Subject: Psychology and Education
Topic: PSYCHOLOGICAL CLINICAL ASSESSMENT
Language: English (U.S.)
Pages: 8
Instructions
ust follow the report outline provided above with the requisite headings and be formatted according to APA style as outlined in the Ashford Writing Center. Must include a title page with the following: Title of paper Student’s name Course name and number Instructor’s name Date submitted Must address the assessment with critical thought. Must use at least five peer-reviewed sources that were published within the last ten years, in addition to the text, a minimum of four must be from the Ashford University Library. Must document all sources in APA style as outlined in the Ashford Writing Center. Must include a separate reference page that is formatted according to APA style as outlined in the Ashford Writing Center.

Psychological Clinical Assessment

Identifying Information

Patient’s Name: Joan Crawford (born Lucille Fay LeSuer)

Sex: Female

Gender: Female

Sexual Orientation: Bisexual

Age: Died at the age of 77 although accounts differ

Race: Caucasian

Occupation: Actress

Location of Residence: Died in New York.

Chief Complaint/Presenting Problem

           In this instance, there is no verbatim complaint from the patient. However, there are a few observable pieces of information about her behavior that could be deemed as symptoms of an underlying clinical issue. Various people have provided a detailed explanation of some of the behaviors she exhibits during different occasions.

           The patient was a famous actress who starred in several Hollywood productions for more than four decades. Throughout her life as an actress she encountered several people who have had different things to say about her personality. Most of her fellow actors and actresses, bosses and the general public viewed her as a happy, strong, beautiful woman who loved her children. Everyone believed that she was a philanthropist because she used part of her considerable wealth to adopt and raise four children. Such acts of philanthropy have made people believe that she is of sound mind.

           However, there have been complaints that suggest that the actress could be behaving differently when she is out of public view. Most of these complaints surfaced after the iconic actress’ death. Her daughter, Christina Crawford released a tell-all memoir of her adopted mother depicting the older Crawford as an alcoholic, a perfectionist, a control freak, and abusive parent. The daughter also claims that the patient was physically and emotionally abusive to her and her brother, Christopher when they were growing up. Some neighbors, acquaintances, and co-workers have also corroborated with this depiction, with each claiming they had witnessed the patient’s abusive nature towards her adopted children when the kids were younger. 

           Christina claims that when she was only thirteen years old, her mother grabbed her by the throat, punched her and slammed her against the floor. She also recalls when her mother bought her extravagant party dresses only to spank her so hard that the hairbrush she was using broke into two. The daughter also claims that the mother used to strap her younger brother Christopher in bed with a canvas to stop him from walking to the loo at night.

           Christina also claims that when they were children, she and Christopher were only allowed to keep one present while the rest were repackaged and sent to local children’s homes and hospitals. This is despite the numerous magazines that display Joan’s home life full of birthday presents and Christmas gifts for her children. Christina also recalls having to write numerous thank-you cards for the gifts they had received but had to give away. Joan would routinely check all of the thank-you cards and leave comments on how to improve them. The cards would have to be re-written repeatedly until they reached their mother’s standards.

           There are also some reports that claim Joan was frequently in and out of depression. When she was depressed, she would drink heavily and was consequently unable to work. Her heavy drinking was not only constrained to when she was depressed. Numerous reports suggest that in October of 1974, she mixed alcohol with antibiotics, which caused her to pass out, fall, and hit her face. Close friends and family also claim that the patient used to wash her hands too often and would take about four showers every day.

           From the above report from family and friends, it is safe to conclude that the patient’s complaints is an abusive nature that is dependent and fueled on alcohol and the need to be considered perfect by all those around her.

Symptoms

Regardless of the fact that there is no verbatim complaint, there is still need for concern over some of the abnormal behaviors that the patient displayed. Some of the symptoms noted from the reports gathered from family members and friends include a severe need for perfection, alcohol abuse, an obsessive nature, an abusive nature, and the need to be portrayed as a loving warm person when in reality she is quite the opposite.

Analysis of the patient’s complaints points to a myriad of mental disorders found in the DSM-5 list of psychological disorders. The patient is presenting with symptoms that could point to her having suffered from obsessive-compulsive disorder, alcohol dependency, borderline personality disorder, and bipolar disorder.

