Sunday, July 22, 2012

Case Study~ Jeffery Dahmer



Jeffery Dahmer is a notorious serial killer that terrorized Milwaukee from 1978 to 1991.  His victims were dismembered and buried.  It is said that some of his sufferers were eaten; however he denies that it was a habit.  This case study will cover Jeffery Dahmer’s biological, psychodynamic, cognitive, and behavioral components of psychosexual disorders.
Jeffery Dahmer
Jeffery Dahmer was born in May of 1960 in Akron Ohio.  His father was a chemist, and his mother was a stay at home mother.  Joyce, Dahmer’s mother had troubles in both his and his brother’s pregnancies thus possibly contributing his demise.  Between his adolescents and early teen years, Jeffery showed little to no interest in hobbies or interactions with other kids, but rather rode his bike around in search of dead animals. By his teens Dahmer was by all classifications an alcoholic  (Chapman, Meyer, & Weaver, 2009).  His parents separated when he was eighteen, completely abandoning him one day while his father was off on a job out of state his mother packed up his younger brother and moved without taking Jeffery with her (Chapman, Meyer, & Weaver, 2009).  1978 is when he crossed from experimenting on animals and graduated to humans. He often fanaticized about male encounters.
In 1982 Dahmer was discharged from the United States Army and move in with his Grandmother in Wisconsin.  August of 1986 Dahmer was charged with indecent exposure and again in September.  Here he received a suspended sentence and ordered to obtain counseling.  In 1987 he had killed again  (Newton, 2006).  Two were killed in 1988 all the while he continued to experiment with dead animals.  In September his Grandmother had had enough and asked him to move.  This second abandonment seemed to speed up his horrific crime.  The day he found an apartment in the Oxford Apartment community, he did not waste any time to find his next victim who was abducted the very next day.  While this young man escaped, Dahmer was only placed on one-year imprisonment, which he only served ten months. While awaiting his sentencing, Dahmer killed another young man only two months after his trial in 1989.  The carnage continued as Dahmer acclimated himself to his freedom. Four victims were slain in 1990.  The eight that fell pray to his idealistic ways came in 1991 (Chapman, Meyer, & Weaver, 2009). A victim he selected on July 22 brought Dahmer’s house of cards down.  While Dahmer attempted to restrain him, the victor fought back and ran into the street where he located a Milwaukee police car. 
Dahmer was immediately taken into custody after the plethora of evidence that was located in his apartment. Dahmer had photos of corpses, bodies decomposing in vats of Dahmer’s trial began in January of 1992 where he entered a plea of guilty but insane.   The jury found him guilty but not insane.  Jeffery Dahmer was found dead two years later at the hands of another inmate who claimed he was doing the work of God  (Newton, 2006).
Biological, Psychodynamic, Cognitive, and Behavioral components of Jeffery Dahmer
It was possible at one time or another that Dahmer suffered from antisocial personality disorder, borderline personality disorder, alcohol dependence, marijuana abuse, sadistic personality disorder, pedophilia, mixed personality disorder, each one of these fall under Axis II of the DSM-IV-TR tier.  While his mother took medications while pregnant it is possible that what she took affected her baby’s outcome.  His desire to have sex with corpses was visible during his teens when he preformed his own version of necrophilia (Chapman, Meyer, & Weaver, 2009).  While Dahmer was not alleged sexual abused as a child, Dahmer 
Dahmer often had nightmares where his penis was missing or removed.  Based on Freud’s mental development this dream could have malformed his ego, super ego and id, because it deals with him feeling inadequate, and something missing as a child.  His father Lionel noted, that Dahmer seemed to grow inward and would sit for hours without emotion (Dahmer, 1994). 
There has been no information provided about Jeffery being the victim of sexual abuse, the bickering between his mother and father was intense.  This fostered his feelings for being alone and unwanted.  It is suggested that because of these feelings, it was easier for him to turn to murder and evil thoughts.  Jeffery Dahmer’s thoughts of dread and doom are strong indications of depression. 
            Antisocial Personality Disorder is a part of the Personality disorders group in DSM-IV-TR cluster B, that also includes narcissistic, antisocial, and borderline personality disorders.  Someone with personality disorder is defined as Disorders characterized by extreme and rigid personality traits that cause distress or impairment  (Hansell & Damour, 2008).  Most of these are life long problems visible in childhood. Antisocial personality disorder is reserved for those whose behavior is un-socialized and those who have repeated conflicts with society. 
            Sexual deviations are for individuals whose sexual pursuits are directed to objects versus the opposite sex.  Most are completed under inexplicable circumstances like pedophilia, sexual sadism, necrophilia and fetishism.  While many feel their acts are distasteful, they are unable to control their addictions. 
Conclusion
            Dahmer is a merciless well-known Milwaukee serial killer who murdered 15 young men.  While Dahmer was found guilty of murder, he was not found insane for his actions.  His sexual deviations, and anti-social disorder all contribute to is spree.  When terrors such as Jeffery Dahmer choose, as he did, to have the medical professionals do research on why he was the way he was are reasons why we do what we do as psychologist.  Dahmer will always be a mystery. 

