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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