased. Upon hearing of her sister's demise, Jenna showed no

obvious signs of sorrow or grief. Jenna also has a niece, who draws pictures of

her Auntie Jenna. Jenna finds the pictures to be offensive, when in fact they are

just childlike renderings of Jenna.

During Jenna's teen years, her mother moved what family she had left from

California to Florida. Jenna attended high school on a boat, which has

subsequently sunk. At the age of 16, Jenna was engaged to a congressman. She

has also reportedly dated O.J. Simpson, a music producer, a sniper, a mob boss,
and hinted at having been in a three-way relationship with Rosanne and Tom

Arnold. Jenna's started singing at a young age, as a distraction for her mom,

who was busy shoplifting. Jenna went on to study voice at Northwestern

University and also at the Royal Tampa Academy of Dramatic Tricks, where she

majored in playing prom queens and murdered runaways. She has been in

various films and commercial, and is currently employed as an actress on a

television series.

There is no history of substance use, however, there is a history of binge eating,

but the episode was brief, and Jenna's eating habits have since returned to

normal. Jenna is in good health, with no reported concerns.

Jenna seems to have coped with her life difficulties by becoming the "center of

attention," and the center of her own universe. Abandoned by her father and

used by her mother as a decoy, Jenna possibly feels unloved and rejected.

Jenna's inability to empathize with others and sustain lasting relationships with

are major weaknesses. She is constantly battling with someone, whether it be a

co-worker, a friend or a family member. Currently, Jenna is involved with a

transvestite who dresses as Jenna. In fact, Jenna met her lover while

participating in a Jenna Maroney Look-Alike Contest, in which Jenna herself only

placed fourth. Her new lover won the contest, and they have been intimate since

that time.

Description of the Problem

Jenna does not feel she has any problems, other than not receiving the attention

and recognition she feels she deserves. Her achievements are not commensurate

with her desire to be "worshipped," and adored. Jenna feels she is entitled to
special treatment and when this fails to occur within her career or social life, she

becomes explosive and stubborn. She has an excessive need for admiration, as

evidenced by her choice of careers. She seems to have no empathy regarding

others, and on the rare occasions empathy is displayed by Jenna, it is not

genuine empathy, but a means to an end. In other words, she fakes empathy to

manipulate others, or for personal gain. Jenna repeatedly poisoned a co-worker

in the hopes of dating one of the "hot" EMT workers who came to the rescue.

Jenna is severely jealous of her co-star in her current television series, and is

constantly looking for ways to undermine him. She dreams of unparalleled

success and believes she is the most beautiful, talented woman to grace this

planet. While Jenna does not see this as a problem, the rest of society fails to

agree with her assessment of herself, and this causes much frustration for

Jenna. Jenna reacts very unfavorably to even the slightest criticism, as she

believes herself to be perfect and unique. If she is criticized, she feels that the

person doing the critique, "just doesn't understand her," because they are not as

special and wonderful as she.


Background Information

Michael Scott is a forty-six year old Caucasian male from Scranton, Pennsylvania.

Scott is the regional manager at Dunder Mifflin Inc., a local paper and printer

distribution company, where he has worked for the last fifteen years. There are

no known medical conditions held by Scott, though his family history is unknown.

He claims to be of English, Irish, German, Scottish, and Native American descent,

though this is unconfirmed, and perhaps an exaggeration. The patients outward

appearance is well put together, as he presents as a business professional, and

there are no obvious health concerns. Despite his seemingly composed

demeanor, Scott displays exaggerated emotions and reactions. In addition to

this, romantic relationships have proven turbulent for Scott throughout his life,

as he goes from one relationship to the next with the other person usually being

the one to end it. He has few close friends or relatives, and tends to perceive

new friendships as closer than they actually are. Scott believes his subordinates

to be his family, and often times gets involved in their personal lives without

their consent. His parents divorced when he was young (age unknown), and he

displays clear resentment towards his stepfather and sister, whom he once didnt

talk to for fifteen years. Scott has a very close relationship with his mother now,

though this was not case when he was a child. Though Scott seems to be lacking

in managerial style, responsibility, and delegation, he demonstrates above

average sales abilities due to his personable qualities. Scott does not have a

history of drug or alcohol abuse, though he will drink in social situations and

when pressured to do so by coworkers.

Description of the Problem

The patient demonstrates many personality traits that could be indicative of a

variety of disorders. Scott seeks attention every opportunity he gets, and this

often interferes with his ability to function in his job as manager. In addition to

attention-seeking, Scott often interrupts his subordinates from working to discuss

his personal life. This behavior not only affects his ability to work, but it

interferes with the overall productivity of the office. It is Scotts belief that he

should not be seen as just a boss, but more of a close friend and even family

member, to the dismay of his subordinates. This expectation of a close bond

leads Scott to display rapidly shifting emotions, from exuberant and hopeful, to

depressed and hopeless. There seems to be a lack of consistency in his behavior,

rather a dramatic shift from extremely happy to irreversibly sad. In Scotts

depressed state, he feels as if the entire office should be focused on his problem

and that others problems pale in comparison, such as his birthday being of more

importance than a coworkers cancer scare. When he is happy, however, work at

the office ceases to a halt, as his well-being is put before the needs of the

company. In addition to his attention-seeking and rapidly shifting emotions, the

patient is easily suggestible and is often the victim of pyramid schemes and

persuasive coworkers. Scott also shows a pattern of theatric behavior, including

different characters, voices, and personalities, in which he uses as distractions on

a constant basis.