Name : Howard Robard Hughes, Jr.

Gender : Male
Date of Birth : December 24, 1905
Date of Death : April 05, 1976
Chronological : 70 years, 3 months
Occupation : Entrepreneur, Aviator, Aerospace Engineer, and Film Maker
Educational : Elementary graduate, High School undergraduate, College drop
Status out
Civil Status : Married
Nationality : American
Ethnicity : White
Religion : Episcopalian

I. Reason for Referral
Howard was referred because of the chronic pain he was enduring due
to injuries he sustained after an airplane crash. He was also suffering from
severe case of obsessive compulsive disorder. He was very indecisive,
obsessed with trivial details, had frequent mood swings, and was
unsuccessful in maintaining a relationship.

II. History of Present Illness
 Present concern [OCD]: Symptoms/manifestations, frequency, severity
& duration
o He has compulsions.
 He frequently, compulsively needs to wash his hands.
 He always drinks milk with the cap of the bottle still on.
 He, sometimes, cannot help but keep on repeating
 “The way of the future”
 “Show me all the blueprints”
o He will not eat something he considers dirty.
o He refuses to shake hands.
o He refuses to touch objects without the use of tissue papers or
o He worries too much.
 An example would be when he bugged Ava Gardner’s
house, including the telephones.
o He was obsessed with making and ensuring that all rivets on a
plane they were constructing were flushed flat into the surface.
o He compulsively burnt all of his clothes in the middle of the
o He was seen hoarding.
 He was hoarding his used tissue.
 He was using milk bottles to collect his urine, and was
keeping them in display in perfect lines.

or stressor.  Effect of illness on patient’s life o At first. o The shock he received from the accident may have also been a cause. it was noted by most that. the patient is thought how to properly respond to their obsessive thoughts without resulting to their compulsions. it is hard to say whether or not he already had any mental illnesses. III. o He was also experiencing a lot of stress in life. and interpersonal relationships (not all of the stressors occurred at the same times). Past Psychiatric History As there was not much known about the childhood of Howard Hughes. it may have been hard on him to sleep and complete his daily functions (Nolen-Hoeksema. triggers. or conditions at that time. he seemed to have been able to cope however. o It seemed like he was aware that he had a problem. possible causes. as his stressors kept on piling. coping o His mom was hinted to be mysophobic. o He seems to have fluctuating episodes. including his accident. he found it harder to cope. o His OCD began to intensify after his accident and after experiencing other professional and personal problems. trigger. the death of his parents. sertraline.  Relationship of the psychological illness to current medical status o His psychological illness has made his physical health decline. This probably caused his compulsions worsen. stressors.  Events related to the presented problem. his problem with his relationships. as a child. 2011). However. and fluvoxamine)  Atypical antipsychotic o Behavioral  Exposure and Response Prevention Therapy (ERP)  Repeated exposure of the client to their obsessions and compulsions to prevent compulsive responses to anxiety o Cognitive Therapy  Through this. As he frequently worries over every little thing and often has compulsive thoughts. He even isolated himself inside his home theatre. paroxetine.  Treatments o Biological  Antidepressants (Clomipramine)  SSRIs (fluxetine. because there were times where he seemed to be able to function properly. This may indicate . and his work.  Stresses may be a large inheritance. his mother instilled unto him her phobia for germs. too much work. disorders.

