For this Discussion, review the client in the case study withinthe Learning Resources. Consider symptoms or signs presented by theclient for a diagnosis. Think about how you, as a futureprofessional in the field, might justify your rationale fordiagnosis. Consider what other information you may need fordiagnosis on the basis of the DSM diagnostic criteria.
Trauma and Stressor Related Disorders
FEMALE SPEAKER: Well, I just keep thinking what if somethinghappens? I mean I've always had trouble concentrating. But thistime, it's different.
FEMALE SPEAKER: Different, how?
FEMALE SPEAKER: Well, you know how like you were talking on yourcell phone or something and it cuts out. You lose the connection.It's kind of like that. My mind just goes blank.
And when I'm at the hospital and it happens, I flip out. I couldgive the patient the wrong medication or something. What if it'searly dementia? I mean I've read about that happening. I read anarticle just the other day about people in their 30s and 40sgetting that. That's horrible.
FEMALE SPEAKER: It sounds like you're constantly nervous thatyou'll go blank and that something bad will happen. You mentionedhaving other symptoms. Like what?
FEMALE SPEAKER: Well, at work, my temper. I flip out on patientssometimes and on other nurses. I just freak out. I even startedsnapping at my daughter. And that has never happened before.
FEMALE SPEAKER: Well, I understand. You're feeling anxious. Andyou're having some temper issues, which are sort of out ofcharacter for you. How are things going at home?
FEMALE SPEAKER: Well, I'm not sleeping very well at all. One ofmy favorite things used to be to curl up at night with a book. ButI can't concentrate. I have this whole stack of books by my bedsidetable. I mean they're history books. And I love reading abouthistory. But I haven't even touched them.
And my husband got so upset the other day because he brought methis kit for scrap-booking, which is something I used to reallyenjoy doing. But I just took them back to the store. I could notdeal with that either.
FEMALE SPEAKER: Well, it seems like you're not findingrelaxation in the things that used to enjoy doing. Now, when youreturned your husband's gift, you said that you couldn't deal withthat. What exactly couldn't you deal with?
FEMALE SPEAKER: The expense. You have no idea what thesescrap-making materials cost. I could spend that much in groceriesin a week. And I thought—So that I lie in bed at night at 3:00 AMworrying about, just money, money, money, money, money.
And my husband and I both work. We work really long hours. Butit's just not enough. We really should have started saving forcollege. I mean my eldest is going to start college in a few years.And I don't know what we're going to do. We don't have themoney.
FEMALE SPEAKER: Did you talk to your husband about yourconcerns?
FEMALE SPEAKER: Yeah. Yeah. We talk. Alex, my husband, he's 12years older than me. I mean we get along fine.
But I worry about him. I mean at work for example, he's been upfor this really big promotion. But now it looks like he's not goingto get it. And his health, he's got a whole history of early heartattacks in his family. And I just worry about that. I mean hehasn't shown any symptoms or anything. But I really, really, worrythat one day something might happen to him. I mean the whole thingjust feels like a awful. With care reform now, what if they cutback on my hours at work? And what if I lose my job? Doctor, Icannot afford to lose this job.
FEMALE SPEAKER: Any idea how long you've been having thesesymptoms, the lack of concentration, trouble sleeping, problemsrelaxing?
FEMALE SPEAKER: A while. Off and on, I guess. I went to see acounselor when I was in nursing school. I was Ms. Overachiever. Iwas making straight A's, but I couldn't help but worry that it wasnever enough.
FEMALE SPEAKER: It sounds like you were feeling the pressure oftrying to achieve your career goals. Did the counseling helpyou?
FEMALE SPEAKER: Yeah. Yeah. I guess it did. I mean I went for acouple of months. And the counselor had me do this body scanexercise. And he suggested I should start meditating. But who hadtime to meditate. I was too busy making straight A's
With these thoughts in mind:
1. A diagnosis of the client in the case study.
2. Then explain your rationale for assigning this diagnosis onthe basis of the DSM diagnostic criteria.
3. Finally, explain what other information you might need aboutthe client to make an accurate diagnosis based on thosecriteria.
