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DSM Case Study – Rudy

DSMCase Study –Rudy

Accordingto DSM-V, the necessary features of character disorder are thepersonality functioning deficiencies. About Rudy’s case-study, andbeing his psychiatrist, I think he would not open up entirely, or hewould rather lie about his problems because some of the acts he hasdone are of embarrassment.

Rudyhas a neural development disorder which specifically is AutismSpectrum Disorder (American Psychiatric Association, 2013). Peoplethat exhibit this disorder usually have a deficit in theircommunication such as they show the inability to give an appropriateresponse to conversations or experience difficulty in establishingfriendships with their age mates. Also, people with this disorder maybe oversensitive about changes in the environment, and they tend toinvolve in inappropriate behavior. In the diagnosis of this disorder,I used present behavior across multiple contexts criteria.

Rudyshows some of the signs associated with this disease. He associateswith Juvenile peers who are younger than him, and they look up to himand also, drinks alcohol with underage children. It seems that Rudyis able to relate to peers that are not of his age. He is alsofocused on inappropriate behavior as he goes to jail because offorcing his 8-year-old cousin into the sexual act he takes drugs andshoots the paintball at homeless men and women. What it seems is thathis personality is characterized by many inappropriate behaviors. Tosupport this diagnosis ultimately, I need to know if Rudy hasmisleading nonverbal interactions and also if his symptoms fall on acontinuum.

Thebest treatment for Rudy in this situation is individual counseling. Most of the people with this ailment have other medical conditions,for example, they experience sleeping disorders, seizure or they maysuffer from stress. I could recommend that these requirements behandled first if they are there and prescribe medicines in possibleareas. Addressing these conditions will ensure that the patient canreceive therapy appropriately by being attentive and it will alsohelp in learning. Moreover, I could involve Rudy in transitionalservices that would enhance his development into self-governing andemployment opportunities of adulthood. The reasons for this treatmentwould be to get him to change the behavior after persistence therapyfor a period. The essence of having peer-group relationships shouldbe brought up as well as the teaching of ways of establishing thefriendships.

Abenefit of DSM-V is that it assists in developing evidence-basedtreatment and there is reliability among health care providers. Thereis the criticism of DSM in the failure to be entirely reliable andvalid in the diagnosis that it makes because the determination isbased on superficial symptoms instead of fundamental causes.

Anotherdiagnosis is the substance abuse disorder. The criteria I used forcategorizing this disorder are pharmacological indicators that aretolerance and withdrawal. This approach signifies addiction. The bodyparts begin adjusting in an attempt to get used to the high levels offrequent drug intake (Wise, 1988). When people raise the consumptionof drug for reasons of getting the desired effects, the body becomestolerant. The pill gives fewer effects even when used in the usualdosage as one’s body gets used to it. Withdrawal is how the bodyreacts in responding to the cessation of the drug when it reaches inthe body.

Thereis an outline of Rudy symptoms in this diagnosis. When he began usingMarijuana and Xanax at 13 years, the average amount he used to spendis 5-10$, and now the amount has highly increased to 50-75$. Thisshows that he consumes a lot of drugs compared to that time. He alsosmokes Marijuana every day and Xanax pills 3-4 times a week and alsotakes alcohol. This narcotic intake had led him to commit a crimewhen he was high. My diagnosis has enough facts to support it, andthere is sufficient information to determine that he is sufferingfrom addiction.

InRody`s recovery, I would apply substance use treatment. The treatmentshould occur in ‘an outpatient setting of which the patient couldopt to be alone or with his parents or friends. Inpatient treatmentcan only happen in cases where the patient is in hospitalization forother disorders or other drug abuse which may need attention. Theresearches for treating disorders which occur due to marijuana abuseare unlimited. There are no particular pharmacotherapies, forwithdrawal of marijuana or dependence. Regarding psychosocialremedies, an approach that prevents intensive relapse by linkingmotivational interventions with the development of coping strategiesmay have the likelihood of success in marijuana dependence treatment.(J, Metzger D, O`Brien CP., 2013)The objective of the treatment is toreduce the levels of addiction at a slow pace until it is completelyover. Also, other psychological effects that have developed as aresult of drug overuse should be treated.

Anotherdiagnosis is the coercive paraphilia. This paraphilia is diagnosed incases where an individual is involved in forcing an individual intosexual intercourse. A big number of people who suffer from thisdisease are males, and the victims are usually females. Raping is adisorder but not a psychological one though there may be otherelements that contribute to the act like the influence of drugs thataffect the normal brain function thus leading the person from doingthe act. However, mental illness should never be an excuse of raping,and those who rape should be jailed with no considerations.

Rudyforces his 8-year-old cousin into sleeping with him three times wherehe was caught for the third time and arrested. Most probably he wasunder the drugs when it happened or rather the persistence abuse ofnarcotics had taken his sanity away. His lack of sympathy is alsoevident when Rudy expresses cruelty to pets and is happy on theirdeath. The criterion used in this context is the sexual abuse that hecommitted. To support my diagnosis, I would like to know if exactlywhen Rudy committed the crime was high.

Thetreatment for coercive paraphilia is behavior modification. Rudyshould stay in prison and learn to change his morals through thehostile events in jail. In cases of any therapy intervention, itshould be done in prison. DSM-V is beneficial in this researchbecause it denounced raping as any form of mental disorder andoutlined that no matter what, the victim should go to jail. The aimis to shape his behavior.

Psychoticand Mood disorder is part of the many disorders diagnosis in Rudy. Hethrew a brick at a girl, and he missed just because he was told tostop throwing shooting paintball to men and women and that he wasimmature. That stone could have hurt the innocent girl, and he didn`tcare which signifies that he is a psyche. Again, he shows no mercywhen he threw the shooting paintball at homeless men and women. Heacts out of violence, and he has anger outburst which signifies thathe has mood swing issues and have no control of his bitterness. Thetreatment, in this case, is individual counseling which would helphim understand his behavior and know how to manage it.

Thestudy of Rudy’s case portrays mental as well as behavioralimpairment. Despite having bad behavior, I consider substance abuseas an enhancement to the immorality. However, with patience,understanding and support he can respond to treatment effectively.


AmericanPsychiatric Association. (2013). Diagnostic and statistical manual ofmental disorders (5th ed.). Washington, DC

MetzgerD, O’Brien CP. A new measure of substance abuse treatment: initialstudies of the treatment services review. (1992). J Nerv Ment Dis180:101–110 [G]

Roy,A.W. The neurobiology of craving: implications for the understandingand treatment of addiction. (1988). Center for Studies in BehavioralNeurobiology 97:118–132 [G] 21