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Sample Case Study Of Psychological Disorder

ByChristian Jarrett

These ten characters have all had a huge influence on psychology and their stories continue to intrigue each new generation of students. What’s particularly fascinating is that many of their stories continue to evolve – new evidence comes to light, or new technologies are brought to bear, changing how the cases are interpreted and understood. What many of these 10 also have in common is that they speak to some of the perennial debates in psychology, about personality and identity, nature and nurture, and the links between mind and body.

Phineas Gage
One day in 1848 in Central Vermont, Phineas Gage was tamping explosives into the ground to prepare the way for a new railway line when he had a terrible accident. The detonation went off prematurely, and his tamping iron shot into his face, through his brain, and out the top of his head. Remarkably Gage survived, although his friends and family reportedly felt he was changed so profoundly (becoming listless and aggressive) that “he was no longer Gage.” There the story used to rest – a classic example of frontal brain damage affecting personality. However, recent years have seen a drastic reevaluation of Gage’s story in light of new evidence. It’s now believed that he underwent significant rehabilitation and in fact began work as a horse carriage driver in Chile. A simulation of his injuries suggested much of his right frontal cortex was likely spared, and photographic evidence has been unearthed showing a post-accident dapper Gage. Not that you’ll find this revised account in many psychology textbooks: a recent analysis showed that few of them have kept up to date with the new evidence.

Find out more: Using brain imaging to reevaluate psychology’s three most famous cases
Neuroscience still haunted by Phineas Gage
Phineas Gage – Unravelling the Myth
Looking back: Blasts from the past
Coverage of Phineas Gage in the book Great Myths of the Brain

H.M.
Henry Gustav Molaison (known for years as H.M. in the literature to protect his privacy), who died in 2008, developed severe amnesia at age 27 after undergoing brain surgery as a form of treatment for the epilepsy he’d suffered since childhood. He was subsequently the focus of study by over 100 psychologists and neuroscientists and he’s been mentioned in over 12,000 journal articles! Molaison’s surgery involved the removal of large parts of the hippocampus on both sides of his brain and the result was that he was almost entirely unable to store any new information in long-term memory (there were some exceptions – for example, after 1963 he was aware that a US president had been assassinated in Dallas). The extremity of Molaison’s deficits was a surprise to experts of the day because many of them believed that memory was distributed throughout the cerebral cortex. Today, Molaison’s legacy lives on: his brain was carefully sliced and preserved and turned into a 3D digital atlas and his life story is reportedly due to be turned into a feature film based on the book researcher Suzanne Corkin wrote about him: Permanent Present Tense, The Man With No Memory and What He Taught The World.

Find out more: Using brain imaging to reevaluate psychology’s three most famous cases
Henry Molaison: the amnesiac we’ll never forget
Understanding amnesia – Is it time to forget HM?

Leborgne’s brain is housed at
the Musée Dupuytren museum in Paris

Victor Leborgne (nickname “Tan”)
The fact that, in most people, language function is served predominantly by the left frontal cortex has today almost become common knowledge, at least among psych students. However, back in the early nineteenth century, the consensus view was that language function (like memory, see entry for H.M.) was distributed through the brain. An eighteenth century patient who helped change that was Victor Leborgne, a Frenchman who was nicknamed “Tan” because that was the only sound he could utter (besides the expletive phrase “sacre nom de Dieu”). In 1861, aged 51, Leborgne was referred to the renowned neurologist Paul Broca, but died soon after. Broca examined Leborgne’s brain and noticed a lesion in his left frontal lobe – a segment of tissue now known as Broca’s area. Given Leborgne’s impaired speech but intact comprehension, Broca concluded that this area of the brain was responsible for speech production and he set about persuading his peers of this fact – now recognised as a key moment in psychology’s history. For decades little was known about Leborgne, besides his important contribution to science. However, in a paper published in 2013, Cezary Domanski at Maria Curie-Sklodowska University in Poland uncovered new biographical details, including the possibility that Leborgne muttered the word “Tan” because his birthplace of Moret, home to several tanneries.

