Comp Exam

Please note that the following vignettes represent samples of the types of questions you will be asked to respond to on the comprehensive exam. You will NOT receive these questions on the comprehensive exam; they are for study purposes only.  Vignette   Please compose a well-written and organized essay in response to each of the following questions. When writing your essays, please 1.Use APA (6th edition) Style, with 1-inch margins, double-spaced, 12 font, with a reference list at the end. 2.Write clearly and concisely. 3.Cite appropriate, and especially current, literature (empirical and/or theoretical). 4.Avoid all sexist idioms and allusions. 5.Remember to demonstrate your multicultural competence where appropriate.  Vignette: Utilize this scenario for all of your responses  A 42-year-old African American woman was brought to the emergency room by police officers for evaluation prior to going to jail to await disposition. She reported that she had been shopping when “something happened.” She said that she had no recollection of events between the time she entered the store and an hour later, when she was arrested for shoplifting in a nearby department store with a considerable amount of stolen property on her person. She protested her innocence and became so agitated, belligerent, and profane that the arresting officers took her to the hospital for evaluation. At the hospital she reported that two years previously she had been arrested for shoplifting and had had amnesia for the act. The charges against her were then dropped because she explained that both the shoplifting and the amnesia resulted from her forgetting to eat after taking her insulin. Of note, her blood-sugar level on testing in the emergency room was elevated.  The patient calmed down appearing asymptomatic after the evaluation and was transferred to jail pending a preliminary hearing. When she learned that her release was planned for the next day and that the charges against her would not be dropped, she became extremely agitated, angry, and abusive to the officers. Shortly thereafter, she complained of a headache and said she had no recollection of her abusive behavior. Later that evening she accosted an officer angrily. When the officer responded and addressed the patient by name, “Naomi,” the patient said that her name was “Oprah” and that she would not allow herself to be called “Naomi,” whom she described as a “wimp and a loser.”  “Oprah’s” voice and movement were somewhat different from those of “Naomi.” She claimed that she had done the shoplifting and stepped back so that “Naomi” could be caught and humiliated, and that if she had wanted to, she could have evaded detection easily. She was returned to the ER and subsequently admitted to the inpatient psychiatric unit for observation. For the next two days, the patient had many apparent switches of personality, accompanied by conspicuous changes in dress, makeup, and demeanor. On several occasions “Oprah” was disruptive, and twice “Naomi” reported to nurses that she had found things belonging to other patients in her possession.  There were no consistent differences in blood-sugar levels in the different personalities or changes at the time of the shifts. A neurological workup with extensive electroencephalographic studies proved unremarkable. The patient began to complain that her behavior was out of her control and that she could not be held accountable for it. Each day’s progress notes revealed further details of the differences between “Oprah” and “Naomi.”  A counselor was asked to see the patient. He observed the presence of both “Oprah” and “Naomi” and documented their polarized and clear-cut differences. The personalities were detailed and elaborate as they discussed issues relating to the patient’s current legal difficulties. He learned that the patient had an extensive history of discrepant behaviors that she had “forgotten,” to which many witnesses would attest, and that her family often remarked that she was “like two different people.” He found that these episodes had usually occurred when the patient had engaged in behavior that brought adverse personal consequences upon her. He noted that the patient was on a unit that, by coincidence, had three other patients with similar symptomology and that, beginning the day the patient learned that the charges against her would not be dropped, she had begun to associate more frequently with those patients.  An extensive history, taken over several days, and ancillary sources failed to reveal any history of childhood abuse and there was no indication that the patient had experienced any other overwhelming traumatic events. Furthermore, the history indicated that the patient, despite the apparently classic nature of her two personalities, had never shown or complained of any other significant psychological symptomology. Her history includes having been raised as an only child in a middle-class urban environment by her mother and grandmother. She reports that she has a good relationship with all members of her family although she has a more distant relationship with her father, who works long hours as an engineer. His mother and grandmother work as teachers in nearby private schools. Both her parents are of Haitian descent though the patient was born and has lived her entire life in the United States.  The patient’s developmental history includes having met all physical and cognitive developmental milestones on time, with mild difficulties in reading and peer relationships. In early elementary school she was reported to have had some ‘acting out’ problems including hitting another child, and talking back to adults, however, these behaviors were not severe or long-term enough to warrant suspension or ongoing concern. In high school, no behavior problems were noted, and she was described as socially somewhat reclusive, having only one or two close friends.  Prior hospital records were found for “Naomi” indicating a long history of alcohol, heroin, and cocaine use, but upon confrontation about this history she claimed to have been clean for three weeks prior to her arrest. Her initial blood work was positive for both opiods and cannabis.  