 He had an obsessive-compulsive disorder  He had unpredictable mood swings due to his disorder. His date of birth was uncertain but he claimed that it was Christmas Eve. 2010).  He developed an addiction to codeine. play with other kids. Eventually. that he already had mysophobia when he was a child. Mysophobia and his reclusion may have worsened to a point where he eventually developed OCD. 1905. In addition to this. and a foot injury. whose mysophobia and suffocating love isolated him from others. 1869 – January 14. as he grew older because of the amount of stress he faced (Howard Hughes. He did not have similar emotional equipment as other children had. Howard Jr. it was noted that even as a child Howard Hughes was extremely recluse. Family History Howard Robard Hughes. She made sure that Howard Jr. During his childhood. there were no emotional and social foundations laid for him. his parents were by his side. Howard’s father was mostly absent in his life. he was not allowed to run around. He only followed orders from his parents.  He experienced a fatal airplane crash to which he sustained significant injuries such as a crushed collar bone. was the only child of Allene Stone Gano (July 14. 1922) and Howard Robard Hughes. (September 9.’s body was always clean. and possibly a personality disorder. This was because of his mother. He was raised in an atypical manner.  He experienced chronic pain. Medical History  He experienced a plane crash which caused a severe gash on the top of his head. IV. Sadly. She would always check her son’s body and wash it thoroughly. His aunts signed his affidavit birth certificate stating that he was born on December 24. and numerous third-degree burns. The closeness of Howard with his mom left no room for friends. Sr. His father was also a philanderer. 1924). sometimes referred as health phobia or health anxiety. and get dirty. multiple cracked ribs.  Kidney failure was the cause of his death. Jr. a crushed chest which caused a collapsed left lung. Every time he was sick. He grew up as a shy and awkward man and did not have much social skills. 1883 – March 29. while his father was an American businessman who died at the age of 54 due to a heart attack. VI. V. His mother died at the age of 38 due to complications of ectopic pregnancy. developed hypochondria. But . He was not taught to socialize with other children. Howard’s mother had mysophobia. Personal History Howard was born as the only child of his parents.

Hughes inherited 75% of the family fortune and was declared an emancipated minor. When he was 11 years old. he attended Rice University but he dropped out when his father died. While from 1946-1949. 1947. he made another transcontinental record which was the greatest long distance speed flight from Los Angeles and Newark of 7 hours and 28 minutes. When he was 12 years old. In 1936. doubling the rate of fire. flying. Hughes Aircraft built the fastest plane as Howard sets a new land speed record of 352. he developed and tested the first retractable landing gear and flushed rivets to streamline airplane in the future. he perfected the power-boosting radio receivers and transmitters in contemporary aircraft. 1935. he was inspired to include the creation of a medical research laboratory in his will at age 19. at age 15. Massachusetts. From 1941-1943. he designed the first cost-effective routes to Europe and South Pacific. he again sets new speed record in transcontinental travel from Los Angeles to Newark with 9 hours and 27 minutes. he climbed back into the XF-11 for a successful test flight. 1905. he was enrolled in an exclusive Fessenden School in West Newton. In 1939. Later. Howard proved that high-altitude flying greatly increases airspeed through death-defying flights. Howard Hughes was able to contribute a lot for the advancement of aeronautics and engineering in the field of aviation. With the death of his parents. he was enrolled in Thacher School in Ojai Valley. At a very young age. California. California. he designed and perfected an oxygen feeder that enhanced pilot safety during high-altitude flights. as a principal shareholder of TWA. He graduated in the latter mentioned school at the 8 th grade. his father decided to remove him from the school. 1937. he founded Hughes Aircraft Company in Glendale. In 1935. At an early age. he proved the critics wrong when he was able to make the Hercules (HK-1) fly .46 mph at Santa Ana. Then. He also opened a new frontier for commercial aviation. he was featured in a newspaper for building a motorized bicycle. he liked mathematics. In January 1936. But when his mother died. He took his first flying lesson at age of 14. In January 19. When he turned 20. California. Howard was enrolled at Prosso Elementary School in Houston. 1938. 1947. In 1932. he built the first Houston’s first radio transmitter out of an electric doorbell. in the Silver Bullet. After which. From July 10-14. he begun to film his own movie and got married to a woman. Howard flew around the world for 3 days with a new world record of 19 hours and 17 minutes. and mechanical things that made him indifferent to other students. his birth was listed as September 24. On September 13. he designed revolutionary ammunition feed chuted for 50-caliber machine guns. enabling him to take full control of his legacy at an age of his baptismal record at Iowa. he became known for his skills in mechanical engineering through his creation of aircrafts. Two year later. In November 2. At age 14. he was enrolled at South End Junior High in Houston. Then. Howard showed great ability in engineering. In April 5. eventually.

