Dion Johnson Case Studies

Dion Johnson is a 19 year old, single, African American, male. Dion had an 8-year history of emotional and behavioral problems, that eventually caused him to withdraw from school. His behavors became increasingly severe, and included excessive washing and showering; ceremonial rituals for dressing and studying; compulsive placement of any objects he handled; grotesque hissing, coughing, and head tossing while eating; and shuffling and wiping his feet while walking. Dion grew up in a loving and nurturing household that included himself, his mother and father, and his younger brother. He was always quiet and withdrawn and he had few friends. However he was preformed very well academically and functioned reasonably well until the seventh grade.
The two major diagnoses are Obsessive-Compulsive Disorder: Severe, and Obsessive-Compulsive Personality Disorder: Moderate. The two associated diagnoses are associated anxiety, and associated delusions. I chose Obsessive-Compulsive Disorder because the textbook defines this disorder as “when obsessions and compulsions feel excessive or unreasonable, cause great distress, take up much time, and interfere with daily functioning” (pg 137). Dion meets all of this criteria, he is unable to function daily because his compulsion take up so much of his time, they cause him distress and anxiety, and all of his compulsions are excessive and he feels compelled to repeat them multiple times a day. Dion has anxiety associated with the OCD (Obsessive-Compulsive Disorder). “The obsessions cause intense anxiety , while the compulsions are aimed at preventing or reducing the anxiety” (pg 137). Dion’s obsession with making sure everything is in a certain place to prevent contamination and eating normally causes his great anxiety, therefore his compulsions to move and place objects and his compulsions to cough, hiss, and throw his head while eating are all ways he relieves his anxiety of catching germs. Dion also experiences associated delusions. The textbook defines delusions as “ ideas that people believe wholeheartedly but have no basis for” (pg 388). As a result of his OCD, he feels that if he doesn’t follow his rituals
The very first thing I looked into was depression, however I ruled this out because while Dion met the criteria for being withdrawn, he did not meet the criteria for excessive sadness, fatigue or loss of motivation, or suicidal thoughts. I also considered delusional disorder because Dion had a delusion about germ and disease and the ways that it would get into his body, but I did not choose this diagnosis because his delusion was not one of jealousy, erotomanic, grandiose, or persecutory, therefore he did not properly meet the criteria for this