Find out more: Glimpsed at last – the life of neuropsychology’s most important patient
Using brain imaging to reevaluate psychology’s three most famous cases

Wild Boy of Aveyron
The “Wild boy of Aveyron” – named Victor by the physician Jean-Marc Itard – was found emerging from Aveyron forest in South West France in 1800, aged 11 or 12, where’s it’s thought he had been living in the wild for several years. For psychologists and philosophers, Victor became a kind of “natural experiment” into the question of nature and nurture. How would he be affected by the lack of human input early in his life? Those who hoped Victor would support the notion of the “noble savage” uncorrupted by modern civilisation were largely disappointed: the boy was dirty and dishevelled, defecated where he stood and apparently motivated largely by hunger. Victor acquired celebrity status after he was transported to Paris and Itard began a mission to teach and socialise the “feral child”. This programme met with mixed success: Victor never learned to speak fluently, but he dressed, learned civil toilet habits, could write a few letters and acquired some very basic language comprehension. Autism expert Uta Frith believes Victor may have been abandoned because he was autistic, but she acknowledges we will never know the truth of his background. Victor’s story inspired the 2004 novel The Wild Boy and was dramatised in the 1970 French film The Wild Child.

Find out more: Case Study: The Wild Boy of Aveyron (BBC Radio 4 documentary).

Kim Peek
Nicknamed ‘Kim-puter’ by his friends, Peek who died in 2010 aged 58, was the inspiration for Dustin Hoffman’s autistic savant character in the multi-Oscar-winning film Rain Man. Before that movie, which was released in 1988, few people had heard of autism, so Peek via the film can be credited with helping to raise the profile of the condition. Arguably though, the film also helped spread the popular misconception that giftedness is a hallmark of autism (in one notable scene, Hoffman’s character deduces in an instant the precise number of cocktail sticks – 246 – that a waitress drops on the floor). Peek himself was actually a non-autistic savant, born with brain abnormalities including a malformed cerebellum and an absent corpus callosum (the massive bundle of tissue that usually connects the two hemispheres). His savant skills were astonishing and included calendar calculation, as well as an encyclopaedic knowledge of history, literature, classical music, US zip codes and travel routes. It was estimated that he read more than 12,000 books in his life time, all of them committed to flawless memory. Although outgoing and sociable, Peek had coordination problems and struggled with abstract or conceptual thinking.

Find out more: New York Times Obit for Kim Peek.
Autism – myth and reality
Calendar calculating savants with autism – how do they do it?
I Am a Calendar Calculator

Image: Wikipedia

Anna O.
“Anna O.” is the pseudonym for Bertha Pappenheim, a pioneering German Jewish feminist and social worker who died in 1936 aged 77. As Anna O. she is known as one of the first ever patients to undergo psychoanalysis and her case inspired much of Freud’s thinking on mental illness. Pappenheim first came to the attention of another psychoanalyst, Joseph Breuer, in 1880 when he was called to her house in Vienna where she was lying in bed, almost entirely paralysed. Her other symptoms include hallucinations, personality changes and rambling speech, but doctors could find no physical cause. For 18 months, Breuer visited her almost daily and talked to her about her thoughts and feelings, including her grief for her father, and the more she talked, the more her symptoms seemed to fade – this was apparently one of the first ever instances of psychoanalysis or “the talking cure”, although the degree of Breuer’s success has been disputed and some historians allege that Pappenheim did have an organic illness, such as epilepsy. Although Freud never met Pappenheim, he wrote about her case, including the notion that she had a hysterical pregnancy, although this too is disputed. The latter part of Pappenheim’s life in Germany post 1888 is as remarkable as her time as Anna O. She became a prolific writer and social pioneer, including authoring stories, plays, and translating seminal texts, and she founded social clubs for Jewish women, worked in orphanages and founded the German Federation of Jewish Women.

Find out more: Freud’s Anna O. Social work’s Bertha Pappenheim [pdf document]
A Dangerous Method is a feature film about another influential patient of psychoanalysis, Sabina Spielrein, who subsequently became a psychoanalyst herself.

Image: Wikipedia

Kitty Genovese
Sadly, it is not really Kitty Genovese the person who has become one of psychology’s classic case studies, but rather the terrible fate that befell her. In 1964 in New York, Genovese was returning home from her job as a bar maid when she was attacked and eventually murdered by Winston Mosely. What made this tragedy so influential to psychology was that it inspired research into what became known as the Bystander Phenomenon – the now well-established finding that our sense of individual responsibility is diluted by the presence of other people. According to folklore, 38 people watched Genovese’s demise yet not one of them did anything to help, apparently a terrible real life instance of the Bystander Effect. However, the story doesn’t end there because historians have since established the reality was much more complicated – at least two people did try to summon help, and actually there was only one witness the second and fatal attack. While the main principle of the Bystander Effect has stood the test of time, modern psychology’s understanding of the way it works has become a lot more nuanced. For example, there’s evidence that in some situations people are more likely to act when they’re part of a larger group, such as when they and the other group members all belong to the same social category (such as all being women) as the victim.

