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Donnie Darko

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Alexa Thompson

on 9 December 2013

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Transcript of Donnie Darko

The movie takes place in 1988

Donnie Darko, a troubled 15 year old boy,sees a giant rabbit named Frank, who tells him the world will end in 28 days, 6 hours, 42 minutes, and 12 seconds.

The next morning, Donnie discovers a jet engine has crashed through his bedroom. If it hadn't been for "Frank," Donnie would have been in his bedroom, and died.

As the date draws closer, Donnie is increasingly impacted by Frank, who instructs him to commit various crimes in order to follow his destiny.
Donnie Darko
Movie Clips
Guess
his
Symptoms!
DSM V Criteria:
Schizophreniform Disorder
Treatment
Generalist Social Work
Synopsis
Core Competencies
*Disclaimer: Donnie Darko is a sci-fi thriller, with
various theories for what the director is trying to
convey.The scenes depicted will be used to
display the symptomatology of a psychiatric
disorder, not to suggest the intentions
of this film.


1. "Wake Up"

2. "Talk about Frank."

3. "They Made Me Do It."

4. "Who are you talking to?"

5. The Therapist's Office.

6. "When's this gonna stop?"

7. "Frank is going to Kill."
Symptoms Present
A.Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):
1. Delusions
2. Hallucinations
3. Disorganized speech (e.g., frequent derailment or incoherence).
4. Grossly disorganized or catatonic behavior
5. Negative symptoms

B. An episode of the disorder lasts at least 1 month but less than 6 months.

C. Schizoaffective disorder and depressive or bipolar disorder with psychoic with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occured concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness

D. The disturbance is not attributable to the psyciological effects of a substance or another medication
Differential Diagnosis
(1)“Wake up” scene
a. Auditory hallucinations (“Wake up”)
b. Visual hallucinations (Seeing Frank in the front lawn)
c. Nihilistic delusions (The world is going to end in 28 days, 6 hours…)
d. Disturbed sleep pattern (throughout the entire film)

(2) Talk about Frank scene
a. Believes his hallucinations are real, stated he made a new friend
b. Anxiety and phobias

(3) They Made me Do it scene
a. Inappropriate affect (smiling when walking home after school closed)
b. Delusion of influence: “They made me do it”

(4) Who are you talking to?
a. Visual and auditory hallucinations
b. Prevalence of seeing Frank increases
c. Visual hallucinations expand from Frank, to seeing the space time

(5) The Therapist’s Office
a. “Aggressive behavior”
b. “Increased detachment from reality”
c. “Friend Frank”

(6) When’s this gonna stop? Scene
a. Delusion of influence (Believes an outside source controls behvaior)
b. Visual hallucinations increase (see’s movie change on the screen, and
c. Inappropriate affect

(7) Frank is going to kill
a. Grandiose delusions (thinks he can build a time machine)
b. Nihilistic delusions (the world is going to end)
c. Persecutory delusions (they are going to come after me)
d. Visual hallucinations (see’s frank and the sky opening up)
e. Anxiety and phobias


2.1.3 Apply critical thinking to inform and communicate professional judgements

2.1.4 Incorporate diversity into practice

2.1.5 Advance human rights and social and economic justice

2.1.6 Engage in research-informed practice

2.1.10 Engage, assess, intervene, and evaluate with individuals, families, groups, organizations, and communities





Prejudice still exists for persons with mental illness, especially those that are within the schizophrenia spectrum disorders


Therefore, this is useful for advanced generalist social workers to help increase awareness in the community about mental illness.

Films, such as this, provide an opportunity for
people to ask questions and delve deeper into
the real experience of schizophrenia



Micro


Macro
The importance of the theraputic relationship

Family and Natural supports
Talk Therapy
Hypnotherapy
Increase in medication
Generally, combination of medication and psychotherapy

Atypical Psychotics for Schizophreniform: Risperdal, Seroquel, Geodon, Zyprexa

People with severe symptoms may need to be hospitalization

Studies estimated treatment discontinuation for 74%
References
1: Kingdon, D., & Turkington, D. (n.d.). The ABCs of Cognitive-Behavioral Therapy for Schizophrenia. In Psychiatric Times. Retrieved December 5, 2013, from http://www.psychiatrictimes.com/schizophrenia/abcs-cognitive-behavioral-therapy-schizophrenia

2: Goldberg, J. (2012). Schizophreniform Disorder. In WebMD. Retrieved December 9, 2013, from http://www.webmd.com/schizophrenia/guide/mental-health-schizophreniform-disorder?page=2
2
2
1
CBT is recognized as an effective
intervention for schizophrenia
1
Cogntive Behavioral Therapy
Links established between thoughts, feelings, and actions
1
Duration between 12- 20 sessions
*Psychotic Disorder:
-No evidence that disturbance is the direct consequence of another medical condition
*Delirium or NCD:
-No cognitive deficits that prohibit independence of daily functioning
No return to normal level of functioning
*Substance/medication induced psychotic or delirium
-No evidence that positive symptoms are a result of a substance/medication
*Depressive or bipolar with psychotic features
-Hallucinations not congruent with mood and no themes of personal inadequacy
*Schizoaffective disorder
-Does not meet criteria for a major mood episode
*Depressive or bipolar disorder with catatonic features
-No catatonic features present
*Schizophrenia
-Duration is a month and not 6 months or longer
*Brief psychotic disorder
-No evidence that he returns to a normal level of functioning
*Delusional disorder
-Criteria A for schizophrenia (prominent hallucinations/delusions) cannot be
met
*Schizotypal personality disorder, Schizoid personality disorder,Paranoid personality disorder, Paranoid personality disorder
-Does not meet full criteria
*Obsessive-compulsive disorder
-Has the haullcinations and delusions which rules him out
*Posttraumatic stress disorder
-Symptoms present before traumatic event

-
Pharmacologic therapy can leave 60% with
persistent positive/negative symptoms, even
when compliant with dosages
1
2
1
3: Hypnosis for schizophrenia. (2005). American Journal of Clinical Hypnosis, 47(3), 217-218. Retrieved from http://ezproxy.msu.edu/login?url=http://search.proquest.com/docview/218782506?accountid=12598
3
ASSESSMENT:
patient to express his or her own thoughts about his experiences
formulation of symptom causation

ENGAGEMENT:
Drawing out the client's understanding of the issue and ways of coping
Validation by the therapist for the client's stuggle

ABC MODEL:
For patient to organize
confusing experiences
Activating Event, Beliefs,
Consequences

GOAL SETTING

NORMALIZATION:
Educate that many people can have unusual experiences
Reduces anxiety and the sense of isolation

COLLABORATIVE ANALYSIS: Reality vs. non-reality
Drop out: 12%
Significant improvement of positive and negative symptoms
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington,VA:American Psychiatric Publishing.
Full transcript