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Jane, a 22 year old, single Caucasian college freshman, had been in the emergency room for a reaction to alcohol. She had a blood alcohol level of .30 and was almost comatose. They were able to stabilize her in the ER. She had been binge drinking (over 4 drinks per night) for the last 2 weeks. She was admitted to the hospital for observation and stayed in the hospital for the next few days. When the alcohol was out of her system, she admitted to the counselor that she had been "hearing voices" belittling her for the last six months. She had been feeling people were talking about her on TV and on the radio and felt her professors and her roomate were conspiring against her. She stated she had felt this way for the past 7 months. She had become more and more socially isolated because of her mistrust of others and her grades had dropped. Jane said she started drinking to "drown out the voices" so she could sleep. She wanted the counselor to get the professors and her roomate to stop bothering her. According to Jane, her main problem was about the other people who were bothering her(professors and roomate) and she had just been drinking to help herself sleep and block out the "voices". Jane had a great aunt who had been involuntarily hospitalized for an "emotional disorder". One of her siblings had Schizotypal traits and was considered a little unusual by others. She (Jane)had been an above average student in high school and in college until she began hearing voices and then she became a D student and was missing class frequently. Prior to this she had no mental health history but she had a history of being chronically suspicious and mistrustful of others that did not impair her overall functioning significantly. This had limited her friendships to a few that didn't last very long. She was intelligent and an A- average student in high school. Her physical health was affected by severe chronic asthma since age 3.
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