Find out more: The truth behind the story of Kitty Genovese and the bystander effect
Foundations of sand? The lure of academic myths in psychology
37 is a short film about the Genovese murder

Little Albert

“Little Albert” was the nickname that the pioneering behaviourist psychologist John Watson gave to an 11-month-old baby, in whom, with his colleague and future wife Rosalind Rayner, he deliberately attempted to instill certain fears through a process of conditioning. The research, which was of dubious scientific quality, was conducted in 1920 and has become notorious for being so unethical (such a procedure would never be given approval in modern university settings). Interest in Little Albert has reignited in recent years as an academic quarrel has erupted over his true identity. A group led by Hall Beck at Appalachian University announced in 2011 that they thought Little Albert was actually Douglas Merritte, the son of a wet nurse at John Hopkins University where Watson and Rayner were based. According to this sad account, Little Albert was neurologically impaired, compounding the unethical nature of the Watson/Rayner research, and he died aged six of  hydrocephalus (fluid on the brain). However, this account was challenged by a different group of scholars led by Russell Powell at MacEwan University in 2014. They established that Little Albert was more likely William A Barger (recorded in his medical file as Albert Barger), the son of a different wet nurse. Earlier this year, textbook writer Richard Griggs weighed up all the evidence and concluded that the Barger story is the more credible, which would mean that Little Albert in fact died 2007 aged 87.

Find out more: Little Albert – one of the most famous research participants in psychology’s history – but who was he?
Looking back: Finding Little Albert

Chris Sizemore
Chris Costner Sizemore is one of the most famous patients to be given the controversial diagnosis of multiple personality disorder, known today as dissociative identity disorder. Sizemore’s alter egos apparently included Eve White, Eve Black, Jane and many others. By some accounts, Sizemore expressed these personalities as a coping mechanism in the face of traumas she experienced in childhood, including seeing her mother badly injured and a man sawn in half at a lumber mill. In recent years, Sizemore has described how her alter egos have been combined into one united personality for many decades, but she still sees different aspects of her past as belonging to her different personalities. For example, she has stated that her husband was married to Eve White (not her), and that Eve White is the mother of her first daughter. Her story was turned into a movie in 1957 called The Three Faces of Eve (based on a book of the same name written by her psychiatrists). Joanne Woodward won the best actress Oscar for portraying Sizemore and her various personalities in this film. Sizemore published her autobiography in 1977 called I’m Eve. In 2009, she appeared on the BBC’s Hard Talk interview show.

Find out more: the Chris Costner Sizemore Papers at Duke University. 

David Reimer
One of the most famous patients in psychology, Reimer lost his penis in a botched circumcision operation when he was just 8 months old. His parents were subsequently advised by psychologist John Money to raise Reimer as a girl, “Brenda”, and for him to undergo further surgery and hormone treatment to assist his gender reassignment. Money initially described the experiment (no one had tried anything like this before) as a huge success that appeared to support his belief in the important role of socialisation, rather than innate factors, in children’s gender identity. In fact, the reassignment was seriously problematic and Reimer’s boyishness was never far beneath the surface. When he was aged 14, Reimer was told the truth about his past and set about reversing the gender reassignment process to become male again. He later campaigned against other children with genital injuries being gender reassigned in the way that he had been. His story was turned into the book As Nature Made Him, The Boy Who Was Raised As A Girl by John Colapinto, and he is the subject of two BBC Horizon documentaries. Tragically, Reimer took his own life in 2004, aged just 38.

Find out more: What were the real reasons behind David Reimer’s suicide?
_________________________________

main sources and further reading
The Rough Guide to Psychology
Great Myths of the Brain.
10 of The Most Counter-Intuitive Psychology Findings Ever Published
The 10 Most Controversial Psychology Studies Ever Published

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

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Records 1 to 50 of 50

A Case of a Pheochromocytoma
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A Case of Mistaken Memory?
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A Case of Seasonal Affective Disorder
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A Collision of Two Worlds
This case uses an excerpt from the novel I Never Promised You a Rose Garden to teach students to recognize symptoms of mental illness. Students read the excerpt and then work in small groups of two to three to identify and label symptoms of me...