Reference

Blatt, S., & Levy, K. (1999). Attachment Theory and Psychoanalysis: Further Differentiation
            Within Insecure Attachment Patterns. Psychoanalytic Inquiry , 541-575.
Chapman, K., Meyer, R. G., & Weaver, C. (2009). Case Studies in Abnormal Behavior Eighth
            Edition. Boston, MA: Allyn and Bacon.
Dahmer, L. (1994). A Fathers Story. New York, New York: Marrow.
Farmer, F. (N.D.). Serial Killers and Self Concept. Retrieved January 27, 2012, from Serial
            Killer Pages-Narcissistic Personality Disorder:
            http://www.francesfarmersrevenge.com/stuff/serialkillers/selfconcept.htm
Hansell, J., & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: John Wiley &
            Sons, Inc.
Newton, M. (2006). The Encylopedia of Serial Killers Second Edition. New York, NY:
            Checkmark Books.
Phillip W. Long, M. (2011). Mentalhealth.com. Retrieved January 27, 2012, from Antisocial
            Personality Disorder: http://www.mentalhealth.com/dis/p20-pe04.html
Schechter, H. (2004). The Serial Killer Files, the who, what, where, how and why of the worlds
            most terrifying murderers. New York, New York: Ballantine Brooks.
Vronsky, P. (2004). Serial Killers The method and madness of Monsters. New York, New York:
            Berkley Books.


