Page 20 - Delaware Medical Journal - April 2018

FIGURE IV15: Violent Crime Index Offenses Arrests per 100,000 Persons Ages 10-17
The rate is defined as the arrest of individuals ages 0-17 per 100,000 people between the ages of 10-17. Violent Crime Index includes manslaughter, murder, rape, aggravated assault and robbery.15
homicidal thoughts towards her mother. She reported that the intensity of these thoughts was 4/10. She also had thoughts of using a knife to cut herself or to hang herself. She locked herself in the bathroom for 45 minutes with her cellphone and tablet and would not talk to anyone for 15 minutes. Her mother became concerned and contacted emergency services.
During her admission, AA rated her suicidal ideation as 2/10 in intensity. AA had brought a notebook during the admission that had the following words written: depressed, death, alone, fat, stupid, and demons. She reported that her symptoms of depression and anxiety were precipitated by poor relationships with her siblings and her mother. She also reported that the lack of privacy
in her personal life contributed to her current condition.
School data: AA had missed 10 days of school and her grades had been declining.
Social/peer functioning: AA reports that she has some friends that she likes to hang out with at school. She does not meet with any friends outside of school. AA had
met with a girl at her previous inpatient hospitalization. She frequently texts her and enjoys communicating with her.
Prior hospitalizations: Inpatient hospitalization in June 2017 for about
a week. According to her mother,
prior to June 2017, AA had no prior hospitalizations or psychiatric symptoms.
Mental Status Exam:
Maturity: Appropriate; Dress: Appropriate; Speech: Articulate; Speech Rate: Slowed; Activity: Decreased.
Cooperation: Appropriate; Depression: Severe; Elation: None; Irritability: Moderate; Affect: Blunted.
Thought content: Suicidal thoughts with no
from Slender Man. Like these two teens, the patient in this case report was also on becoming a follower. One of the teens has been committed to 25 years in a state mental institute while the other teenager is awaiting her sentence. According to Effron and Robinson’s report on Slender Man, the game permits players to enter a frightening adventure in the form of a protagonist who must travel throughout a dark place and hide from Slender Man.9 If you come too close to the Slender Man, the game is over.
CASE PRESENTATION
AA is a 12-year-old Hispanic American female who was brought to the CSU by her mother. AA’s presenting problem were suicidal thoughts, with a plan to hang herself, and homicidal ideations toward her mother and her sister. AA was also exhibiting signs of depression. According to the school counselor, AA had expressed
to the counselor that she had a vision about stabbing her mother in the back and that she had attempted to kill her sister in the past. AA’s mother thought she was crazy and had demonic thoughts. AA lives with her mother, stepfather, 18-year-old sister, and her older brother. AA has never been in contact with her biological father, who lives in Latin America. AA’s mother
and older brother work and are the sole providers for the household. According to her mother, AA has been spending a lot
of her time in her room for the last few months. She has low motivation, anxiety, and poor energy. AA reports that she struggles at home due to poor relationships with her family members. She develops thoughts of hurting herself and gets depressed due to her home environment. A day before her admission to the CSU,
an incident occurred where AA’s mother tried to take her sister’s phone and, as a result, AA wanted to stab her in the back. AA felt like she was losing control and started yelling in the house. She developed
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Del Med J | April 2018 | Vol. 90 | No. 4