Case Study 1

Staria is a seventeen-year-old girl who has been brought to youroutpatient treatment center by her mother. Staria has beensuspended from high school on two occasions over the past six weeksfor fighting and disorderly conduct. She has a history of recurrentdetention and classroom dismissals for similar, though less severe,behavior at her previous high school. On the last occasion, she andanother student were engaged in an altercation in the hallway. Whensecurity was called in, it was discovered that Staria had a pint ofvodka and a small quantity of marijuana in her locker. At the time,it was noticed that Starina seemed intoxicated. She later testedpositive for marijuana.

You meet Staria and her mother and learn that Staria stolealcohol and marijuana from her father's stash and that he wasoutraged by the discovery. Staria blames her parents for her schooldismissal and feels she is being blamed and scapegoated by herparents. According to her, her parents are the ones who needcounseling. She also reports that her grandfather recently passedaway due to cirrhosis. Her mother states that Staria has a twinsister, who never uses drugs, cigarettes, or alcohol and thatStaria should be more like her sister.

Case Study 2

George is a civil service employee who has been struggling withhis drinking problem for years. He has tried to control his alcoholuse and has made many attempts to refrain. Lately, he has beendrinking more frequently to feel the same effect; he even drinksbefore he goes to work. His family has a history of alcoholism.Although George is aware of the genetic origins concept, he feelsembarrassed and struggles to identify himself as an alcoholic. Hecompares himself with others who drink far more than he does, andin his perception, this rationalizes that he is not that bad.
George continues to drink despite the adverse consequences on hishealth and sociocultural relationships. In the past three years, hehas experienced the following consequences:

One arrest for driving under the influence (DUI)

Loss of a job

Mood swings

Fights and arguments with family members over his drinking

Frequent inability to stop drinking

Blackouts

Need for increasing amounts of alcohol in order to get high

George's present employer asks him to attend AlcoholicsAnonymous meetings. George responds, \"I am not like those people. Iam not that bad.\"

Using the DSM-V criterion, diagnose Staria and George.Explain the diagnosis by incorporating discussion over the conceptsof addiction (i.e., withdrawal, tolerance, physical dependence,comorbidity, and psychological dependence). Be sure to explain theselected diagnosis.

The models for substance use can be categorized as physiologicaland psychological. Within each of these general categories,however, are different specialized foci. Review the Theories ofAlcoholism document, as well as conduct research to determinewhich model(s) aid in understanding what is happening with Stariaand George.