QUESTION 1 (14 Marks)
Refer to the following case study and answer the questions that follow:
Tracey, a 36-year-old successful businesswoman, has been unable to function on almost all levels since the death of her beloved husband four months ago. He was a victim of a hijacking incident while Tracey was attending an international conference for businesswomen. Tracey is deeply depressed; she suffers from severe feelings of guilt and has a general sense of worthlessness and hopelessness. She has lost interest in her business and has suffered serious financial losses over the past few weeks. She suffers from severe terminal insomnia, and her sad and depressed mood is worse in the morning. She has lost a lot of weight and experiences no joy in life. For the past three days, she has been lying immobile in bed without paying any attention to her personal hygiene. When her arms and legs are moved by someone to different positions, they just stay there. Tracey has stopped speaking and does not appear to hear what is being said to her. Except for a few business associates, Tracey has no support systems in times of stress. Her father and brother were killed in a car accident when she was six years old, and her mother, who suffered from an episode of severe depression, committed suicide several years ago. Tracey went to several psychologists. One psychologist diagnosed Tracey with Bipolar 1 disorder, while another diagnosed her with schizophrenia.

In diagnosing Tracey’s abnormal behaviour several disorders were considered, and some of them were eliminated. Unfortunately, both differential diagnoses made by the respective psychologists are incorrect. Provide an explanation as to why Bipolar 1 and Schizophrenia should be eliminated as diagnoses. (5 marks)

According to the DSM-5 classification system, the principal diagnosis for Tracey’s abnormal behaviour can be classified as . (1 mark)
A. Bereavement.
B. Major Depressive Disorder.

Using the DSM-5 criteria, provide an explanation for your answer to Question 1.2. (8 marks)

QUESTION 2 (15 Marks)
Write a short case study that depicts an individual with Generalised Anxiety Disorder. The person in your case study should be displaying the diagnostic criteria for Generalised Anxiety Disorder from the DSM-5. The case study should be ½ – 1 page in length and should include details about the person, his/her life, his/her behaviour, etc.

QUESTION 3 (11 Marks)
Refer to fictitious scenario below and answer the questions that follow:
Tommy, a three-year-old boy, is brought to the clinical psychologist for an assessment. His mother reports that he was born full term following a normal pregnancy and delivery. At 18 months, he underwent medical surgery due to bouts of inflammation of the middle ear. At the time, his mother also had concerns that he was not speaking any words, but his doctor said, “let’s wait and see”. A follow-up appointment was scheduled with the paediatrician for when he turned two years old where it became evident that Tommy was ‘developmentally delayed’ and the doctor advised that Tommy start attending special interventions. Since the age of two, Tommy has attended three preschools. He was asked to leave his previous schools because of behavioural problems. Since he began preschool, his teachers have reported that he appears to be “In his own world”, will not follow new instructions easily and largely ignores the children in the class. Tommy’s mother further reports that he has been in good health recently. She voices, tearfully, that all his milestones were delayed, particularly his language. She denies any history of developmental regression. She adds that Tommy has made progress, since starting with special interventions, and he will now use single words like “Juice” and “cookie” to make requests. At home, Tommy is described as a “handful”, especially when his routine is disrupted, but he will usually calm down when his mother turns on his favourite TV cartoon programme. Tommy’s mother states that he will have prolonged tantrums when denied what he wants, and the tantrums will often occur when they are attempting to leave their house. During these tantrums, he will frequently bang his head and bite his hand, which frightens her. For some time now, she has been concerned that Tommy does not like to play with his cousins (of the same age) during family get-togethers, but she thought this was because he was an only child and did not like to share.

According to the DSM-5 classification system, Tommy meets criteria of a diagnosis of . (1 mark)
A. Autism Spectrum Disorder.
B. Attention-Deficit/Hyperactivity Disorder.
C. Oppositional Defiant Disorder.

Provide a reasoning for your answer to Question 3.1 based on the DSM-5 classification system. (10 marks)

QUESTION 4 (10 Marks)
Identify and briefly discuss the clinical picture of a group of disorders that were historically made provision for in the DSM, but no longer is a category in the DSM-5.