Then. From 1941-1956. and Scarface. and date . Two Arabian Knights. Aviation Hall of Fame was given to Howard in 1973. After several years. Outrage. he produced Sins of Harold Diddlebock. Terry Moore claimed to have been secretly married to Howard in Mexico in 1949 and never divorced but it was alleged. 1971 in Hawthorne. he received Octave Chanute Award in 1940 for his outstanding contribution as a pilot to the advancement of arts. from 1959-1964. Howard Hughes was also able also to contribute to the improvement of movie making. He also received Congressional Gold Medal in 1941 in recognition of his achievements in advancing the science of aviation and thus bringing great credit to his country and throughout the world. Son of Sindbad. The French Line. In May 1948. Susan Slept Here. Underwater. science and technology. Then. In 1936 and 1938. Angel Face. The Front Page. and invented and mass produced the navigational control system of the F-102 interceptor.000 employee powerhouse that includes Hughes Electronics and Hughes Helicopters. Around 1940. The Age of Love. produce movies. These were Swell Hogan. Nevada Business Hall of Fame was awarded to Howard. he developed the “all-weather Interceptor”. Androcles and the Lion. he built Hughes Electronics into the single largest supplier of weapons systems for US Air Force and Navy. he conceived and manufactured the “air-to-air missile”. Sky Devils. He produced movies of his own from 1949-1957. Just this 2003. While his interests were to play golf. One Minute to Zero. Vendetta. He also received the American Legion Award in 1952. Howard never had a child. Where Danger Lives. He again got married to Jean Peters on January 12. Collier Trophy was given in 1938 to Howard and to his crew for their successful around the world flight. The Whip Hand. Macao. Best of the Bad Men. His Kind of Woman. Nevada. and The Jet Pilot. The Conqueror. 1957 but they got divorced on June 18. Double Dynamite. Howard’s hobbies were to design aircrafts and fly them in the sky. Stromboli. In 1947. Fast and Beautiful. He produced The Outlaw in 1943. he pioneered and produced the unmanned satellite prototypes. Cock of the Air. but they got divorced on December 29. International Aerospace Hall of Fame was awarded to Howard in 1987. The Racket. Howard took control of RKO Pictures. 1925 he got married to Ella Rice in Houston and decided to live in Los Angeles. Two Tickets to Broadway. In 1960. from 1950-1956. From the years 1932 – 1962. Flying Leathernecks. The Hell’s Angels. he does transactions with different people. On June 1. Howard kept on producing movies. Moreover. Gambling House.for less than 60 seconds. play the saxophone. he built Hughes Aircraft from a 4 man operation into an 80. and aeronautics. Back in 1949. Hard. Road Block. In his everyday living. Everybody’s Acting. Howard built TH55A helicopter. 1929. Howard received a Harmon trophy for being an outstanding Aviator. The Las Vegas Story. My Forbidden Past. Then. These movies were The Big Steal. The Mating Call. Holiday Affair.

He hires people who have nowhere to go and who no one would accept. The stress experienced by Howard Hughes from inheriting a large company after being orphaned worsened or caused the onset of OCD. and a major drug addict. women. Howard Hughes was reportedly upset by matter that he wrote a detailed memorandum to his crew on how to fix the problem. an anti-Semite. Biopsychosocial Formulation BIO Genetics: Research suggests that genes can play a role in the development of the disorder. Another trait which is sometimes associated with OCD is perfectionism. a paranoid madman. VII. in his book. PSYCHO Personality traits: Research has shown that several general personality traits may be linked to some forms of obsessive-compulsive disorder (Summerfeldt & Antony. an anti rabid communist. He also revealed that Hughes was having unpredictable mood swings. a political briber. particularly when it entails excessively high or rigid standards for oneself. Moreover. there is still a good side to him. people with OCD often report increased obsessions and having a greater difficulty resisting compulsions. His favorite movie was Ice Station Zebra. ice cream. One of these is anxiety. 2002). Hughes’s mother was noted to have an obsession with germs. . or the predisposition to be made anxious more easily or more frequently. steaks. 2002). There are strong evidences proving that obsessive-compulsive disorder runs in families (Summerfeldt & Antony. During stressful periods. Life Experiences: Life stress situates people with OCD at risk for worsening of their symptoms (Summerfeldt & Antony. a consummate playboy. Fleischer explained that Hughes was fixated on trivial details and was alternately indecisive and obstinate. But despite his undesirable traits. and Hershey chocolates. which he may have inherited. 2002). a shrewd and cunning businessman. This industry placed him in stressful environments composed of high-cost contracts under time constraints that could have worsen his symptoms. In line with this. He also loves milk. Howard Hughes reported symptoms seemed to coincide with his entrance into the aviation industry where there is a need for perfection. He is a kind and gentle person. He helped the people around him in financial aspects. Howard was known for being an exaggerated nationalist. Just Tell Me When to Cry. even to the extent of helping them in their medication and bailing them when needed.