Obsessive Compulsive Disorder is a mental disorder whereby the sufferer has to perform certain rituals repeatedly in order for him to perform normally or to mitigate his anxiety. Most of the sufferers also have the need to check things constantly without fail. A break in the routine may lead to the person’s complete breakdown (Fenske & Schwenk, 2009). Many patients who are diagnosed with OCD present with extreme compulsions including constant hand washing, repetitive actions, and checking things.

On the other hand, bipolar disorder is a mental condition marked by alternating periods of depression and hyperactivity. During the hyperactive or elated mood, the individual feels extremely irritable or energetic and is quick to make rash decisions that are poorly thought out. In the depression state, individuals demonstrate a negative outlook on life, sadness, and a generally depressed mood (Mondimore, 2014).

Borderline personality disorder is characterized by constant mood swings, unstable relationships, as well as abnormal behavior. Most people who suffer from the mental illness engage in reckless behavior and are often impulsive. BPD often begins in late adolescence or early adulthood.

Personal History

           Joan Crawford was born on March 23 1904, although the real birth year has been disputed severally. Her birth name was Lucille Fay LeSueur, which she changed when she rose to fame. She was the third born of Anna Bell Johnson and Thomas LeSueur. Her father abandoned the family a few months before Crawford was born. There has been a lot of speculation as to whether her parents were legally wed as census records indicate that her mother’s second marriage to Henry Cassin was her first.

           According to reputable reports, her family life was quite unstable, which severely affected her education. Many cite her troubled family life as the reason she did not progress beyond elementary schooling. Her greatest ambition while growing up was to become a dancer and reports show that her stepfather was a big supporter of her dancing career.

           When her mother and stepfather broke up, she remained with Cassin in St. Agnes as a work student. Unfortunately, she spent more time cleaning and cooking rather than actual studying. She moved on to Rockingham Academy, still as a work student. Here, she had her first serious relationship with an individual who prompted her to take education more seriously. Consequently, she joined Stephens College in Missouri but dropped out after only a few months when she realized she was not cut out for college life.

           With her movie career on full throttle, she got married to Douglas Fairbanks in 1929. Her husband’s parents were considered Hollywood royalty and thus for her it was a step in the right direction. The couple divorced in 1933 and she claimed it was because of her husband’s unending jealousy of her friends.

           A few years later, she was married to Tone, a stage actor in New York. Crawford claims that her second husband began to drink and became physically abusive prompting a hasty divorce from him. Her career soon took a dip in the late 1930s as her popularity waned. She was even referred to as Box Office Poison in the Independent Film Journal.

           In 1940, she adopted her first child, Christina through an agency in Las Vegas. Two years later, she was married for the third time to fellow actor Phillip Terry after only six months of courtship. The couple adopted a son named Philip Terry Jr, but Crawford changed his name to Christopher after the marriage ended in 1946. Crawford went on to adopt two more children, identical twins, in 1947.

           In 1955, Crawford married her final husband, Alfred Steele, the CEO and Chairman of  the Board of Pepsi Cola. Her husband died four years later and she filled his seat on the board of directors of the company until 1973.

Family History

           It is believed that Joan’s mother was around 24 when she had Crawford while her father’s age remains unknown. Her parents’ marriage was not recognized by law and her mother cited her second marriage as her first. Joan’s biological father abandoned the family before the girl was born. Joan’s stepfather, her mother’s new husband, played a more significant role in her upbringing. Her mother and stepfather were Joan’s primary caregivers during her formative years.

The family moved a lot owing to her stepfather’s theatre occupation. There was a point in time when her stepfather was blacklisted in one of the towns they settled in. He was accused of embezzlement but was later acquitted. The accusations necessitated their move to Kansas City in 1916. The instability probably gave her a different perspective on life, education, and men from the worldview held by girls her age.  

Her stepfather was a catholic and he brought Crawford up as a catholic. He even enrolled her in St. Agnes Academy, a catholic school, when they moved to Kansas. She remained there as a work student even when her parents split up.

            

Therapy History

           Currently, there is no record of Joan Crawford seeking psychological help for her abnormal behaviors. It is likely that she used alcohol to help her with some of the symptoms mentioned in the above sections. However, she gave up alcohol during her later years after she damaged her face owing to the fact that she had mixed alcohol with her antibiotics.