A Recipe for Invention
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A Rush to Judgment?
This case describes a study conducted by students in which a number of ethical issues arise, including the treatment of research participants and the supervision of student research assistants by faculty. By examining the way in which the study was con...


A Social-Cognitive Exploration of Reactions to Leiby Kletzky's Abduction and Homicide
An eight-year-old boy, abducted while walking home from day camp, is killed and dismembered, and his alleged murderer, a member of the boy's community, is arrested. Students read details about the case with the goal of exploring how people have respond...


Abnormal Psychology in the Hundred Acre Wood
In 2000, Sara E. Shea and co-authors published "Pathology in the Hundred Acre Wood: A neurodevelopmental perspective on A.A. Milne" in the Canadian Medical Association Journal. That article gave provisional "diagnoses" to Christopher Robin and...


Agony and Ecstasy
This interrupted case study explores the scientific, legal, and societal complexities of repurposing an illicit substance, 3,4-methylenedioxymethamphetamine (MDMA), also known as "Ecstasy" or "Molly," into a clinically accepted medicine for treating po...


Anxiety Doesn’t Work
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Are You Blue? What Can You Do?
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Artificial Sanity
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Brain Workouts
This directed case study follows two college roommates, Darrell and Anthony, who have just returned to school after winter vacation. They share that their ageing fathers are concerned about their declining faculties and are amused by their fathers' eff...


Case of Maria
This case illustrates concepts of assessment, diagnosis, and treatment within the context of a counseling relationship. Its primary purpose is to teach students about the dynamics of the therapeutic relationship, specifically that the relationship is o...


Chemical Eric Can't See
This autobiographical case study presents the story of Eric as he learns that he has a genetic eye disease, which progresses to the point that he becomes legally blind. The story is true and, in this respect, similar to another case by the same author ...


Dire Straights
This case study is a fictional account of a romantic interlude in which a secret concerning the gender history of one of the characters is revealed. The case is intended to offer students a greater understanding of gendered culture and to discuss diver...


Emily and Dr. Haskins
This case study on clinical practice, preparation, and acumen follows the story of Emily, an intelligent, hard working, and motivated student who yet encounters difficulties in the clinical fieldwork component of her senior seminar. A follow-up section...


Exploring Unintentional Racism
This case study is designed to help students explore their attitudes about race and examine the complexity of racism. It also has been used to teach about the social psychology of unintentional racism, attribution theory, and institutionalized racism. ...


Extrasensory Perception: Pseudoscience?
The overall purpose of this case study is to teach students to be skeptical of scientific claims, particularly those that are sensational and fall outside the boundaries of normal scientific explanation. Students read the case and then evaluate informa...


Feeling Detoxified
This case study uses the example of ionic foot baths to examine how placebo treatments can affect our health and wellness. Inspired by a student’s real visit to a spa, the story begins with a description of the experience of an ionic foot bath, a...


I Almost Missed the Marathon
This case study is about a German man named Fritz Jähn. Fritz was physically active in his youth and an achievement-striving individual who was academically and professionally accomplished. He distinguished himself as an anesthesiologist and a fat...


I Can See Clearly Now
This series of mini cases focuses on the cortical areas associated with vision and visual perception. Each case depicts a breakdown in visual perception that may be traced to damage in an area or areas of the visual system and is based upon an actual c...


Joe Joins the Circus (or Elephant Love)
In this interrupted case study, students cover concepts and terms related to classical and operant conditioning as they read about how "Joe," an animal trainer for a circus, trains the two elephants in his charge. Joe sets about his task using concepts...


Josie
In this interdisciplinary case, students meet Josie, the main character, who suffers from a variety of symptoms. Students must grapple with the conflicting data presented, which ultimately leads them to a diagnosis of either porphyria or schizophrenia....


Kate-tastrophy
In this interrupted case, students examine the concept of unconsciousness and develop an understanding of how clinicians diagnose death. Developed for a freshman course in human biology, the case focuses on brain death, but raises related issues, inclu...


Local vs. Foreign Tragedy
This case study challenges students to understand and apply a set of concepts from the domain of social psychology to an inflammatory article that was published in The Guardian. Students prepare by reading a chapter on prejudice and stereotypi...


Michael's Story
This interdisciplinary case study introduces us to the Greens, a family with a recently diagnosed autistic child. Autism is one of several disorders grouped within the acronym ASD, or autism spectrum disorders. Autistic children have problems with comm...


