1. What is the precipitating stressor event that probably triggered the onset of Janet's
Schizophrenic episode? What other factors may have contributed?
Her personality was also described as a shy, socially awkward and sensitive girl. This attributes may be linked to the shizotypal personality, which Janet could be said to possess. These traits have been with her since she was young. Individuals with schizotypal personality disorder are said to be predisposed to the development of schizophrenia later in life (Mayo Clinic, 2012). Therefore, her personality could actually be a contributory factor to her development of schizophrenia. Individuals with schizotypal personality disorder are often described as being odd or eccentric and they do not usually form close relationships with other people (Mind disorders, 2012). They are said not to generally understand how relationships are formed, this is said to lead to severe anxiety in them, and they tend to turn inward in these situations (Mind Disorders, 2012). Schizotypal personality disorder typically manifests in early childhood and may persist into adulthood (Mayo Clinic, 2012) (Mind Disorders, 2012). In Janet's case, one of the manifestations of this disorder could be the incident that occurred when she was young that she refused to go to school, which warranted a therapy session before she agreed to go. Also, the events that occurred when she became an adolescent whereby she indulges in self-destructive acts whenever she was agitated could also be symptoms of this disorder. She also engages in odd behavior like performing complex rituals so that she could go to sleep and not wanting to be seen eating.
2. Identify Janet's primary delusion. How can we understand this as a way that Janet is trying to "make sense" of her collapsing world? How do her hallucinations fit together with her delusion?
Janet's primary delusion is a belief that she was meant to save the world together with Dr. M. Janet became stuck in her world of fantasy in which she visualized the world has needing her help which she was meant to provide together with Dr. M. she gradually began to fantasize about him up to the stage of believing that he was in love with her. She became obsessed with the notion that he was in love with her and subsequently only attended his lectures.
Janet took on a substitute reality in order to deal with the unfamiliar environment, which she found herself. This is her own way of coping with the stress of being in an unfamiliar environment. She resorted to fantasies and created a world, which she needed to save. She also made herself important by believing that she was desired by someone who is more superior to her, justifying it by saying that they needed to save the world together. When her parents came to the schools and told her that they were taking her home, she interpreted this as an attack on her world and she violently rejected this. Her hallucinations can be explained by her fighting off aggressors who she viewed, were trying to destroy her world, the world she has built for herself to escape from reality. She was going to fight off anyone who attempted to interfere with her newfound world.
3. Janet's hospitalization both makes her available for treatment and protects her and others. Explain the nature of danger to Janet and others that exists in her current acute condition.
In her current acute condition, Janet is a dangerous to herself. She may go on to harm herself as she has done in the past. Also, Janet is dangerous to others as she can go on to attack her family members and hospital staff. She already believes that they are all conniving together to harm her. She might decide to harm them believing that she is defending herself (Frankenburg (2012).
Since Janet is also responding to auditory hallucinations, which command her, she might also harm others if the inner voice tells her to do so. She might carry out the act because perception of reality is already deranged by the delusions and hallucinations. She might not be able to discern between the auditory voice and real voices. In this way, Janet is also dangerous to others. It is also likely that she responds to commands telling her to harm herself, also because of the derangement interpretation of auditory percepts. Janet is also currently in an anxiety state because of the concerns she has about world. She responds in a heightened way and this could lead to violent responses to people around her.(Frankenburg, 2012).
References
Mayo Clinic (2012). Schizotypal Personality Disorder. Mayo Clinic. Accessed on 24th April, 2012 from http://www.mayoclinic.com/health/schizotypal-personality-disorder/DS00830
Mind Disorders (2012). Schizotypal personality disdorder. Encyclopedia of Mental disorders. Accessed on 24th April, 2012 from http://www.minddisorders.com/Py-Z/Schizotypal-personality-disorder.html
Frances, Frankenburg (2012). Schizophrenia Clinical Presentation. Medscape Reference. Accessed on 17th April, 2012 from http://emedicine.medscape.com/article/288259-clinical
