Solved

A 26-Year-Old Man Comes to the Office Due to Back

question 829

Multiple Choice

A 26-year-old man comes to the office due to back pain. He hurt his back while lifting a heavy box and now has discomfort while working on his computer. He proceeds to give an overly detailed analysis of the mechanics of his chair in relation to the height of his desk and computer screen. The patient has no medical problems and takes no medication. He lives alone and has a computer data entry job that allows him to work remotely. He prefers working from home because he does not enjoy socializing. The patient says, "I don't really get people's sense of humor, and I think they might be laughing at me. I also prefer to eat at home so I can follow my routines and keep the food separated on my plate." The patient does not use alcohol, tobacco, or illicit drugs. He has no psychiatric history but recalls that his mother once had him evaluated in grade school due to concern about his development.
Physical examination is unremarkable. On mental status examination, the patient makes poor eye contact and appears anxious and uncomfortable. He declines to put on a paper gown because he dislikes the feel of the paper against his skin. He answers questions appropriately in a stilted and monotone voice. He does not feel sad and has no hallucinations or delusions.
Which of the following is the most likely explanation for the patient's behavior?

Definitions:

Electric Brake

A device that uses electrical energy to apply mechanical resistance for slowing or stopping motion.

Servo Motor

A specialized motor designed to provide precise control of angular or linear position, velocity, and acceleration.

Control Valve

A valve used to regulate the flow of a fluid by varying the size of the flow passage as directed by a signal from a controller.

Derivative Action

In control systems, a component of a PID controller that predicts system behavior and acts proportionally to the rate of change of the error signal.