The counselor also noted that the “Naomi” he was interviewing was somewhat different from the “Naomi” with whom her family and friends were familiar. The usual “Naomi” was pleasant and mild-mannered unless “crossed,” at which times she became angry and belligerent. He also found that the patient was not very hypnotizable. He undertook a prolonged interview in which he covered a wide range of topics over several hours. As the interview proceeded, “Oprah,” who was completely consistent in her presentation during her discussion of matters related to the shoplifting and disruptive events on the ward, began to become inconsistent in her voice and manner. She complained that the consultant disbelieved her and was trying to “trick” her. As “Oprah” seemed unable to maintain her presentation, “Namoi” vehemently reproached the consultant for doubting the account offered by “Oprah,” for whose past behaviors and current interactions with the consultant she had consistently maintained she had amnesia. At these angry moments, her behavior was indistinguishable from “Oprah’s.” After another hour’s interviewing, during which the patient made several efforts to convince the consultant that she had amnesia during the shop lifting episode, she ceased to display the amnesiac behaviors.  When she was introduced to her public defender who told her she would be arraigned the following day, she flew into a rage and threatened that she would slash her wrists with the first sharp object she could find. She also claimed that she was hearing voices in her head telling her to kill herself.  Based on the vignette provided, please compose a well-written and organized response to each of the following questions.  When writing your responses, please: •Use APA (6th edition) Style, with 1-inch margins, double-spaced, 12 font, with a reference list at the end. •Write clearly and concisely. •Cite appropriate, and especially current, literature (empirical and/or theoretical). •Avoid all sexist idioms and allusions. •Remember to demonstrate your multicultural competence where appropriate.   Psychological Theory and Practice A.What assessments would you conduct to enhance your understanding of the problems of the person in the vignette and how would your choice of assessment(s) inform your diagnostic formation and treatment planning? Assessments may include structured or unstructured interviews, valid and reliable assessment measures, and/or formalized assessment procedures that may be conducted by yourself or by someone else referred by you.  B.Provide your diagnostic impressions (based on the DSM-5) for this individual. In narrative form, please describe how the individual meets the diagnostic criteria for the disorder(s) chosen in addition to the differential diagnostic thought process that you used to reach your hypotheses. Be sure to include any additional (missing) information that is needed to either rule out or confirm your differential diagnoses impressions.  Legal Theory and Application A. Explain the background, current presentation, and behavior of the person in the vignette utilizing biological, learning, and social theories on offenders to support your position. Do not simply restate the background information from the vignette. Instead, provide a theoretically-based discussion to understand the criminal behaviors of the person in the vignette. B.Consider the type of crime in the vignette and discuss how that type of crime generally impacts a victim of it.  Do not limit yourself to discussing just the victim in this vignette.  Instead obtain scholarly sources for information on how this type of crime can affect any victim, their family members, and other members of society.  C.Describe the psycholegal standards and/or definitions for each of the following: competence to stand trial, duty to warn, and insanity. Identify and describe one or more landmark case(s) for each standard (at least three cases total). Describe the elements or issues that a mental health professional usually focuses on when assessing a person’s adjudicative competence, risk and insanity, and any additional items that might be especially important to focus on in the provided vignette.  Assessment, Research and Evaluation A.Describe tests or assessment procedures you would employ to address the psycholegal issues of (competence to stand trial, risk of dangerousness, and insanity). You may refer to these from the Psychological Theory and Assessment Section “A” if you already covered them there.  Discuss what the anticipated conclusions would be based upon information provided in the vignette. B.Develop a research question and a testable research hypothesis regarding offenders or the type of crime that is discussed in the vignette (such as, addiction, recidivism, criminal behavior, etc.).  Explain the variables in your question and the type of research study that could answer your question as well as why that research would make a contribution to the field of forensic psychology.  Leadership, Consultation, and Ethics A.What are the ethical and legal dilemmas this vignette introduced? What would be your immediate steps and why? Please be specific and make sure that you describe your process of ethical decision making and the solutions/consequences to which this process might lead. Your discussion should be informed by the American Psychological Association’s Ethics Code as well as the Specialty Guidelines for Forensic Psychologists.  Interpersonal Effectiveness A.What diversity factors, cultural considerations, or other demographic variables pertaining to the person in the vignette would you take into account in rendering diagnoses, choosing assessment measures, forming case conceptualizations, and designing the treatment plan?  Be sure to discuss cultural/diversity factors that could apply even if they are not explicitly mentioned in the vignette. B.Your writing, use of citations, ability to form a logical argument, and proper APA Style, including the use of paraphrasing, will be evaluated as a measure of your interpersonal effectiveness. No response is required for “B”.

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