Criminal Minds- Patient Description
The patient Mr. xx is a 42-year-old Caucasian man who has been imprisoned for 10 years for several counts of murdering young men, torturing them, raping them, and cutting off their penises. From history, xx had a difficult childhood. Xx facing traumatizing situations as a child. When he was just five years, he had a double hernia and he underwent surgery where his penis was cut off. This really traumatized him as he was taunted by his peers while he was growing up. He also grew up with an abusive father who left him to fend for himself, neglected him, and often called him names. He was also sexually molested by his uncle who lived with them. According to Freudian psychology, the perceived castration when his penis was cut off and the abuse, neglect by his own father, in addition to the sexual molestation may be what led him to kill, torture, rape, and cut off the penises of his male victims. His pathologies included serial killer, serial rapist, and sadistic personality. During the imprisonment, xx was undergoing cognitive behavioral therapy.
Substance Abuse or Violence Issues for the Patient
Since teenage hood, the patient had been abusing drugs such as cocaine, heroin, and opioids. He was also an alcoholic. He had been involved in various violent episodes within the community due to his aggressive behavior.
Attempted Interventions
The attempted intervention for the patient was cognitive behavioral therapy (CBT). CBT is an intervention that focuses on changing the maladaptive negative thinking patterns into more positive ones (David et al., 2018). The CBT focused on the childhood victimization of the patient and the original of his distorted attitudes. The childhood experiences were used to trace the cognitions that led to the patient’s behavior. The patient was trained to change the distorted cognition into a more positive one. However, the intervention had not been successful since the patient manifested aggressive behavior during imprisonment.Criminal Minds- Patient Description
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Personal Thoughts about the Patient’s Mental Health Issues
The patient’s mental health issues stem from the childhood trauma he went through. He was neglected as a child, traumatized by cutting the penile surgery, underwent taunting from his peers, was abused by his father, and sexually molested by the uncle. Children who are neglected and whose cries are overlooked tend to develop deviant behavior, and gradually become involved in more illegal and deadly activities such as murder (Kerig & Becker, 2015). Mr. xx probably started odd behaviors while he was growing up. Had the maladaptive behavior been addressed early, perhaps he would not have become involved in the subsequent murders and raping.
Cognitive Concerns and Possible Intervention
The patient still has underlying anger and emotional issues that need to be addressed. His cognitive distortions and deviant sexual arousal need to be addressed. The possible interventions include anger management training using cognitive-behavioral strategies to ensure self-control, behavioral techniques to modify his sexual arousal patterns, and cognitive restructuring (Craig & Rettenberger, 2018).
Nursing Care Plan
Priority Nursing Diagnoses
Antisocial personality disorder: This disorder is characterized by totally disregarding others’ feelings, violence, lack of remorse, aggression, impulsive actions, and breaking the law (Black, 2015). Mr. xx was not remorseful about his killing and rape acts, was aggressive, violent, and showed total disregard to the feelings of his victims, justifying the diagnosis of antisocial personality disorder.
Sadistic personality disorder: This disorder is typified by a pattern of cruelty, harshness, aggressiveness, as well as demeaning, humiliating, and intimidating behavior (Chester et al., 2019). Mr. xx manifested cruel, aggressive, demeaning, intimidating, and harsh behavior towards his victims. Additionally, childhood abuse is a risk factor for this disorder. The patient was abused during his childhood and this informs the diagnosis.
Substance use disorder: The patient reported being addicted and dependent on drugs such as heroin and cocaine, justifying the diagnosis of substance use disorder.
Interventions
Victim empathy training: The patient will be trained to develop empathy in order to increase his emotional or affective response to the other’s distress.
Anger management training using cognitive-behavioral strategies to ensure self-control. This is because anger is the driving force for aggressive behaviors and violent acts such as rape and murder.
CBT: This will focus on cognitive restructuring in order to modify the maladaptive behaviors, including the sexual arousal patterns.
Mental Health Resources for the Patient
American counseling association (ACA): The patient can receive free counseling and therapy from professional counselors at ACA. He can also access free reading resources.Criminal Minds- Patient Description
Federal resources such as Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA).
Educational tool: The patient will be educated about his mental health conditions and the importance of adhering to the proposed and recommended treatment interventions.
References
Black D. W. (2015). The Natural History of Antisocial Personality Disorder. Canadian journal of psychiatry. Revue Canadienne de Psychiatrie, 60(7), 309–314. https://doi.org/10.1177/070674371506000703
Chester, D. S., DeWall, C. N., & Enjaian, B. (2019). Sadism and aggressive behavior: Inflicting pain to feel pleasure. Personality and social psychology bulletin, 45(8), 1252-1268.
Craig, L. A., & Rettenberger, M. (2018). An etiological approach to sexual offender assessment: CAse Formulation Incorporating Risk Assessment (CAFIRA). Current psychiatry reports, 20(6), 43.
David, D., Cristea, I., & Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers in psychiatry, 9, 4. https://doi.org/10.3389/fpsyt.2018.00004
Kerig, P. K., & Becker, S. P. (2015). 12 Early Abuse and Neglect as Risk Factors for the Development of Criminal and Antisocial Behavior. The development of criminal and antisocial behavior (pp. 181-199). Springer, Cham. Criminal Minds- Patient Description