Article Summary Reports
Title Page
Client Background: Describe all of the key background points about the person/patient based on the information provided. What information would you like to know more about?
Abnormal Behavior: Describe how and why this behavior is considered abnormal (i.e., the 6 criteria from chapter 1)
DSM Classification: Describe the official diagnosis. Match the case symptoms with the diagnosis.
Describe the Treatment Plans. What are some other possible interventions based on your chapter?
Conclusion: What did you learn from this real case about abnormal psychology?
Citations. If you use resources other than course materials, please cite that reference appropriately using APA style (author, date). The paper must be at least 2-3 pages in length (not including cover and reference page) and must be doubled-spaced, 12-point font, and submitted on a Microsoft Word document
Review: Opioid Use Disorder (DSM-5 Criteria – APA, 2013)
Problematic pattern of opioid use leading to clinically significant impairment or distress, with at least two of the following within a 12-month period:
1. Opioids taken in larger amounts over a longer period than was intended (high usage rate)
2. Persistent desire to cut down or unsuccessful attempts to cut down or control opioid use (can’t control it)
3. A great deal of time spent on activities trying to get the opioid, use it, or recover from it (high time allocation)
4. Craving, or strong desire to use opioid (psychological dependence).
5. Recurrent use of opioid disrupting major responsibilities or obligations (Obligations Disrupted)
6. Continued use despite problems caused by opioid use (substance abuse)
7. Important social, work, or recreational activities stopped due to opioid use (stopped normal functioning)
8. Repeated use of opioid in physically hazardous situations (dangerous settings)
9. Repeated use despite knowledge of having persistent problems due to opioid use (self-aware/knowledgeable of problem)
10. Tolerance established (high tolerance)
11. Withdrawal symptoms and signs noted (withdrawal)
Here is the real case.
Case 26-2019: A 27-Year-Old Woman with Opioid Use Disorder and Suicidal Ideation
Nisavic Mladen (Links to an external site.); Flores, Efren J (Links to an external site.); Heng, Marilyn (Links to an external site.); Kontos, Nicholas J (Links to an external site.); Quijije Nadia (Links to an external site.). The New England Journal of Medicine (Links to an external site.); Boston Vol. 381, Iss. 8, (Links to an external site.) (Aug 22, 2019): 763-771. DOI:10.1056/NEJMcpc1904043
Presentation of Case
Dr. Andrew Cruz (Psychiatry): A 27-year-old woman was evaluated at this hospital because of a suicide attempt.
Approximately 3 months before admission, the patient became homeless and was staying intermittently with friends. Two months before admission, she began to ingest clonazepam daily, and 3 weeks before admission, she began to use intranasal heroin daily. She had depression and anxiety, and 2 days before admission, she expressed that she felt tired of living this life and wanted to end it all.
On the evening of presentation, the patient reportedly smashed her cell phone on the ground and ate the glass shards as a suicide attempt. Nausea and diffuse abdominal discomfort developed, and she reportedly had an episode vomiting, with the vomit containing 2 teaspoons (10 ml) of blood. Three hours after the ingestion, she presented to the emergency department of this hospital with throat, chest, and abdominal pain. She reported that she had regret about the ingestion and wanted help with her substance use and suicidality.
The patient reported past sexual trauma but did not provide details; she did not report any previous suicide attempts, homicidal ideation, or hallucinations. A limited review of systems was notable for anorexia, diaphoresis, diarrhea, impaired sleep, fatigue, mood lability, nightmares, and flashbacks. Her psychiatric history included polysubstance use disorder (with the use of intravenous heroin, fentanyl, benzodiazepines, and cocaine), cutting behavior during adolescence, and anxiety and depression. She had never undergone psychiatric treatment or hospitalization. Her medical history included hepatitis C virus infection, obesity, genital herpes simplex virus infection, and a low-grade squamous intraepithelial lesion of the cervix; in addition, a motor vehicle collision had led to open reduction and internal fixation involving the left arm. She took no medications and had no known adverse reactions to medications. She worked in a local store and had a small child. She had smoked one and a half packs of cigarettes daily for the past 10 years and was a current smoker. She drank 1 pint of vodka daily and reported no history of withdrawals or blackouts. Multiple relatives, including both of her parents, had a history of substance use disorder.
On examination, the temperature w
