Christian Garner

Abnormal Psychology
Case Study Sonny
1

Case Study: Sonny

Diagnosis and Criteria

In the case of Sonny Ford, who is a 21 year old Caucasian male. The diagnosis that

should be given according to his symptoms and the case evidence is the Schizophrenia disorder,

295.90 (F 20.9) in the DSM-5.

In the DSM-5 there are various criteria within in order to have the Schizophrenia

disorder. Criterion A states that the individual must have two (or more) of the following, where

each of them are present for a significant portion of time during a period of one month (or less if

treated successfully). At least one of these following must be present; delusions, hallucinations,

or disorganized speech such as incoherence. Other symptoms part of this criterion is if the person

is grossly disorganized or have negative symptoms.

Criterion B stated that for a portion of the time of the onset of disturbance, level of

functioning in one or more of following areas; work, interpersonal relations, or self care is below

the level achieved prior to onset.

Criterion C states that a continuous signs of the disturbance is persist for six months.

During this six months it must include at least one month of symptoms (or less if successfully

treated) that meet Criterion A (active phase) and may also include periods of prodromal

symptoms. During these prodromal symptoms the signs of distribution may only be manifested

by negative symptoms or by two (or more) symptoms listed in Criterion A.

Criterion D states that the Schizoaffective disorder and depressive or bipolar disorder

with psychotic features have been ruled out because of the following one or two reasons. One

being no major depressive or manic episodes have occurred concurrently with the active phase

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 Christian Garner
Abnormal Psychology
Case Study Sonny
2

symptoms. Second reason being if the mood episodes have occurred during active phase

symptoms, and have been present for minority of the time during the active and residual periods

of illness.

Criterion E states that the disturbance is not attributed to the physiological effects of a

substance (drug abuse) or another medical condition.

Criterion F states that if there is a history of autism spectrum disorder or communication

disorder of childhood onset, then the additional diagnosis of schizophrenia is made only if

prominent delusions or hallucinations are present. In addition to the other required symptoms of

Schizophrenia, the symptoms must be present for at least one month (or less if treated

successfully).

In the case of Sonny, he meets majority of the criteria in order to be diagnosed with

schizophrenia. Within Criterion A, Sonny has dealt with his symptoms of delusions and

hallucinations for more than one month, especially after partaking in marijuana. Some of these

delusions were thinking that people were coming after him or authorities are trying to catch him

in homosexual acts. The hallucinations that Sonny was having were voices in his head. He knew

they were in his head but he could not make out what they we saying to him. Also when

watching some television shows Sonny believed that they were telling him that the authorities

were out for him. As Criterion B stated, before the time of onset the individual must have

disturbances in functioning prior to the onset of symptoms. Sonny in fact did have this, he was

struggling with part time jobs of keeping one and also problems within his own family, mostly

his mother who was not accepting of him and his homosexual orientation. Sonny does meet

Criterion C, he has dealt with his symptoms for more than six months in fact Sonny has dealt

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 Christian Garner
Abnormal Psychology
Case Study Sonny
3

with symptoms of hallucinations and delusions persisting past six months after smoking

marijuana. More so Sonny also holds prodromal phases which his symptoms slowly and

gradually developed, and then eventually moved into the active phase. The Schizoaffective

disorder and depressive or bipolar disorder has been ruled out because Sonny has it suffered from

any manic episodes nor depressive episodes have occurred while the active phase was in effect,

which is stated in Criterion D. Within Criterion E, Sonny did smoke marijuana which may in fact

develop his symptoms more severely. He would meet this criterion because the marijuana is not

attributable to physiological effects nor was the marijuana abused by Sonny.

In Criterion F, Sonny does have a history of being distant from others in society, but not

officially diagnosed with communication disorder. Sonny does hold schizophrenic symptoms

lasting more than one month.

Contributing Factors

In the case of Sonny he has been struggling with his symptoms for two years. Some of

these symptoms being difficulty concentrating, anxiety, and obsessive thinking. One year prior to

his admission Sonny's symptoms began to worsen after smoking marijuana his freshman year in

college. This substance could have affected him psychologically and socially, which can also be

a potential risk factor for this patient. When Sonny smoked marijuana his delusions and

hallucinations began to progress and surface. The patient believed that when he smoked the

marijuana his mind was “warped” and permanently damaged. Although there is no psychological

theory proposing that schizophrenia develops as a result of psychological phenomena I believe

that the marijuana in fact affected Sonny psychologically. His cognitive thinking was not as

sharp as it was before, and he was emotionally unstable, which I believe was a result from his

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 Christian Garner
Abnormal Psychology
Case Study Sonny
4

adoptive mother not accepting him. Sonny was already withdrawn from society, as he was

growing up he was a loner and until now he has no friends. I believe when he smoked the

marijuana it increased his paranoia and made him more distant from society. More so, two years

prior to admission Sonny had troubles with part time jobs. He held a janitorial state position for

seven months until his symptoms worsen, and then his attendance at work became sporadic to

none. The marijuana played a major effect on Sonny's thinking, work ethic, and paranoia.

Socially as stated before his adoptive mother was not as accepting of him like his father was.

