what is vingette 3

5-6 pages total plus a title and reference page

Jackie is a 35 year old European American woman who is referred to you
by her primary care physician. Her husband George, a 45 year old man
of Native-American descent, is present for this first session. Jackie
tells you that her doctor is overreacting. “Just because I lost 10
more pounds, he thinks I have an eating disorder. He’s ridiculous.
Don’t I look a bit pudgy to you?” You notice Jackie is dressed in
loose fitting clothes, looking painfully thin. Jackie tells you, “I
gained a lot of weight as a kid hoping to keep my old man off of me.
It didn’t work, so I started cutting to stop the rage. A lot of my
friends were cutting back then. And making yourself throw up was the
norm in high school. Sure was a quick way to knock off those pounds!
Jackie and George have been married for 5 years. The couple has a 4
year old daughter. Prior to George, Jackie admits to being in several
“mutually-abuse” relationships. She describes George as, “ a passive
softie. He hates conflict. Sometimes he’s so boring, but he loves me
no matter what.” George is reluctant to comment on his wife’s
behavior. He does tell you, “I worry about our little girl. She looks
so scared sometimes when Jackie is having one of her episodes. When
Jackie doesn’t get her way, things start flying across the room.”

Consider Eating and Personality Disorders

Taking into account the genetic, neurobiological,
sociocultural, familial and environmental factors of assessment and
diagnosis, what are your diagnostic thoughts for Jackie? What might be
going on with George? Use the DSM-5 criteria to formulate your
diagnostic impressions for Jackie and possibly for George, supporting
what you see in the vignette that supports your diagnostic
impressions.

2. Using the psychotherapeutic and pharmacological interventions
discussed in the text, describe an initial treatment plan for Jackie
and George. Remember to treat the persons in the vignette, and not the
diagnosis. Also remember to consider culture and legal/ethical issues.


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