Anna:

Anna had a long history of severe mental illness dating back more than 20 years. During her first depressive episode, she had killed her baby while suffering psychotic symptoms. She also made two serious suicide attempts. Anna has been divorced twice and now lives alone in a council house. She has an adult daughter who is deaf and severely handicapped. Prior to her last arrest, her daughter lived at home, and she cared for her with help from local social services. Her daughter was placed in residential care when Anna was incarcerated. In view of the previous infanticide, social services had always monitored the situation with regard to risk factors for her daughter's safety; however, this was less of an issue now that she was an adult. Anna's illness history is characterized mainly by depressive episodes with psychotic features. She had experienced episodes of paranoid thoughts when she believed her neighbors knew all about the past and she was reluctant to go out because she felt persecuted. Anna felt extreme guilt at having killed her child. When psychotic, she would shout that she was evil and deserved to be punished. It seemed that the guilt had affected her considerably to manifest in a negative self-concept. Even when well, Anna never spontaneously talked about herself in a positive manner at all.

Continuing in your role as an intern with the psychological treatment center for a local correctional facility, assume your supervisor has asked you to prepare an analysis of the etiologies of the disorder development for the client.

Include etiologies analysis:

• Analysis of symptom development
• Analysis of possible risk factors of the presenting patient
• Analysis of the etiology of disorder development based on biological, psychological, and social theories

Cite a minimum of 2 peer-reviewed journal articles to support your summary.