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The Case of Gina M.
Gina is an attractive 15-year-old, fashionably dressed and well-groomed. She describes feeling depressed in the past because things never went right. She says that this is how she felt when she attempted suicide on her 14th birthday… She… has told others she will kills herself if school does not go well this year… She describes herself as having little self-confidence and very low self-esteem. She complains of feelings of rejection by her mother, father, and step-father. Gina says that she has a math problem, but is unable to describe it further. Gina expressed herself well during the interview, and appears to have normal intelligence.
At Admission
Social Relationship with Family
Mental Status
Gina’s mother describes her as hostile and impossible to control. The family is fearful of Gina. The parents report that Gina has threatened to set them on fire. She has also gotten into fist fights with her sister and, in one instance, the mother intervened. She said that she had Gina down on the bathroom floor with her fingers around Gina’s neck, and felt like killing her.
At DischargeSchool/Learning
Our interpretation of Gina’s performance (on a set of tests) is that she has a deficiency on tasks requiring mental manipulation of spatial/visual information. Low skills in visual/spatial organization are often associated with poor math skills and with organization of complex stimuli. For example, Gina has trouble seeing relationships involving a directional concept and quantity. This interferes with such tasks as telling time or rounding off numbers…Within the structured program at the NPI school and with individual attention, Gina’s behavior and progress were excellent. Gina was willing to exert a high level of effort, followed the rules, and was pleased with her success. With instruction geared to her level and abilities, she was able to learn things that had been very difficult for her, such as telling time….
Mental Status
Gina reported at discharge that she was beginning to believe that she could be a “winner”. She admits that there are many problems at home, but is hopeful at resolving them… Gina expresses herself very well, has developed some insight into her problems, and says she feels hopeful about the future.
Williams Syndrome
Williams Syndrome is genetically based with both physical and psychological traits
The genetic fault involves a set of missing genes on chromosome 7 leading to an abnormality in a part of the brain that processes visual-spatial information.
Psychological characteristics include
•Impaired visuospatial skills•Friendliness towards acquaintances and strangers alike•Seeking out of human contact•Converses easily with others•React with extreme sensitivity towards others’ feelings•Impressive vocabulary•Keen recall of faces and names