Case 3 (Axis II: Personality Disorder: Cluster C)
Sarah, a 32-year-old mother of two and a part-time tax accountant, came to a crisis center late one evening after Michael, her husband of a year and a half, had abused her physically and then left home. Although he never physically harmed the children, he frequently threatened to do so when he was drunk. Sarah appeared acutely anxious and worried about the future and "needed to be told what to do." She wanted her husband to come back and seemed rather unconcerned about his regular pattern of physical abuse. At the time, Michael was an unemployed resident in a day treatment program at a halfway house for paroled drug abusers. He was almost always in a surly mood and "ready to explode."
Although Sarah had a well-paying job, she voiced great concern about being able to make it on her own. She realized it was foolish to be "dependent" on her husband, whom she referred to as a "real loser." Several times in the past few months, Sarah had made up her mind to get out of the marriage but couldn't bring herself to break away. She would threaten to leave, but when the time came to do so, she would "freeze in the door" with numbness in her body and a sinking feeling in her stomach at the thought of "not being with Michael."
Use the DSM Library to diagnose the case study. Answer questions:
1. Identify the disorder.
2. List symptoms that led to this disorder (using what is listed on DSM).
3. Include any differential diagnoses (what it may not be) and why.
4. Include any specific details (culture, age, gender, etc.) that may have played a role in making the diagnosis.
5. Develop a treatment plan that may facilitate help for the individual.