Part 1: Diagnosis. In this section provide a description of how you made the diagnosis (i.e. what criteria were or were not met) and how and why you ruled out other disorders. You should describe how the person meets each of theDSM-Vcriteria for the disorder that you think fits the person. Part 2: Treatment. In this section provide a description of the types of treatment that might be used to help the person. Also identify the type of treatment that you think would be most appropriate Your answers should be approximately two pages in length.

Case #1: Wendal Jones(Adapted from Morrison, 1995)

Pausing for a moment, Wendal Jonesleaned forward to straighten the stack of journals on the interviewer's desk. When he leaned back and resumed talking, he folded his hands. The skin was chapped and the color of dusty bricks.

"So I would get this feeling that there could be semen on my hands and that it might be transferred to a women and get her pregnant, even if I only shook hands with her. I started washing extra carefully each time I masturbated."

Wendal Joneswas a 23-year-old graduate student in plant physiology. He was enormously bright and dedicated to science, but his grades had slipped badly over the past several months. He attributed this to the handwashing rituals. Whenever he had the thought that he might have contaminated his hands with semen, he felt compelled to scrub them thoroughly.

A year earlier, this had only meant three or four minutes with a bar of soap and water as hot as he could stand it. Soon he required a nail brush; still later he was brushing his hands and wrists as well. By now this had evolved into an elaborate ritual. First he scraped under his nails with a blade; then he used the brush on them. He then lathered surgical soap to his elbows and scrubbed with a different brush for fifteen minutes per arm. Then he would have to start over with his nails, because semen scrubbed off his arms might have lodged under them. If he had the thought that he had not performed one of the steps exactly right, he would have to start all over again. In recent weeks this had become the norm.

"I know it seems crazy," he said with a glance at his hands. "I'm a biologist. That part of me knows that spermatozoa can't live longer than a few minutes on the skin. But if I don't wash, the pressure just builds up and up, until I have to wash - washing is the only thing that relieves the anxiety."

Wendaldidn't think he was depressed, though he was appropriately concerned about his symptoms. His sleep and appetite had been normal; he had never felt guilty or suicidal.

"Just stupid, especially when my girlfriend stopped seeing me. I used the bathroom in a restaurant where I took her to eat. After 45 minutes, she had to send the manager in for me." He laughed ruefully. "She said she might see me again if I cleaned up my act."

Reference: Diagnostic and statistical manual of mental disorders (5th Ed.), American Psychiatric Association, American Psychiatric Association, 2013