[Note that your case study should be double-spaced,
but the Web format does not allow me to double-space.
|Pseudo S. Tudent|
|December 5, 2003|
Case Study - Fox Mulder
[In this section, you should try to state, very briefly, what the person would say if they decided to come to a psychologist for help, or if they were forced to go to one for evaluation. You should attempt to present the problem as the client would see it. Use the client's own words, if possible. If the client would not see him/herself as having a problem, tell me what you think he/she would say in response to being forced to see a psychologist. Do not provide information about history, prior treatment, or interpretation in this section.]
Mr. Mulder indicated that he had come to see me at this insistence of his partner, FBI agent Dana Scully. Mr. Mulder stated that he felt that he was functioning pretty well "under the circumstances." He indicated that he was under a great deal of pressure in his job due to the fact that he had uncovered a government conspiracy to conceal evidence of an alien invasion. He admitted to feeling very stressed in his job, and to having a lot of anxiety over both the government conspiracy and the alien invasion.
History of the Presenting Problem
[This is where you provide the "case history." This should not be just a biography of the patient; essentially, it should be a biography that focuses on the details of the patient's life that appear to be relevant to the presenting problem, or to your ultimate diagnosis or your case formulation. In general, you should present your information in chronological order, starting with relevant information about the client's childhood and working up to the present time. If the person has specific symptoms related to the disorder, be sure to indicate when they started to appear and how they were dealt with at that time.]
Mr. Mulder indicated that his outlook on life was changed forever by an event that happened in his childhood. When he was eight years old, his sister, who was then six, disappeared. No body was ever found, and she was never seen or heard from since that time. Mr. Mulder became convinced that his sister had been abducted by aliens. Since the time of his sister's abduction, he has largely devoted his life to trying to find her, and to prove the existence of aliens on this planet. He indicated that from elementary school on, people have thought of him as "very intense and very odd." In high school he earned the nickname of "Spooky Mulder." He ultimately attended Oxford University, in England, where he majored in psychology. He also focused on learning anything he could that might help him to find his sister.
Upon graduating from college, Mr. Mulder joined the F.B.I., which he thought would afford him more connections and opportunities to investigate the circumstances surrounding his sister's disappearance. He indicated that, while solving many cases for the F.B.I., he had also earned a reputation as a "maverick" and a trouble maker. He was ultimately assigned to investigate particularly unusual cases that had elements of the paranormal; this group of cases came to be known as the "X-files." He believes that the F.B.I. assigned him to these cases largely to get him out of the way and keep him out of trouble. The F.B.I. also assigned him a partner (his current partner, agent Dana Scully) for his work on the X-files whom he describes as "very straight-laced and uptight." Mr. Mulder believes that Agent Scully was initially assigned to "watchdog" over him and keep him out of trouble. However, he indicated that they have formed a very solid friendship in the four years they have worked together. However, Agent Scully appears to have been unsuccessful at keeping Mr. Mulder out of trouble. Since working together on the X-files, both agents have been reprimanded several times, and both have been suspended more than once from their jobs. A month ago, Mr. Mulder was been placed on indefinite suspension for disregarding orders to cease work on the X-file investigations. Agent Scully continues to work for the F.B.I., although she has been reassigned. Mr. Mulder indicated that he has felt more stress since being placed on suspension, and has felt pretty down about it. He said that his job, and in particular, the X-files investigations, were the most important things in his life. He has continued to maintain contact with Agent Scully, and it was she who encouraged him to seek counseling.
On questioning, Mr. Mulder indicated that he has felt very "down" for the past month. He said that he has often felt like crying, although he has not actually done so. He indicated that he has mostly stayed in his apartment, often staying in bed all day. He said that things just aren't very enjoyable to him any more. (He also indicated, however, that he had never been a very cheerful person. He felt that he had been chronically, mildly unhappy since the time of his sister's disappearance.) Mr. Mulder indicated that he has had thoughts of suicide, but stated that he had no plans to act on those thoughts. He stated that he has been having difficulty sleeping at night. Specifically, he has had difficulty falling asleep, often lying awake until 2 or 3 in the morning. Once asleep, he said that he has been waking frequently in the middle of the night, and also having difficulty getting back to sleep. Mr. Mulder said that his appetite has decreased slightly. He has lost 18 pounds over the past month.
DSM IV Diagnosis
|Axis I:||Major Depression
Rule out Delusional Disorder, Persecutory Type
|Axis II:||No diagnosis on this axis.|
Justification of Diagnoses
Mr. Mulder meets the DSM-IV (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 1994) criteria for major depression. He has suicidal thoughts, loss of pleasure in activities that used to be pleasurable, changes in sleeping habits, lack of energy during the day, change in eating habits, and a substantial weight loss.
Mr. Mulder also appears to meet the DSM-IV (1994) criteria for dysthymic disorder, in that he describes himself as having a low-level depression from age 8 to the present.
At present, it is difficult to know whether Mr. Mulder may also be suffering from the persecutory type of delusional disorder. His symptoms suggest that he has delusions around the circumstances of his sister's disappearance and the presence of aliens on the earth. However, this clinician cannot rule out that these beliefs may not actually be delusional. Also, his overall level of functioning, until recently, has been fairly high, with no evidence of delusional thought in other areas. The answer to this diagnostic question may become clearer as I get to know the client better.
At present, Mr. Mulder's most pressing problem appears to be his depression. Since the onset of his depression appears to have been triggered by the loss of his job, it appears that his depression is best explained by the existential perspective. According to this perspective, depression may result when people suffer the loss of a relationship or activity that gives meaning to their lives. Mr. Mulder indicated that his job was the most important thing in his life. Therefore, it is not surprising that being suspended from his job has resulted in depression for Mr. Mulder.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. (4th ed.). Washington, DC: Author.
The X-files. (Various episodes viewed on FOX network television broadcasts).
Last updated on Tuesday June 10, 2008.