Schizophrenia, Lifespan Development



DSM-IV-TR classifies and explains schizophrenia and lifespan development disorders.  Each of the  categories focuses on a different part of the disorder to find applicable treatment.  The more advances found will benefit psychologists in an understanding of mental disorders and help find reasons for their cause. 
Schizophrenia
Schizophrenia is associated with behavioral and cognitive symptoms that linger for six months or longer and initiate life impairment (Hansell & Damour, 2008).  Schizophrenia begins slowly over a few months to a few years; however the symptoms are not noticeable right away (Mayo Clinic, 2010).  “Signs and symptoms of schizophrenia generally are divided into three categories — positive, negative and cognitive” (Mayo Clinic, 2010). Hansell and Damour state that schizophrenia is thought to have ties with abnormalities of the brain, 2008.    The brain abnormalities are in two different categories, the proximal (immediate) and distal (predisposing) (Hansell & Damour, 2008).  Problems found in the proximal area see a surplus of dopamine (D2)  as well as neurotransmission (Hansell & Damour, 2008).  In the distal section, most causes are relates to environment, genetics, and biological factors. “Treatment with medications and psychosocial therapy can help manage the condition” (Mayo Clinic, 2010) Reconstructing both cognitive behavioral rehabilitations and cognitive behavioral interventions are ways that someone suffering from a psychotic disorder is treats.  Operant conditioning, social skills training as well as milieu treatment are ways psychotic behaviors can be treated based on a biological view (Hansell & Damour, 2008).   Psychodynamic treatment help in preventing relapses, improve personal adjustment as well as maintaining ongoing treatment (Hansell & Damour, 2008). 
Lifespan Development Disorders
Disorders that deal with lifespan development were not intergraded into the DSM-IV-TR until the twentieth century.  DSM-IV-TR acknowledges five different types of classifications.  The categories include mental retardation, pervasive development disorders (PPD), attention deficit/disruptive behavior (ADD), learning disorders, and separation anxiety (Hansell & Damour, 2008).  It is complicated to diagnose children with disorders because they are evolving rather quickly.  One can relate it to the development of the child (Hansell & Damour, 2008). 
DSM-IV-TR label attention deficit/disruptive behavior as externalizing behaviors next to oppositional defiant disorder and conduct disorder (Hansell & Damour, 2008).  Approximately one out of every 20 to 30 children have attention deficit hyperactivity disorder (ADHD), this makes it the most diagnosed childhood disorder (Hansell & Damour, 2008).   ADHD is  passed down genetically, there are also prenatal factors that contribute to ADHD as well as neurological factors.  Treatment of attention deficit/disruptive disorder is stimulant medications, therapy, rules established for the child when there is punishment needed and the need for maintaining parent control (Hansell & Damour, 2008).  Attention deficit disorder can be outgrown as the child grows and learns techniques to remain focused in the world (West, 2012).
Learning disorders are misfiring’s in certain academic abilities when compared to others in that given age bracket, education level, and intellect (Hansell & Damour, 2008).  DSM-IV-TR differentiates between dyslexia (unable to learn words and understand words) and dysgraphia (expressing thoughts in writing) and dyscalculia (difficulty with math) as the three main learning disorders (Hansell & Damour, 2008).  Most are related to biological factors. They are enhanced by psychological factors.  Technology has allowed professionals to find abnormalities in the brain (Hansell & Damour, 2008).  The cognitive and behavioral aspects rely on how families and schools interact with each other and how to overcome a learning disorder (Hansell & Damour, 2008). 
Mental retardation is either biological or sociocultural.  Mental retardation mars the logical functioning and adaptive behaviors and is visible at birth (Hansell & Damour, 2008).  Often mild, moderate, severe, and profound mental retardation is related to biological backgrounds, these biological factors are prenatal and postnatal complications, genetic abnormalities, and metabolic deficiencies.  The socio-cultural causes are stemming from a lack of environmental stimulation or possibly insufficient nutrition (Hansell & Damour, 2008).  According to DSM-IV-TR three criteria need to be met to be diagnosed with mental retardation, but the most evident is a lower than norm IQ. There is no cure thus far for mental retardation, thus lasting the entire life of the child.
Pervasive developmental disorders are impairments in development and daily functioning (Hansell & Damour, 2008). The child who exhibits PDD does not develop communication and social abilities and seems not to obtain connections with others (Hansell & Damour, 2008).  Autism, childhood disintegrative disorder, Asperger’s and Rett’s disorder are forms of PDD. Autism is the most common it is unclear how a young child receives this disorder (Hansell & Damour, 2008).  Medications only help the symptoms in conjunction with behavioral and cognitive therapy seem to be the most helpful (Hansell & Damour, 2008). 
Separation anxiety disorder (SAD) is caused from separation of the home or caregiver that causes anxiety in the child (Hansell & Damour, 2008).  Four percent of children suffer from this common anxiety disorder (Hansell & Damour, 2008).  Children express fears and clinginess, which could grow into agoraphobia.  It is stated that different genes are to be the cause of SAD, causing males to have his more than females but oddly, it is inherited by girls more than it is in boys (Hansell & Damour, 2008).  Psychosocial stressors bring on SAD as well as unconscious anger, especially after a traumatic event.  Most parents after a traumatic event tent to become overprotective, this gives way to feelings that separation is unsafe (Hansell & Damour, 2008).  When someone is seeking treatment to separation anxiety disorder many prefer counseling and no medication. 
Conclusion
The continual advances in technology will allow psychologist to understand schizophrenia and lifespan development disorders.  Each of these are better understood when biological, behavioral, cognitive, and emotional perceptions are considered.  The DSM-IV-TR defines each disorder and how to aid in treating its sufferers better. 