Sonny had homosexual tendencies that his father knew about as well as his mother, but she

would verbally abuse him by calling him “fag”. These homosexual tendencies began at the age

of 16, where he accepted his sexual orientation, but feared contracting a disease such as HIV. I

believe that since he has accepted himself as well as his father, but not his mother this added

distress among Sonny. Sonny was adopted and raised in a household of four girls that were older

and also adopted. He can recall very few memories, but the ones he does pertained to is with his

adoptive father. I believe this failed memories of his family as a whole might also play a

contributing factor for Sonny. His adoptive mother was an alcoholic and had a critical demeanor

about her that affected Sonny’s self-esteem in a negative way. Because of his mother's intense

criticism he was hypersensitive to any real or perceived criticism in school or with other people

in the community. With this information at hand I do believe that his family is a risk factor for

him that may have influenced development of the disorder.

Some possible protective factors that may have influenced Sonny is moving out of his

adoptive parents’ house and community and going to a local college. Although Sonny had

difficulties with social interactions I do believe him leaving his parents’ house was a good

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 Christian Garner
Abnormal Psychology
Case Study Sonny
5

decision for the simple fact that his only support system was his father, whereas his mother was

abusive verbally and not supporting. In addition, Sonny did not complete college rather than

going back to his parents he went and moved into his sister's house to get away from the people

after him. Sonny was quite paranoid and had hallucinations after partaking the marijuana, he

believed that the FBI/CIA were after him and people were talking behind his back. No one

believed Sonny that the marijuana had this effect on him, which is why he moved to his sister's

house to get away from those coming after him.

Assessment

Within the case study there were some factors that were missing that should have been

discussed in the case. The first thing that should have been discussed in more detail is his family

origin/background. Although Sonny was adopted at birth there was no records available about his

family origin. I would collect this information because maybe his birth parents may hold similar

symptoms like Sonny, or in other words have similar medical conditions as Sonny. Another

factor that was missing within the case study was why Sonny cannot cope with crowded areas or

completing required test or homework while he was in school or in other words why does he get

socially frustrated. Why does having too many bodies affect his functioning in class? Why is he

unable to complete required assignments given to him? Finding answers to these questions may

show underlying problems within Sonny that could be biological or even psychological. By

getting these answers I would do a structured interview because it would give me more closed

ended answers rather than open ended. I would prefer this over unstructured interviews for the

fact that when Sonny was doing his intake evaluation his answers to the doctors questions were

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 Christian Garner
Abnormal Psychology
Case Study Sonny
6

seeming off and not actually answering the questions at hand. For example the doctor asked

Sonny, “What were some difficulties that you needed help with?” Sonny would reply with “I

think it was the marijuana”. Although the advantages to having an unstructured interview would

provide more personal information from the client, I do not believe this would be beneficial to

Sonny during the assessment phase.

Using the DSM-5 section three this will help determine Sonny's severity of his symptoms

that he has. His hallucinations as well as delusions are two main factors that seem to be

preventing Sonny to carry out his day. Using the DSM-5 section three it will help me decide on a

treatment plan for Sonny based on his severity of symptoms.

Other important information that would be portent to obtain for Sonny’s case that was not

obtained was if Sonny was having suicidal tendencies or thoughts as well depressed. Usually the

LGBT community has a high risk for suicidal thoughts and tendencies. In Sonny's case although

he did not admit he was suicidal there were something's that could make him suicidal. For

example his mother not accepting him could provoke him to having suicidal thoughts. More so

although Sonny could not hear the voices in his head if these symptoms progressed they may

become more clear telling him to do harm to himself. These factors need to be addressed more to

get the whole picture for Sonny's case. To obtain this information I would administer a

psychological standardized test. This test would mainly have questions pertaining to suicide and

rating his answers on a scale. As stated before, in the case if Sonny depression was not

mentioned. Also Sonny does suffer from anxiety but the case did not mention how severe. This

needed to be touched more because these two factors could be results of schizophrenic symptoms

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 Christian Garner
Abnormal Psychology
Case Study Sonny
7

he is having. The two test these I would administer a MMPI test or personality test. These tests

would rate Sonny's depression levels and anxiety levels and will tell his severity of both of these.

Treatment

To treat the case of Sonny there are various things that could be done to help treat his

symptoms and help ease him. I believe that Sonny could be a part of outpatient treatment with

medication. This would be more beneficial to Sonny rather than inpatient because his symptoms

are not so severe where he cannot function day to day. Although Sonny’s attendance at work is

sporadic and his has problems holding a job I believe that having outpatient treatment with

therapy sessions and medication could help him get back to functioning. I believe the medication

will help treat his hallucinations and delusions that he is having. The two types of psychotherapy

I believe that should be used is group and family therapy. I do not think individual therapy would

be effective on Sonny because he has social withdrawal and if he is doing therapy with one other

person (doctor) I do not think Sonny would be open to it. In group therapy I believe people with

the same conditions should be a part of the therapy session. Since Sonny is gay I think fellow

gay people who are suffering from similar symptoms and conditions would be beneficial to

Sonny showing him he is not the only one. With family therapy the main focus would be on

Sonny and his mother. Getting the background information on why Sonny’s mother does not

accept him and why. This would be beneficial for Sonny on getting answers on why his mother

treats him this way and maybe the mother will understand on how Sonny feels as well.

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