I decided to base my clinical assessment of a movie character on Conrad Jarrett, the lead character of the film Ordinary People. Conrad is seventeen years old and is the only child of Beth and Calvin Jarrett. The Jarrett’s live in the affluent suburb of Lake Forest, Illinois, where Calvin works as a successful tax attorney. The Jarrett’s have just recently experienced a family tragedy, where their eldest son, Buck, drown in a boating accident, while Conrad witnessed the entire event. Six month after the accident, Conrad has become severely depressed, and slit his wrists with a razor blade in a failed suicide attempt. His parents discovered him unconscious in the bathroom, and immediately committed him to a psychiatric hospital. He spent eight months in treatment and has recently returned home, as well as resumed his classes at Lake Forest High School. He is struggling socially, academically, and has a strained relationship with his mother, Beth. Immediately following his discharge, Conrad continues to experience nightmares, and flashbacks to the boating accident in which he watched his older brother die from drowning. He is also experiencing chronic agitation, appetite loss, poor concentration, and avoidance of his former friends and extracurricular activities. When Conrad was receiving treatment, he was initially diagnosed with major depression with agitation, without active suicidal ideation. He attends psychotherapy twice weekly with Dr. Tyrone Berger.
I have based the Axis I diagnosis of Post Traumatic Stress Disorder on the analysis of Conrad’s symptoms, which support my clinical decision. Conrad witnessing his brother drowning is the exposure to a traumatic event, which is the basis of this disorder. This event has involved both a loss of a loved one, as well as his response to the event which has involved intense fear, horror and hopelessness. In Conrad’s case he has also responded with disorganized and agitated behavior. Conrad is also struggling with persistent re-experiencing of the event. This is demonstrated by his frequent flackback memories, recurring distressing dreams, and an intense negative psychological response to any objective or subjective reminder of the traumatic event. Conrad is also presenting signs of persistent avoidance and emotional numbing, by avoiding former friends, quitting the swim team, and a general withdrawal from significant life activities. He has shown in his sessions with Dr. Berger that he is has a decreased capacity to feel certain feelings, specifically related to his brother’s death. He has also shown in his interactions with others, that he believes the event changed him and has now not made him “normal” to others. Regarding physiological response issues, Conrad has shown an increased difficulty falling or staying asleep, problems with anger, and concentration, since the traumatic event. The duration of his symptoms have been for more than one month, dating back to the event itself, which was over one year ago. Also, each of Conrad’s symptoms has lead to clinically significant distress or impairment involving his life, social relations, extracurricular activities, and all around important areas of functioning.
I have decided that no Axis II is present so I have coded it as V21.09. Conrad does not demonstrate any symptoms that indicate a personality disorder or mental retardation. His symptoms seem to have started after he experienced the tragic loss of his brother. In addition, Conrad does not have any general medical conditions that would be listed under Axis III.
In regards to Axis IV, Conrad has been experiencing severe psychosocial and environmental problems since the death of his brother. However, Conrad has seemed to struggle with problems related to his primary support group, particularly his mother, from a young age. His relationship with her has become even more strained since Buck passed away. Conrad’s mother, Beth, is a very...
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