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Ms. Seeker is a 23 year old medical assistant who was hospitalized after she recently attempted to slash her wrists with a tin can. She told the staff on admission, “I don’t really need to be here.” Three months before admission she learned her mother was pregnant and she began drinking heavily in order to “sleep at night.” During her heavy drinking she began sleeping around in a variety of 1 night stands. Before admission she reported feeling panicky and having the feeling like she was removed from her body and in a trance. At one point she claims she heard a voice telling her to jump off a bridge.
At admission to the hospital, Ms. Seeker appeared disheveled and frail. She was cooperative and coherent and looked forward to being free of her anxiety. She reported feelings of loneliness and inadequacy and brief periods of depression and anxiety since adolescence. She claimed that she was “just an empty shell that is transparent to everyone.”
Ms. Seeker’s parents divorced when she was three and she was raised by her grandmother who was an alcoholic. She had night terrors and had to sleep with her grandmother. She was sent to a boarding school when she was 6 years old when she reports she was sexually abused by a teacher. As an adolescent she had an active but unsatisfying sex life but her relationships with men would end abruptly after she became angry with them for disappointing her in some way. She could not establish a stable living arrangement with roommates with whom she would often become quite jealous and angry. She was living alone at the time of admission.
Questions:
What is her diagnosis?
What are the symptoms that helped you make this diagnosis? What diagnostic criteria do they relate to?
What are two other possible diagnoses and why did you not choose them?
What is her prognosis?
