READ (the following case study): Case Study: José and the BDI, CBCL, and SCL-90-R
José is a 17-year-old Hispanic high school junior. He lives with his parents and three siblings. José identifies himself as homosexual.
Referral Question: José’s parents have noticed an abrupt shift from José’s typically cheerful and energetic demeanor to a pattern of tearfulness, lethargy, anxiety, irritability, and inability to eat or sleep adequately. José has told his parents that he has been feeling depressed and anxious about his college applications, stating “I don’t know what I want to do with my life.” He was referred by his parents for a psychological evaluation to determine the nature of his current symptoms and obtain appropriate recommendations. There is significant family history of depression and anxiety.
Tests Administered: Interview, BDI, CBCL, and SCL-90-R
Brief Summary and Interpretation of Results: José’s score on the Beck Depression Inventory (23) places him in the “severely depressed” range of this measure. On the Child Behavior Checklist (Parent Report Form), significant elevations were obtained on the Anxious/Depressed, Attention Problems, Somatic Complaints, and Withdrawn scales. On the SCL-90-R, significant elevations were revealed on the Interpersonal Sensitivity, Depression, Anxiety, Paranoia, and Positive Symptom Distress Index scales. Taken together, these checklist measures clearly corroborate significant levels of depression and anxiety in José’s profile. However, the cause, nature, and content of these symptoms still remain unanswered by these measures alone.
Results from the clinical interview revealed that José had become deeply depressed following the discovery that his former boyfriend tested positive for HIV, the virus associated with Acquired Immune Deficiency Syndrome (AIDS). This revelation has plummeted José into a state of fear, guilt, hopelessness, and ultimately, major depression. While he has shared his sexual orientation with his parents, he has been afraid of telling them about his former boyfriend’s HIV, and even more frightened to obtain an HIV test himself. His family history of depression and anxiety may make him biologically vulnerable to depression in the context of significant psychosocial stress.
The clinical psychologist assessing José made the following recommendations. First, José requires ongoing therapy with a supportive clinician who can assist him in traversing this difficult crisis. A clinician especially sensitive to homosexuality, terminal illness, and Hispanic culture would be indicated. Second, adjunctive work with José’s parents, given his consent, will be useful in assisting them in supporting their beloved son. Third, a psychiatric consultation may be useful to determine whether antidepressant medications are indicated to assist in treating José’s depression. Fourth, assisting José in developing contacts with community resources, such as a group for young gay men and AIDS information hotline, would be beneficial. Fifth and finally, processing with José the emotional and medical implications of obtaining an HIV test while remaining alert to his fears will be necessary to assist him in making a responsible choice with adequate preparation.
COMPLETE (IN FULL)-minimum of 3 slides:
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