A Beautiful Mind: a Case Study

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Running head: A BEAUTIFUL MIND 1

A Beautiful Mind:
A Case Study


Diagnostic Impression:

Axis I295.30Schizophrenia, Paranoid Type, Continuous
Axis II V71.09No Diagnosis
Axis III None
Axis IVPsychosocial and Educational Stressors
Axis VGAF = 55 (highest level in past 30 years)

Case Study:
John Nash suffers from Paranoid Schizophrenia. He is a gifted mathematician who began graduate school at Princeton University in 1947. We will begin Mr. Nash’s history from this point in time, for it is here that his symptoms first began to emerge. During this time in his life he is in what is known as the prodromal phase of schizophrenia, which is a period before active psychosis, during which time symptoms first appear but aren’t yet prominent or recognized. Some behavioral examples of this include Mr. Nash’s social awkwardness, his grandiosity, and his unique sensory ability (he was able to see a light pattern from a glass and synchronize it perfectly with patterns on one of his school-mate’s ties).

It is likely that the stress of this new, unfamiliar, and competitive environment is what caused Mr. Nash’s first positive symptom of schizophrenia to emerge, a visual and auditory hallucination in the form of a roommate, and later friend, named Charles Herman. Positive symptoms reflect an excess or distortion in normal behavior and experience (i.e. delusions and hallucinations), whereas negative symptoms reflect an absence or deficit in normal behaviors and experience (i.e. blunted affect, alogia, and avolition) (Butcher, Mineka, & Hooley, 2010).

For the most part, Mr. Nash remains socially isolated, not even attending class, devoting all of his time to the pursuit of a “revolutionary [and] original idea in mathematics.” His only breaks being when Charles, his hallucination, would talk him into taking a break. It is during one of these breaks that John states to himself, through the image of Charles, “I don’t like people much, and they don’t like me,” which is another psychosocial indicator of schizophrenia. It is also at this time that his delusions of grandeur become more pronounced, referring to the professors and the theorists studied in textbooks as “lesser mortals.”

One day, while interacting with his peers, the stressors of his current environment are reinforced as he is defeated in a mathematical board game by his major competitor, Martin Hansen, who also informs him that he has two papers under review, and two other peers, Bender and Sol, have already published. This stress, along with two days of isolation triggers his hallucination of Charles, who “talks” him into going to a bar. At this bar Mr. Nash runs into his peers once again, and it is at this time that one begins to see negative symptoms of schizophrenia. More specifically, there appears to be deficit in his fluency and productivity of thought and speech, as evidenced by the interaction between himself and a woman at the bar, at which time he tells her, “I don’t know what I’m required to say in order for you to have intercourse with me.” He is later approached by the department chair and told that he may not get a placement due to the fact that he has not been attending classes, has not published a paper, and his inability to “focus.” This failure to focus could be impairment in cognition due to his schizophrenia. This new stressor causes John to reach a breaking point, during which time he smashes his head and throws his desk out of the window because he is frustrated and unable to focus on his work. His thoughts of suicide are expressed through the words of Charles, “…go on, bust your head, kill yourself,” and his throwing his desk out the window indicates his diminished impulse control, both of which are linked to schizophrenia.

It is at some point after this that Mr. Nash comes up with the revolutionary discovery of the theory of equilibrium, which would change the face...
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