Worthless Wife Discussion
When Connie comes to treatment, she has all of the characteristic symptoms of a Major Depressive Disorder, Single Episode (DSM-IV, p. 344), noted on Axis I. Her mood is persistently depressed and she feels worthless, has trouble concentrating, has lost weight, and had difficulty sleeping.
The question that many readers may ask is weather Connie has a personality disturbance that has kept her in a relationship with a man who has been mentally and physically abusive. As is typically the case, there is no evidence that Connie has chosen someone because he is abusive or because she gets and particular gratification from being victimized. Instead, what has kept her in the marriage is a combination of her low self-esteem and social pressures against leaving her husband. In more extreme cases of physical abuse, the wife may actually fear for her life or the lives of her children is she leave her abusive husband.
Therefore, on Axis II, we would note None. Because of her current depressive symptoms, we would assign a GAF rating of 52.
Multiaxial Evaluation
Axis I Major Depressive Disorder, Singe Episode
Axis II None
Axis III None
Axis IV Marital separation
Axis V GAF= 52 (current)
Follow-up
Connie received medication and individual psychotherapy for her depression. She also participated in group therapy with other women who had been abused by their spouses.
After 6 months of therapy, Connie was no longer depressed. She bough new clothes and had her hair cut in a more flattering and youthful style. She found employment as an executive secretary and placed Robert in a day-care center, where she participated in parent programs. She reported that she and Robert had fun together in the evening and on weekends. She again began seeing her friends. With financial assistance from her parents, she began divorce proceedings against Donald and requested sole custody of Robert.
Spitzer, R. L., Gibbon, M., Skodol, A. E., Williams, J. B. & First, M. B. (Eds). (1994).
Casebook: A learning companion to the diagnostic and statistical manual of mental
disorders (4th ed.). Washington D.C.: American Psychiatric Press, Inc.