           Her celebrity status could have contributed to her lack of therapy history. She was a global star and any abnormal psychological behaviors would have been outshined by her larger than life super stardom. Furthermore, mental illnesses such as OCD and bipolar disorder were far less understood in the twentieth century than they are now.

Medical Conditions

           The only medical condition on record for Joan Crawford was her dental-related issues. These issues plagued her between 1972 and 1975. She is reported to have had dental surgery in 1974. Since the surgery, she needed round the clock nursing care. During this period, she mistakenly drank alcohol while on antibiotics. She passed out, slipped, and damaged her face because of the concoction.

Substance Use

           Various reports consistently point out the fact that Joan Crawford was an alcoholic. Her daughter, Christina, in her tell-all memoir about her mother depicts Crawford as a raging alcoholic who was extremely quick to anger. She points out many instances where her mother, under the influence of alcohol, would physically abuse her and her brother, Christopher. There have also been numerous reports that when her career stalled during the late thirties, she resorted to heavy drinking.

Collateral

           Most people who knew Joan Crawford intimately describe her as a warm, strong-willed, but caring woman. She always wanted everything around her to go in a certain way, but they understood because she was always in the limelight and her reputation was extremely important to her. Many in the public arena viewed her with admiration at how strong she was and how she had overcome a poor childhood to become one of the biggest names in the acting industry across the globe.

           However, it seems not everyone bought into the façade she was trying to sell. For starters, her adopted daughter Christina, the oldest of the four children that Joan adopted, claims that she suffered irreparable emotional and physical abuse in the hands of Joan Crawford (Day, 2008). She claims that her mother was warm to the public but behind closed doors, she turned into a violent, insecure alcoholic who had compulsive tendencies. She also claims that her mother’s fits of rage, her cleaning obsession, and her drinking got worse when her career began to slump during the mid-thirties.

           Other people also agree with Christina’s claims. For instance, Neil Maciejewski, who runs a tribute website to the fallen star and is also an acclaimed film historian, confesses that indeed Crawford was a control freak, an alcoholic, and probably not in the right mind to be allowed parental rights over any child (Day, 2008).


Results of Evaluation

           Given the information gathered about Joan Crawford and her behavior behind closed doors, as well as her personal history, it is safe to say that the actress was suffering from one or multiple mental disorders. Her early childhood would have probably been the main contributor to her mental health problems that she suffered throughout her career up to her death.

Diagnostic Impression with Differential Justification

           Joan Crawford’s symptoms, as narrated by her daughter and others, point to a woman with severe mental issues. It has been widely reported that she had a compulsion to clean and was a perfectionist. This constant need to clean and to ensure that everything is perfect is indicative of a person suffering from obsessive-compulsive disorder. She was very obsessive about how the public perceived her, which made her ensure that everything in her life was perfect. She did not allow mistakes in her marriages or in her children. It seems this is why she disinherited her daughter and son from her will right before she died.

           Another common symptom that could be gathered from the stories that Christina and others shared is her mood swings. Christina recollects how her mother would be giving her gifts one minute and spanking the daylights out of her in the next minute. These uncontrolled mood swings could be symptoms of both bipolar disorder and borderline personality disorder. It is more likely she suffered from the latter than the former illness because she was able to control her emotions while in the public but would soon burst into anger when she was behind closed doors. Her string of unstable and destructive relationships with both men and women also points to her having borderline personality disorder.

Recommendations

           After conducting an assessment of Joan Crawford’s mental issues, it would have been highly recommendable for her to stop drinking at an earlier age. Her constant alcohol abuse fueled her probable mental disorders to a point where even her eldest daughter did not feel safe with her. Furthermore, it would have been advisable for her to receive psychotherapeutic help for her anger and insecurity issues instead of lashing out at her eldest daughter. Several medications available could have helped her manage her OCD and BPD symptoms. However, therapeutic help would have been the best course of action in this case.

References

Day, E. (2008, May 25). I will Never Forgive Mommie. The Guardian. Retrieved on 10/5/2016 from http://www.theguardian.com/film/2008/may/25/biography.film


Fenske, J.N., & Schwenk, T.L. (2009). Obsessive Compulsive Disorder: Diagnosis and Management. Am Fam Physician 80 (3): 239-245.


Mondimore, F.M. (2014). Bipolar Disorder: A Guide for Patients and Families (3rd Ed). Baltimore, MD: John Hopkins University Press.