Siena College of San Jose

City of San Jose del Monte, Bulacan

VAL ED 18 Midterm Exam

Name: ___________________________________ Course & Year: ___________________ Date:____________________

CASE ANALYSES. Answer the following questions substantially. Make sure to elaborate your answers (20 points each)

A. Rick, age 15, Grade 10 student

In elementary school, the other children had whispered about Ricks rituals. He had placed his books under his chair in
the same spot every day. His pencil always had a sharp point and was positioned at the top of his desk, exactly in the
middle. An eraser was kept on the upper right had corner, not too close to the edge. His papers always were arranged
carefully in the middle of his desk. This has continued in secondary school. As a secondary school student, Rick has few
friends. He doesnt like having visitors to his house because it takes too much effort to put things back in order after they
leave. He experiences a lot of anxiety at school when furniture and equipment are moved in his classrooms, or there is
an unanticipated change in routine. Rick takes a long time to get from one class to another and is frequently late for the
start of class. He is easily upset when other students come close to his desk; some of the other students have noticed
this and take pleasure in teasing Rick by threatening to mess up his papers. Consequently, he frequently watches the
clock and begins to pack up his belongings several minutes before the end of the period. Lately, he has been missing a lot
of his classes, reporting that he wasnt feeling well. Formerly a high achieving student (on the work that he handed in),
he is now handing in even less work than previously and is in danger of losing his credits.

Questions:
1. What more do you need to know to help Rick? How will you get this information?
2. Which of Ricks behaviors are suggestive of an anxiety problem?
3. What specific steps will you take to assist him?

B. Marcia, age 14, Grade 9 student

Marcia has just started grade nine at your school. In her first semester she attended a school in another town. She is
vague when asked about her past, but you get the impression that she has moved around a lot and attended several
elementary schools. Youre not sure how capable she is academically, because she produces very little work. Much of her
time in class is spent with her head down on her desk, or looking out the window, or sketching in a notebook that she
always carries with her. When you approach her desk, she covers the notebook with a textbook and pretends to be doing
what the class is supposed to be doing. When called upon to answer a question, Marcia nearly always has the correct
response, but delivers it in a few words and with no feelings. She generally avoids the other students, but has been
seen talking with her classmate Margaret. Marcia does not go to the canteen to eat her lunch, but rather sits in a corner
of the library by herself. The librarian has noticed that Marcia tends to read dark and heavy literature.
One day, Margaret comes to see you at the end of the day to say that she is very worried about Marcia. Marcia had
allowed her to look at her sketchbook, and Margaret was alarmed by what she saw.

Questions:
1. What more do you need to know to help Marcia? How will you get this information?
2. Which of Marcias behaviors are suggestive of a mood disorder?
3. What kind of mood disorder does Marcia seems to have?
4. What specific steps will you take to assist her?
 C. Kathy, age 29

In 2005, a dissociative identity disorder case study of a woman named "Kathy" (not her real name) was published in
Journal of the Islamic Medical Association of North America.

Kathy's traumas began when she was three. At that age, she would have terrible nightmares during which her parents
would often entertain leaving the child to cry for hours before falling asleep only to awake a few hours later frightened
and screaming.

At age four, Kathy found her father in bed with a five-year-old neighbor. At that time, her father convinced her to join in
on the sexual activity. Kathy felt guilty and cried for several hours only stopping once she began to attribute what had
happened to an alternate personality, Pat. Kathy would insist on being called Pat during the abuse the father committed
for the next five years.

At age nine, Kathy's mother discovered Kathy and her father in bed together. Her mother insisted on the child sleeping in
her bed every night, thereafter leading to a sexual relationship with the child. Kathy could not accept this and created
another identity, Vera, who continued the relationship for another five years.

At age 14, Kathy was raped by her father's best friend and began calling herself Debbie. At that time, she became very
depressed and mute and was admitted to a hospital.

According to the case study, "she showed a mixture of depression, dissociation and trance-like symptoms, with irritability
and extensive manipulation which caused confusion and frustration among the hospital staff."

At age 18, Kathy became very attached to her boyfriend but her parents forbid her to see him. Kathy then ran away from
home to a new town. However, she could not find a job and her need of money drove her to prostitution. She began to
call herself Nancy at this point.

The alternate personality Debbie, rejected Nancy and forced her to overdose on sleeping pills. It was then that Kathy was
admitted to a psychiatric hospital and was diagnosed of a dissociative disorder.

Kathy is now 29, married, and continues to struggle with mental health problems that include dissociative episodes.

Questions:
1. Which of Kathys behaviors are suggestive of a dissociative disorder?
2. What kind of dissociative disorder does Kathy have?
3. What specific steps will you take to assist her?