QUESTION 5 (25 Marks)
Refer to the fictitious scenario below and answer the questions that follow:
Pumlani, a 38-year-old accountant’s husband, Tshepo, died nine months ago, after a short illness. According to tradition and customs Pumlani was given strict instructions that she needs to respect the mourning process and not bring shame to her in-laws or late husband’s memory. According to Pumlani, her relationship with Tshepo has been characterised by his infidelity and continuous emotional and physical abuse she has had to endure. Tshepo spent most of the weekends at his mistress’ house and physically abused Pumlani every time she asked about his escapades. Tshepo moved out of their common home three months prior to his death and died at his mistress’ house. Her in-laws subsequently informed Pumlani that her husband had died and would have to be buried at her home. Pumlani had to put her reservations and unresolved emotional issues regarding Tshepo aside as she was informed by her in-laws that they regarded Pumlani as Tshepo’s traditional wife as Tshepo had paid lobola for her. They wanted to hear nothing about his so-called mistress. Based on the afore- mentioned she was expected to observe all traditional rites pertaining to her husband’s burial. Pumlani was really infuriated by what she regarded as abuse by her in-laws as she felt no one was willing to listen to her side of the story. When people came in to pay their respects, they were reminded by her in-laws’ elders that they were not to shake Pumlani’s hand or hug her, but to only converse with her from a distance. Pumlani refused to wear black as part of the mourning process as she said that she is a modern woman who does not believe in tradition.
She also strongly felt that she was not going to grieve for a man who left her for another woman. Pumlani became involved in two serious accidents shortly after the funeral in which she nearly lost her life. Her in-laws attributed the cause of the accidents to her failure to perform prescribed traditional practices.
Explain the condition that a traditional healer would most likely state Pumlani suffers from, and how it can be cured. (3 marks)

Explain why from an African perspective, Pumlani’s accident according to her in-laws can be viewed as go lahla Maseko/ ukulahla amasiko. (3 marks)

From a traditional African perspective, what is the ritual practice that Pumlani was expected to carry out in mourning the death of her husband? Motivate your answer. (3 marks)
If Pumlani was to have sexual intercourse with a man while she is still in the mourning period, according to the traditional African perspective, what will happen to Pumlani and her sexual partner? Motivate your answer (4 marks)

5.2 Examine maladaptiveness a criteria needed to separate mental disorders from normal behaviour. (12 marks)

QUESTION 6 (17 Marks)
Refer to the fictitious scenario below and answer the questions that follow:

Kyle, a 35-year-old attorney, has been reported by his girlfriend as exhibiting concerning behaviour. Over the last three months, Kyle has become socially withdrawn believing that his body emits a revolting odour. He has spent thousands of Rands buying toiletries he believes are needed to help combat his dreadful body odour. This behaviour persists despite intervention from close family and friends reassuring Kyle that he doesn’t have any such condition. During this time, Kyle has also progressively become more difficult to understand as his speech is often incoherent. His family has sought help for Kyle’s frequent outbursts which involve periods of hyperactivity and loud rantings that shift from one topic to another without any logical flow. However, Kyle’s behaviour lasted less than 6 months.

Which one of the following disorders is Kyle most likely to be diagnosed with according to the DSM-5 classification system? (1 mark)
A. Schizophrenia.
B. Schizoaffective Disorder.
C. Schizophreniform Disorder.

Provide an explanation for your answer to Question 6.1.1. (1 mark)

Based on your answer in Question 6.1.1, provide an explanation as to why you have ruled out the other two (2) options. (4 marks)

6.2 Using the prescribed material, discuss the diagnostic criteria for hebephrenic schizophrenia from the ICD-10. (11 marks)

QUESTION 7 (8 Marks)
Refer to the fictitious scenario below and answer the question that follows:

Kendall, 8, displays a consistently irritable mood. According to her mother, she has at least three extreme temper tantrums per week. This has been going on since Kendall was 6, and her mother is worried about her daughter’s future. Not only does Kendall hit, kick, and punch during her outbursts at home, she also yells at her teachers and classmates at school when she is upset. Because of this, her mother is afraid Kendall will be expelled soon if she doesn’t change her behaviour, but the violent outbursts show no signs of fading.

Considering Kendall’s behaviour, briefly discuss the mood disorder that she is presenting with.

Answers to Above Questions on Psychology

Answer 1: In the given case scenario of Tracey, it is important to remove bipolar 1 disorder and schizophrenia for a number of reasons such as lake of psychotic features, specific features of Tracy such as immobility, lack of responsiveness and ability to speak, changes in her sleep patterns etc.

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