Karl is a 38 year old single (never married, no children) male. Eleven years ago he was living out of state and sought treatment at his local hospital. At this time he reported having feelings of dj vu experiences off and on for the previous two years and these experiences were intensifying. He received some medications (unknown) in the emergency room but was not admitted. Karl was employed full-time in an occupation that required him to travel from state to state. Karl reported that he smoked marijuana once per week and drank alcohol occasionally. At the age of 29, Karl was hospitalized for 6 days in his home town. At this time he was experiencing delusions, paranoia and isolation. Examples of his delusions included the following: beliefs that the television was sending him messages; belief that mythological creatures were trying to entice him to battle; belief that a celebrity on TV wanted to marry him; misinterpretation of numbers to indicate that he was GOD. Again he received medication but stopped the medication once he felt better. Karl contends that he was never instructed to get the medication refilled once he left the hospital. Karl was then again hospitalized for one week. Records indicate that upon admission Karl reported feeling down, depressed, and crying a lot and that he believed he was not himself. He also expressed beliefs that he had been in the military but that he was not sure. In actuality, he had been in the Navy for approximately 4 months but was discharged due to reported feelings of suicide. At the hospital he reported that his thoughts seemed jumbled. At the age of 30, Karl was traveling through Virginia and had stopped to get some dinner at a restaurant. He reported feeling very paranoid as if someone was going to harm him. He stated that he believed some of the people in the restaurant looked like devils and were possessed by demons. Karl went back to his vehicle and secured a knife for protection. He reentered the restaurant and sat down to have dinner. Another patron approached him and began a casual conversation. At this time Karl responded by pulling the knife and telling the patron to leave him alone or he will kill him. The police were called and Karl was admitted to an inpatient unit.

1. If you were a psychologist seeing Karl, what diagnosis would you give and why? (List and explain the diagnostic criteria from the DSM-5TR that you would use to justify your diagnosis.)

2. What treatment would you recommend? (Be specific about why you think your treatment would work best and CITE your source. The treatment plan should not be your opinion. It should be based upon research that has been done on what works well to treat this disorder