Mini Cases in Movement Disorders
This collection of six short cases focuses on brain areas and neurotransmitters involved in the control of movement. Students are divided into working groups and given one or more of the case descriptions. Each scenario depicts a breakdown in the motor...


Mini Cases in Psychoactive Drugs and Their Effects on the Brain
Designed for an upper-level psychology class titled Brain & Behavior, this series of mini-cases can be used in any undergraduate course that covers the major classes of commonly abused legal and illicit psychoactive drugs from a biological...


Modern Frankenstein?
This interdisciplinary case study uses the format of a progressive disclosure to explore certain advances in biotechnology and evaluate them within the framework of societal needs, concerns and pressures.  When faced with a heart valve transplant,...


Nature or Nurture
This case explores the question of whether gender identity is determined strictly by genetics (nature) or social variables (nurture).  It is based on a true story about a man who was raised as a girl and later rejected the female gender identity.&...


Paired Associates Learning, the Shortfalls of Behaviorism, and the Rise of Cognitivism
In this interrupted case study, students learn about a series of studies conducted in the late '50s/early '60s by Robert Young at the University of Texas at Austin. The studies, which explored the type of phenomena that behaviorism has had a difficult ...


Prayer Study
In this case, students read a news article about a study of the effects of intercessory prayer on cardiac patients published in the Archives of Internal Medicine. After reading the case and discussing the questions in small groups, students ev...


Salem's Secrets
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Selecting the Perfect Baby
This dilemma case is based on the true story of Jack and Lisa Nash, whose daughter Molly was born with a rare genetic disorder, Fanconi anemia. By having another child with specific genetic markers, the Nashes hoped to cure Molly using stem cells from ...


Skinny Genes?
This case study introduces Megi, an active teenager who has recovered from anorexia nervosa.  The method of progressive disclosure is used to take students back in time as Megi recalls the physical and psychological aspects of her illness and t...


Speak Up!
This series of mini cases focuses on language deficits (aphasias) and their likely organic causes (problems in specific brain areas). Students read one of the six cases, which are based on actual cases reported in the literature, and connect the sympto...


Split My Brain
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This case study uses an example of racism experienced by a Korean American student to explore the concept of stereotype threat and its impact on college classrooms and student performance. The case was designed for use with college faculty in teach tra...


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The 2000-Meter Row: A Case Study in Performance Anxiety
This case study is based on another case in our collection, The 2000-Meter Row: A Case in Homeostasis, which emphasizes the metabolic, respiratory, and cardiac responses of a young athlete competing in a championship rowing event. In this modi...


The Great Parking Debate
Two friends debate whether people leave their parking spaces faster if others are waiting. They decide to see if they can design a study to test their ideas.  In this interrupted case study, students develop a research question and hypothesis and ...


The Irresistible Costs of Impressing Others
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The Lady of Charleston?
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The Mozart Effect
In this case study, students are given information regarding an advertisement claiming that listening to the classical music in the advertised CD set will enhance a person’s cognitive skills and creativity. Students evaluate the claims and the ev...


The Power of Communication
This directed case study begins with an intentionally ambiguous story: Q suddenly realizes that it is time to relay a message to Z (another inhabitant of their home) to let Z know that it's time to produce some items and send them on to accomplices in ...


Thirty-Two Seconds to Go: A Case of Motivation, Locus of Control, and Self-Efficacy
In the 1983 Big Eight Conference championship football game, Neil Harris deflected a pass with 32 seconds to go in a play that stopped the University of Oklahoma from scoring and clinched Nebraska's perfect 12-0 season, a third consecutive Big Eight co...


To Be Who I Am
This case examines a rare condition known as Body Integrity Identity Disorder, in which an individual has a persistent and consuming desire to become an amputee. Students apply Charles Horton Cooley’s theory of the "looking-glass self" to explore...


Under the Knife and Completely Aware
This case study is based on a newspaper article about the suicide of Sherman Sizemore shortly after he underwent an exploratory laparotomy (abdominal surgery).  After his surgery, Sherman experienced symptoms similar to post-traumatic stress disor...


War, Death, and Cognitive Dissonance
This case study explores cognitive dissonance theory, a theory proposed by psychologist Leon Festinger in 1956 to explain the tension that exists when peoples’ attitudes are incongruent with their behaviors. Students read a news article describin...


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