 Reference:
Children's Hospital of Wisconsin. (2012). Learning Disorders. Retrieved January 21, 2012, from Children's Hospital of Wisconsin: http://www.chw.org/display/PPF/DocID/22123/router.asp
Frank-Briggs, A. (2011). Attention deficit hyperactivity disorder (ADHD). Journal Of Pediatric Neurology, 9(3), 291-298.
Hansell, J., & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: John Wiley &    Sons, Inc.
Harvey, P. D. (2011). Mood Symptoms, Cognition, and Everyday Functioning in Major
            Depression, Bipolar Disorder, and Schizophrenia. Innovations In Clinical Neuroscience,
            8(10), 14-17.
Jentarra, G., Olfers, S., Rice, S., Srivastava, N., Homanics, G., Blue, M., & ... Narayanan, V.  (2010). Abnormalities of cell packing density and dendritic complexity in the MeCP2   A140V mouse model of Rett syndrome/X-linked mental retardation. BMC Neuroscience,  1119.
Kins, E., Soenens, B., & Beyers, W. (2011). 'Why do they have to grow up so fast?' Parental separation anxiety and emerging adults' pathology of separation-individuation. Journal Of Clinical Psychology, 67(7), 647-664. doi:10.1002/jclp.20786
Mayo Clinic. (2010, January 30). Schizophrenia. Retrieved January 21, 2012, from  Schizophrenia: http://www.mayoclinic.com/health/schizophrenia/DS00196
McDougall, T. (2011). Mental health problems in childhood and adolescence. Nursing Standard,   26(14), 48-56.
West, J. B. (2012, January 21). How did you grow out of you ADD. (C. Morris, Interviewer)




Personality Disorders



Categories and subcategories is how the DSM-IV organizes its disorders.  As the matrix explains, the subcategories and the disorders encompass various aspects similar to behavior, reasons for those behaviors, and various treatment options.  This will be explained more during the writing of the eating, substance abuse, impulse control, sex, gender and sexual , and personality disorders, included will be the biological, emotional, cognitive, behavioral, and treatment components as well. 

