During the first week of March 2011, actor Charlie Sheen appeared on numerous television and radio shows. He appeared energized and made exaggerated gestures while stating that he had “tiger blood” with “Adonis DNA.” Individuals whom he disagreed with were referred to as “trolls,” among other terms (Gardner, 2011). Some of the statements he made on mass media included the following (Boudreault, 2011): ■■ “I am on a drug, it’s called Charlie Sheen. It’s not available, ‘cause if you try it once, you will die. Your face will melt off and your children will weep over your exploded body.” ■■ “I’m tired of pretending like I’m not special. I’m tired of pretending like I’m not bitchin’, a total frickin’ star from Mars.” ■■ “I have cleansed myself. I closed my eyes and in a nanosecond, I cured myself. . . . The only thing I’m addicted to is winning.” A mental health professional conducting an assessment might hypothesize that Sheen was showing symptoms of: ■■ A manic episode, a condition characterized by rapid speech and pressure to keep talking; restlessness; irritability; decreased need to sleep; distractibility; poor judgment; grandiosity and inflated self-esteem; and reckless behavior. ■■ A narcissistic personality, with characteristics such as reacting to criticism with rage; exaggerated sense of self-importance, achievement, and talent; preoccupation with fantasies of success, power, and ideal love; unreasonable expectations of favorable treatment; need for constant attention and admiration; pursuit of selfish goals; limited empathy; and disregard for the feelings of others (PubMed, 2010). ■■ A delusional disorder with grandiose features that include an inflated sense of self, power, and knowledge. ■■ A psychotic reaction with grandiose features produced by substance use or substance withdrawal. Of course, a clinician conducting an assessment would evaluate background information; self-reports of symptom onset, as well as reports from friends and family members; and medical tests (including drug screening), and would conduct observations and interviews and consider psychological and/or neurological assessment that could shed light on the nature of the difficulties. Important considerations would include information regarding the onset of symptoms, previous experiences with similar symptoms, and patterns of previous behaviors. Differential diagnosis means correctly identifying how expressed symptoms pattern together to characterize distinct mental illnesses. the case of Charlie Sheen is presented. Why do you believe accurately diagnosing the actor would be difficult?
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During the first week of March 2011, actor Charlie Sheen
appeared on numerous television and radio shows. He
appeared energized and made exaggerated gestures
while stating that he had “tiger blood” with “Adonis
DNA.” Individuals whom he disagreed with were referred
to as “trolls,” among other terms (Gardner, 2011).
Some of the statements he made on mass media included
the following (Boudreault, 2011):
■■ “I am on a drug, it’s called Charlie Sheen. It’s not
available, ‘cause if you try it once, you will die. Your
face will melt off and your children will weep over
your exploded body.”
■■ “I’m tired of pretending like I’m not special. I’m
tired of pretending like I’m not bitchin’, a total
frickin’ star from Mars.”
■■ “I have cleansed myself. I closed my eyes and in a
nanosecond, I cured myself. . . . The only thing I’m
addicted to is winning.”
A mental health professional conducting an assessment
might hypothesize that Sheen was showing
symptoms of:
■■ A manic episode, a condition characterized by rapid
speech and pressure to keep talking; restlessness;
irritability; decreased need to sleep; distractibility;
poor judgment; grandiosity and inflated self-esteem;
and reckless behavior.
■■ A narcissistic personality, with characteristics such as
reacting to criticism with rage; exaggerated sense of
self-importance, achievement, and talent;
preoccupation with fantasies of success, power,
and ideal love; unreasonable expectations of
favorable treatment; need for constant attention
and admiration; pursuit of selfish goals; limited
empathy; and disregard for the feelings of others
(PubMed, 2010).
■■ A delusional disorder with grandiose features
that include an inflated sense of self, power, and
knowledge.
■■ A psychotic reaction with grandiose features
produced by substance use or substance withdrawal.
Of course, a clinician conducting an assessment
would evaluate background information; self-reports
of symptom onset, as well as reports from friends and
family members; and medical tests (including drug
screening), and would conduct observations and interviews
and consider psychological and/or neurological
assessment that could shed light on the nature of the
difficulties. Important considerations would include information
regarding the onset of symptoms, previous
experiences with similar symptoms, and patterns of previous
behaviors.
Differential diagnosis means correctly identifying how expressed symptoms pattern together to characterize distinct mental illnesses. the case of Charlie Sheen is presented. Why do you believe accurately diagnosing the actor would be difficult?