Obsessive-compulsive-related disorders (OCRD) and a range of disorders share characteristics with OCD (e. in symptom profile. he was not taught to socialize with other children. eating disorders and impulse control disorders such as trichotillomania (hair pulling) (OCD. Comprehensive Treatment Plan Obsessive Compulsive Disorder can be treated or managed with behavioral therapies which would decrease the compulsive behaviors.d. VIII. Howard’s childhood was rife with poor grades and poor social skills. 2002). more ways of treating OCD has been discovered such as Electroconvulsive therapy and psychosurgery. Also. X. Differential Diagnosis The main differential diagnosis is depression and many patients with OCD have comorbid depressive symptoms. . as a result. The symptoms of OCD are seen in other conditions such as Tourette's syndrome. there are drugs that can be taken for treatment. obsessive or anakastic personality and occasionally schizophrenia. Some examples would be parocetine and sertraline. Multi-Axial Diagnosis Axis I : Obsessive Compulsive Disorder : Generalized Anxiety Disorder : Specific Phobia : Opiod Dependence Axis : Paranoid Personality Disorder II Axis : Chronic Pain. biology and treatment outcome). hypochondriasis (concerns about imagined illness). the treatment given to him was not specified. However. In modern times. autism and frontal lobe lesions. In Howard Hughes case. SOCIAL Several studies have reported that anxiety is associated with a lack of social connections and a sense of a more threatening environment (Summerfeldt & Antony. Also. left no room for his friends. n. He did not have much social skills because of the closeness he had with his mother which. OCRDs include body dysmorphic disorder (BDD - concerns of imagined ugliness). it can be seen that he was given mild behavioral therapy indirectly. Hence. He did not have the same emotional equipment as other children had.g. anorexia nervosa. Other differentials include phobic disorders.). currently self-medicating with Codeine III Axis : Psychosocial stressors: ongoing legal case IV Axis : Current GAF: 40 V IX.

2013 from http://health. Retrieved August 20. However. S. In the movie "The Aviator". disorder/riskfactors. His OCD continued until his death. Behavioral therapy is a technique wherein the patient is gradually exposed to his or her anxiety and is expected to respond to it accordingly.wordpress. this did not stop Hughes' OCD. (2011). Howard Hughes was gradually exposed to what to his perception was an unclean sink. where Ava told him to wash his face. (2009).). Howard Hughes was shown with Ava Gardner doing a mild behavioral therapy. (n. (2011). J.M.). References Howard Hughes. Retrieved August 20. Howard Hughes: Madman or genius? [PowerPoint slides].).uk/for-health-professionals/ocd- guide/differential-diagnosis-and-screening-questions/ Rojas.stjoes.html . L.nhs. Abnormal Psychology (5th ed. not for his OCD.. (2013). M. 2013 from Summerfeldt. OCD: Differential diagnosis and screening questions.nytimes. from http://www. & Antony. theoretical-casestudy/ Nolen-Hoeksema. passions and mystique.swlstg-tr.d. Retrieved August 20. (2002). The legendary Howard Hughes: His genius. visions. (2010). Philippines: Mc- Graw Hill Education (Asia).webs.htm Obsessive-Compulsive Disorder. 2013 from http://edufracked. He was told by Ava that nothing in this world is clean. a Theoretical Case Study.wikipedia. 2013 from http://en. South West London and St. Retrieved from http://prezi. XI. Retrieved September 3.d. Retrieved August Howard Hughes. (n. Retrieved from http://hrhughesjr. it was told he was taking other drugs to reduce chronic pains.J. M. Obsessive-Compulsive Disorder (OCD). Also.