Eating Disorders
Based on information provided by BehaveNet (2011), in the eating disorders class the disorder includes eating behavior.  All behaviors are related to eating patterns, consumption, purging and binging as well as laxative and diuretic use are discussed in the body image cell.  Additionally, these body images some want correlate with self-worth however they imply that what once could see as inadequacy actually is viewed as a reward to the addict.  However, with the intense and repeated nature of this disorder and cognitive problems these individuals do not recognize they have achieved their goal.  Sadly they look at their body, as an inaccurate image that only they believe is true (Hansell & Damour, 2008).  Thus the wheel begins to spin.  This is tremendously true in those suffering from bulimia nervosa and anorexia nervosa.
Anorexia is “the refusal to maintain body weight at or above minimally normal weight for age and height (less than 85% of expectable weight) (Hansell & Damour 2008, p. 279). Individuals who are suffering from anorexia consume small portions of food similar to starvation and then will exercise, burning off what they consumed and then some.  Biologically someone suffering from anorexia causes damage to organs.  Heart damage, anemia, and electrolyte imbalances can wreak havoc on a body (WebMD, 2011).  Therapy for someone suffering from anorexia nervosa is to insert a feeding tube and or seek medical interventions.  SSRI are considered helpful to some (Hansell & Damour 2008, p. 299).  Granted psychodynamic therapy that includes free association, dream analysis and transference to overcome the reasons behind the eating disorder is highly recommended.  There may be a possible way to discuss family dynamics in a family therapy setting in conjunction with cognitive therapy (Hansell & Damour 2008, p. 298).
Bulimia nervosa occurs when someone habitually engages in binge eating followed by a drastic way to avoid gaining weight (BehaveNet, 2011).  Anorexia nervosa and bulimia nervosa are one in the same when reviewing the end result, which is self-evaluation based on influences by weight and shape.  However the difference in bulimia is that those will binge and then purge and repeat over and over again by using laxatives, diuretics, enemas and probably the most common vomiting  (WebMD, 2009).    Many feel out of control when consuming food.  This induces depression, anxiety and ensues compensatory behavior.  Someone who self-induces vomiting can have severe medical problems such as damage to the `trachea, throat, teeth and the gastrointestinal tract.  As with anorexia the biological elements are lacking, but can produce dehydration, electrolyte imbalances, and amenorrhea  (WebMD, 2009). Treatment for bulimia is the same as with anorexia because they have shared roots.
Impulsive Disorders
Impulse disorders are generated between age seven and fifteen years old.  BehaveNet says it is “ recurrent failure to resist impulsive behaviors that may be harmful to themselves or others” (2011).   Impulsivity is seeking a behavior for a short-term gain but with a long-term consequence.  Something such as gambling is a prime example the short term gain is the reward of winning, while the long term consequence is the possibility of bankruptcy (BehaveNet, 2011).
Pathological gambling is a recurrent failure to resist gambling to the point that it consumes one’s life.  Even if a loss happens, the habitual gambler will see out ideas and ways to obtain more money even if it is illegal.  The gambler attaches the feeling of satisfaction to the winning. 
Substance Disorders
Substance disorders is a dependence and abuse of drugs for voluntary recreation.  It is hard to define the difference between dependency and abuse when dealing with this disorder because they are very similar.  For example dependency is when someone choses to continue taking prescription drugs longer than needed; whereas substance abuse is many may consider taking illegal means to procure the substance. In either case the desired effect is the same, many display withdrawn symptoms, anxiety when not on the drug of choice.  Both the dependency and abuse consume an exorbitant amount of time in order to receive the reward. 
While someone struggling with alcoholism does have determinates on the biological side, most on the dependence side does not and abuse has none at all.  Treatment for these given circumstances can be gradual withdrawal by the use of psychodynamic therapy as well as cognitive therapy.
Personality Disorders
Personality disorder is self-defeating traits that consume someone’s every day living and possibly lead to psychiatric symptoms BehaveNet, 2011).  Many who agonize with clusters A, B, and C have inherited this dreaded problem and it is also possible that under the “right” psychosocial conditions that someone can have a heightened predispositions.  Because of the variables in personality types, traits and circumstances, the behavior disorders can vary tremendously. 
Paranoid personality disorder is a pattern of extreme distrust and suspicion (BehaveNet, 2011).  People believe they are talking about them, attempting to conspire against them, and so on.  Most suffer from failed social bonds during childhood and having it be a traumatic experience. 
Gender Identity Disorder
Gender Identity disorder is a “A strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex) “A strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex (BehaveNet, 2011). Most of the time many state that they began to have symptoms during childhood.  Most associate with those whom they can model their behaviors and want to have playmates of the desired sex (BehaveNet, 2011).  Many will begin cross-dressing and eliminate primary and secondary characteristics (BehaveNet, 2011).
Hormone therapy, gender reassignment and sex change operations are all ways one can treat gender identity disorder.  However, psychodynamic therapy has been a tool to aid in a better understanding, but results have been far from clear.
Conclusion
Each subcategory defines disorders and how they are organized in the DSM-IV. It discusses behaviors and treatment options. Understanding personality disorders and how they affect those suffering from them will aid in a correct and accurate understanding of how to help those in the future.  DSM-IV is a remarkable tool and will change as the need changes for diagnosis. 


References
APA Diagnostic Classification DSM-IV-TR.  BehaveNet, 2011. Retrieved from  
            http://www.behavenet.com/capsules/disorders/dsm4TRclassification.htm#Sexual
Hansell, J. & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: Wiley.
WebMD. (2009, October 22). WebMD. Retrieved January 14, 2011, from Bulimia Nervosa –

WebMD. (2011, February 23). WedMD. Retrieved January 14, 2012, from Anorexia Nervosa: