Table of Contents
Abstract
The objective of the paper is to undertake a diagnostic battery on Chris Brown who is a public figure. Since 2009, Chris Brown has been involved in several violent outbursts that included domestic violence, physical assault, threats to bodily harm and destruction of property. The symptoms are an indication of intermittent aggressive disorder manifested through impulsive and recurring aggression. Chris Brown also witnessed domestic violence when he was young. Cognitive behavioral therapy can help to manage the symptoms of IED through cognitive restructuring, coping skills and relaxation training. Pharmacotherapy will involve administering serotonin reuptake inhibitors such as fluoxetine, phenytoin, and carbamazepine. If the patient is unresponsive, mood stabilizers such as lamotrigine, valproate, lithium and topiramate can be substituted. Follow-up will involve monitoring the patient to check if the symptoms of IED resurface. The process will involve observing the patient, interviewing them or asking for feedback from close family members. Legal and ethical issues include the confidentiality of information and the right of the patient to information.
Introduction
The public figure, Chris Brown, is an American singer, rapper, and dancer. He was born in 1989 in Virginia. Chris Brown entered the spotlight in 2005 when he released his first album. He has risen in prominence ever since and is currently one of the most successful pop artists. He has won Grammy Awards and a number of other awards related to his singing and rapping career. He has released around nine albums throughout the entirety of his career with most turning out to be critical and commercial successes. Despite his success and popularity, Chris Brown has been involved in a number of legal incidents over the years. The paper will undertake a diagnostic battery of Chris Brown. The paper will examine the legal issues encountered by Chris Brown, propose treatment and follow-up based on the diagnosis and review the potential ethical and legal issues.
Background Information
The first criminal issue that Chris Brown encountered related to criminal charges that were levelled against him for domestic violence in 2009. The victim of the domestic violence was his then female companion, singer Rihanna who sustained injuries and underwent hospitalization (Heigl, 2016). In April 2009, he was arraigned in court and charges of assault, and criminal threats were brought up against him. When Chis Brown was arraigned in court, he pleaded not guilty to both charges of assault and criminal threat. In June of the same year, he pleaded guilty to the charge of felony assault but not the charge of making criminal threats. He was subsequently sentenced to five years of probation and six years of community service. He was also required to attend counseling for domestic violence for a year. In addition to the sentence, the judge imposed a restraining order on Chris Brown against Rihanna that required him to keep a distance of at least 50 yards from the singer. The 2009 domestic violence incident marked the first in a list of encounters between Chris Brown and the criminal justice system.
In 2012, Chris Brown was involved in a brawl between his entourage and that of rapper Drake. The incident occurred in a night club in the city of New York. The brawl resulted in the destruction of property, and a few people including Chris Brown sustained injuries. In 2013, Chris Brown was involved in another altercation this time with singer Frank Ocean. The incident occurred in West Hollywood and seemed to step from disagreements over parking space. It was reported than during the incident, Chris Brown punched Frank Ocean and threatened him with bodily harm (Heigl, 2016). In 2013, Chris Brown was accused of involvement in a hit and run incident and charges were leveled against him but later dropped. The incident led to scrutiny of his probation, and as a result, he was served with a thousand more hours of community service.
In October of 2013, Chris Brown was apprehended in Washington D.C. on charges of assault. It was reported that Chris Brown and his security guards were involved in a scuffle with another man outside a hotel. The singer spent 36 hours in jail and was arraigned in court in Los Angeles over the felony assault. Later, he was found guilty of misdemeanor assault and sentenced to inpatient rehabilitation in Los Angeles. In the same month, Chris Brown enrolled for rehabilitation regarding his violent conduct. However, he was expelled from the rehabilitation facility for anger management problems. In March of 2014, Chris Brown was ejected from a rehabilitation facility where a judge had ordered him to serve three months and undergo treatment for his violent behavior. Before he was ousted from the facility, it was indicated that he was making great strides in the treatment of his bipolar condition. He was charged in court for violation of the rules and guidelines of the rehabilitation facility and violating the terms of his probation. As a result, Chris Brown was sentenced to 131 days in prison for the violations (Heigl, 2016). The judge also added another two months to the probation that Chris Brown was facing.
In June of 2014, he was released from jail but remained on probation. Additionally, he was required to visit a psychiatrist every week. In 2015, a judge revoked the singer’s probation after further violations of the terms of his release and probation. Chris Brown had traveled outside of Los Angeles County, which was in breach of the terms of his probation. In 2015, the singer was named in an assault case, but the sentence was later dropped. In January 2016, the police launched an investigation after a person reported that Chris Brown had forcefully taken their phone and physically assaulted them. In August 2016, he was accused of threatening a person with a gun.
Data Collection
For the paper, the primary source of information regarding the legal incidences of Chris Brown was online research. Most of the information about the singer’s previous convictions and charges is readily available online. A website like People.com has tracked the legal incidents of Chris Brown beginning in 2009 and into 2016. Other websites Huffington post provided information about individual legal incidents encountered by the singer.
Diagnosis
Chris Brown can also be diagnosed with intermittent explosive disorder (IED). The disorder is characterized by repeated violent and aggressive outbursts. Violent outbursts happen in the form of fights, shoves, damage to property, and assaults. The outbursts are sudden and are disproportionate to the provocation or situation. A person with IED will react violently to slight provocations, and such violent eruption last less than 30 minutes (AMA, 2013). Usually, the violent incidents have no tangible objective in the context of the situation. People with IED are also verbally aggressive with episodes of temper tantrums and heated arguments (AMA, 2013). People who have experienced emotional or physical trauma early in life are at the highest risk of IED. Chris Brown has exhibited the symptoms of IED in the past. His attack on Rihanna in 2009 was sudden and impulsive. Since 2009, the singer has been involved in a handful of violent outburst, which is a manifestation of the explosive disorder. Chris Brown has also been involved in fiery arguments such as in 2011 when he threw a chair through a window and during an interview (Heigl, 2016).
Related Psychosocial and Family Issues
During his childhood, Chris Brown witnessed domestic violence at his parents’ home. The singer stated that until the age of 13, he regularly witnessed his mother get physically abused by her husband (Kaufman, 2009). Chris Brown stated that the violence that his stepfather directed at his mother scarred him psychologically. The incidents of physical abuse he witnessed as a child and adolescent generated anxiety in him. His fear grew to the point that he would wet his bed because he was afraid to leave his room and witness the domestic violence instigated by his stepfather. At some point, he even contemplated killing his stepfather in order to stop the cycle of abuse that she was going through. Chris Brown also remarked that the domestic violence was a pattern in many families in their area in that period.
Throughout his life, Chris Brown has been prone to incidents of violence. In 2014, Chris Brown was diagnosed with bipolar mood disorder while he was in rehabilitation. Furthermore, the singer was diagnosed with post-traumatic stress disorder and insomnia (Stuart, 2014). Under the diagnosis, the doctors indicated that violent episodes of Chris Brown were a result of the singer’s failed efforts to self-medicate. The bipolar disorder could be identified as a contributing factor to his aggression and irritability. The incidences of insomnia are another pointer to the bipolar disorder. The incidents of violence that Chris Brown witnessed while growing up may have altered his perception towards violence (Miller, 2012).
Related Career and Vocational Issues
The legal charges that Chris Brown has faced due to his violent conduct have considerably affected his career. After the domestic violence incident in 2009, many companies withdrew from sponsorship deals that they had signed with the singer. Many radio and television stations stopped playing his music. A number of companies also pulled advertisements that Chris Brown had starred in. The incidents of violence have affected the relationship between Chris Brown and fellow associates. His one-time manager quit because Chris Brown threatened him with violence (Heigl, 2016). The incidents of violence and incarceration have created a rift between the singer and executives on his music label. The singer’s stints in jail and rehab have affected his music-making routine and slightly stagnated his career at one point.
Proposed Treatment and Intervention Options
The first intervention that is crucial for people like Chris Brown with IED is cognitive behavioral therapy. The therapy sessions can be undertaken within the context of a group or individually. The therapy sessions are aimed at helping the individual recognize the situations that lead to violent outbursts (Donovan, 2015). Identification of these situations will help the individual to learn how to control their aggressive impulses. The therapy helps to identify the emotions and reasons behind their violent episodes to facilitate cognitive restructuring.
The cognitive restructuring will help to change the way the individual perceives situations that cause them to descend into violence. Therapy will provide the individual to develop coping abilities and relaxation skills through training. Relaxation skills will include muscle relaxation and deep breathing. These skills will help the individual to gain a capacity to control their impulses in situations where their aggressive impulses are most likely to be triggered. The main goal of cognitive behavioral therapy in treating IED is a resolution of the symptoms of the disorder and improvement on the part of the patient to a point when they can effectively manage their responses. The therapy will enable the singer to identify the onset of a violent outburst and thus repress it through the relaxation of coping techniques. Finally, the therapy will help to prevent relapses into aggressive behavior.
The next avenue of treatment for the singer is medication. The medication will help in treating the aggressive impulses in the patient. The first line of medication is serotonin reuptake inhibitors (SRRI). The SRRI are recommended as their first line of treatment because of their tolerability and efficacy in the management of aggressive impulses. The most preferable drug if fluoxetine. Fluoxetine is favored because extensive research has been carried out on the effectiveness and reliability of the drug (Carraro, 2016). A randomized trial on 100 IED patients indicated that individuals who took fluoxetine were less aggressive at the ends of the study. The period for administering the drug can range from 6 weeks to 12 weeks depending on how the individual will respond. Each day, the patient will take the recommended dose of the drug, which is 20mg. If the patient will display unresponsiveness to the dose, it will be increased to 30mg or 40mg depending on how the patient can tolerate the dosage (Carraro, 2016). If the patient displays further unresponsiveness, then the dose will be increased by 10mg every week up to a maximum of 60mg daily.
If the individual exhibits any resistance to fluoxetine, then further steps will need to be taken. The patient will be observed for a period of up to 12 weeks to determine the responsiveness to the drug. When it has been conclusively determined that the patient is unresponsive, the next step will be top replace the fluoxetine with another drug. The process will involve gradually reducing the dosage of fluoxetine while at the same time increasing the dosage of the replacement drug. The first drug that can replace fluoxetine is phenytoin. The recommended daily dosage for the drug 300mg that will be administered in quantities of 100mg throughout the day. Changes in the dosage will depend on the tolerability of the individual to the drug. The dosage can be increased to a maximum of 400mg a day. Phenytoin is administered over a period of 6 to 12 weeks.
If the patient displays further resistance to phenytoin, then it will be necessary to replace the dosage with carbamazepine. The starting dose of the medication is a maximum of 200mg a day. The dosage will be increased in divided doses up to a maximum of 1800mg depending on the responsiveness of the individual. Another option to replace phenytoin is oxcarbazepine which works similar to carbamazepine. The starting dose of the drug is a maximum of 300mg daily to be increased to a maximum of 2400mg if the individual will be unresponsive. Oxcarbazepine will be administered over a period of 6 to 12 weeks (Carraro, 2016). If the patient shows continued unresponsiveness, the drugs will be replaced with mood stabilizers such as lamotrigine, valproate, lithium and topiramate. The daily doses of the drugs will vary according to the responsiveness of the individual.
Continuing Assessment and Proposed Follow-Up
It is essential to continue assessing the patient during and after treatment to determine the efficacy of the treatment. If the patient is undergoing pharmacotherapy, it will be necessary to assess the effect of the drug on their aggression levels as well as the side effects of the drugs. By identifying the side effects of the drugs, steps can be taken to reduce the impact of those effects (Donovan, 2015). Some of the side effects of the drugs that will need to be managed include nausea and sleep deprivation. Continuing assessments helps to determine when it is necessary to discontinue treatment. When terminating treatment, it is advisable to incrementally reduce the doses. Continuous assessment will help to identify if the patient is resistant to the drugs or if the patient is refractory.
Follow-up will involve monitoring the patient to check if the symptoms of IED resurface. The process will involve observing the patient, interviewing them or asking for feedback from close family members. Attention will be paid to how the patient responds to frustrating situations and any incidences of violence, verbal altercations, threats and destruction of property. Monitoring will be reduced for patients who show minimal symptoms of IED after the therapy of medication (Donovan, 2015). It may also be necessary to provide maintenance pharmacotherapy to ensure that the explosions of aggressions remit to a manageable level. Maintenance pharmacotherapy drugs will be provided to the patient for a period of up to two years. Recurrence of the symptoms of IED may necessitate a return to therapy or medication.
Potential Legal and Ethical Issues
The top legal and ethical issues relate to the privacy and confidentiality of any personal information. During the process of diagnosis and treatment, any information that will be provided by the individual will have to be kept confidential. Privacy and confidentiality can only be breached if it is deemed that the patient could be a threat to themselves or others. It is necessary for the psychiatrist to follow the code of ethics established by the American Psychology Association throughout the treatment process (Benedek & Grieger, 2015). During the treatment process, the rights and dignity of the patient have to be respected. The psychiatrist has to communicate the treatment options available to the patient as well as the side effects of any medication.
- AMA. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Association.
- Benedek, D. M., & Grieger, T. A. (2015). Legal Issues in Psychiatric Practice. Chester: John Wiley & Sons.
- Carraro, E. (2016). Intermittent explosive disorder in adults: Treatment and prognosis. Retrieved from UTD:
- Donovan, S. (2015). Intermittent Explosive Disorder. New York: Wiley Online Library.
- Heigl, A. (2016). A Complete History of Chris Brown’s Legal Struggles. Retrieved from People:
- Kaufman, G. (2009). Chris Brown haunted by family’s history of domestic violence. Retrieved from MTV:
- Miller, L. (2012). Criminal Psychology Nature, Nurture, Culture. Springfield, IL: Charles C. Thomas.
- Stuart, H. (2014). Chris Brown Has Been Diagnosed With Bipolar Disorder And PTSD. What Does That Mean? Retrieved from Huffington Post