Case Study:

Background Information Anna is a 16-year-old Caucasian female who lives at home with her mother Laura. Laura makes sure Anna has a consistent daily routine and tries to teach her day-today responsibilities. Anna seems to be making slow progress and then other days her condition worsens, especially when her mother is not as attentive to her needs.Anna's mother is a single mother who works from home to be able to provide constant care for her daughter. Her father Marvin comes to visit occasionally but is not consistently there.

He loves his daughter and tries to interact with her, but cannot seem to without becoming overwhelmed and angry. Anna goes to a school for the mentally disabled; however, she does not like the staff and is always acting out to be able to go home. She takes medication twice a day, and has doctor visits regularly. She has a difficult time coping with certain situations and does not know how to control her emotional impulses. Her mother has to hold her and tell her to breathe before she will calm down. Sometimes the outbursts are so bad there is nothing and no one that can control or sooth her. Laura also uses humming to calm and refocus her daughter. Anna is very responsive to this technique and it gets her back down to a controllable level. This is the only form of positive coping shown.Anna's weaknesses are her short temper, and violent outbursts. This makes it almost impossible for her to be out in public or in a social setting.Description of the ProblemWhen a situation arises that a normal 16 year old could handle, she seems to react like a young child. Anna repeats anything said to her, displaying echolalia. Anna also has outbursts of aggression. Her aggressive behaviors include biting, pushing, punching, yelling, and running away from her mother. She has overly dramatic emotional swings during these outbursts, where she is very enthusiastic or very upset. While Anna is experiencing these fits, she becomes physically abusive with objects, throwing them at walls and other objects around her. After the outbursts Anna encounters, she feels sympathetic only to her mother.

She is the only person that she will apologize to for her behavior. When Anna is in public, her emotions are erratic; she is very enthusiastic or extremely angry. She is not concerned with the reactions of people around her or how her behavior impacts others. She has little impulse control and immediately acts on how she feels. She begins to feel the need for some social interaction, but due to lack of knowledge on how to do so, she is angered by this emotion as well. Anna walks on her toes primarily, and she rocks whenever she feels anxiety

1. What disorder best qualifies Anna based on the information presented?

2. Connect the required symptoms for that disorder (chosen above) to the information in the case.

3. Give two examples from the case of symptoms that indicate social impairment versus one that indicates repetitive/stereotyped behaviors?