I. Introduction and Identifying Information
Intelligence of a person somehow defines him/her. Through intelligence, a person will know his capacities and abilities and where he is good at. It boosts someone’s self- esteem and improves the confidence he had in himself. If you’re intelligent, you can possibly do and deal with anything especially if you have a very brilliant mind. An intelligent person knows how to deal with people and accept their mistakes and imperfections. Intelligence adds confidence but overconfidence that leads to mistrust and hostility is another issue. Intelligence must also be balanced with the emotional quotient which everyone must work hard for. Such is not the case at hand.
The patient is a male whose name is Joe. He lived in a lower middle- class neighborhood in a large, northeastern city. His father is a steamfitter and his mother is a home maker. He had 2 older brothers and a younger sister. When Joe was 11 years old, his grandmother started living with them. His grandmother is already invalid and is not already capable to take care of herself after Joe’s grandfather died. Joe was exceptionally bright student. Yet, he had several chaotic relationships with his family, friends and other people around him. Later on, he developed anxiety and panic attacks that made him consult to a doctor. Then the doctor referred him to go to a psychiatrist.
II. Background Information
History and Course of the Present Problem
The patient is described to be exceptionally bright and overconfident. He was admitted to a prestigious high school and college. He was an “A” student and often made jokes about people who “couldn’t make the grade.” Whenever a teacher made a mistake in class, Joe was always the first to laugh and make a side comment. He avoided group activities and issues with relationships. He couldn’t trust everyone and he was very suspicious. He liked to work alone over his projects because he always thought that people will steal his ideas. Joe would always think that he was the best and nobody could compete with him.
The patient had argued with a teacher about a grade and after that he heard one of his classmates say, “I don’t know why some people have to work so hard for everything”. Joe took this comment as an insult to his family so Joe decided to get revenge. So while this student is attending a basketball game, Joe found his car and poured sugar in his gas tank. Suddenly, he started experiencing panic attacks that resulted him to go for a check-up.
Current and Past Medical History
The patient went to a doctor because he wanted a treatment for his anxiety and panic attacks. He had palpitations, sensations of shortness of breath, chest pain and nausea or abdominal stress. But his panic attacks are not associated with agoraphobia. Joe felt that he had no mental disorder at all. The doctor prescribed him Tofranil, an anti-depressant. But Joe had more knowledge on how this drug affected neurological mechanisms than the doctor. The said treatment was unsuccessful because Joe did not think that he has a personality disorder. The doctor, which he named as Dr. Fein, did not have any prior knowledge that Joe might have a paranoid personality disorder. Joe was not open to his life and Dr. Fein should have considered the possibility that Joe has a paranoid personality disorder that is why he behaved the way he did. Right now, Joe’s panic attacks still continued. Social History
Joe is said to be rude and arrogant. His first steady relationship is with Carla but then later on, Carla broke up with him. Joe wanted to get revenge. Since then, he became extremely suspicious of women’s intentions. One time, Joe made fun of a guy talking to his date at a party. Joe always finds chaos with others. He argued with a professor for receiving a B+ instead of an A. Joe began to date his future wife Ruth. He also got his first job working with a drug...
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