To complete each assignment, you will need to read the casestudy. Assume that the client described in each case study meetscriteria for a DSM-5 disorder. You will then consult the DSM-5criteria and write 1-2 detailed paragraphs in which you assign aprimary diagnosis for the client and justify that diagnosis. Inthis section you should reference EACH of the DSM-5 criteria forthe diagnosis you are assigning and provide evidence from the casestudy for or against the presence of that criterion. If you have noinformation for a particular criterion you should specify this. Forexample, if the DSM-5 criteria specify that the symptoms cannot beaccounted for by a medical condition and you have no evidence thatthe client has a medical condition that would explain theirsymptoms, you should state this. Next, write a paragraph in whichyou provide an example of at least one related diagnosis that youare ruling out based on the information you have. This is a processcalled “differential diagnosis.†As you know, the categoriesprovided in the DSM-5 do not represent “true†categories in nature,and often clients will often have symptoms in multiple categories.As a clinician, you need to rule out other categories orexplanations for the symptoms. For example, if someone isexperiencing panic attacks in the wake of a traumatic event, youmight consider the diagnoses of Posttraumatic Stress Disorder,Acute Stress Disorder, or Panic Disorder. The DSM-5 criteria willhelp you figure out which is the most appropriate diagnosis, andyou should specify why you are ruling out another disorder,providing specific justification for ruling it out. The bestdisorders to rule out are those that share features or symptomsdescribed in the case but are not the best diagnosis for theclient. Finally, you will write one paragraph in which you mayspecify the use of a psychosocial treatment, a psychoactivemedication, or both. You must briefly describe how this treatmentworks and you must justify your choice of treatment based on theresearch evidence for the efficacy of the treatment.
Case Study #1
Linda is a 36-year old, Afro-Latina, married insurance executiveliving in the Northeast United States. She has been experiencingsymptoms of anxiety since she was in high school, but they haverecently become much worse after the birth of her second child, ason, 4 months ago, prompting her to seek treatment. She says thatfor the last 4 months she has felt keyed up, anxious, and “onalert†almost constantly. She has difficulty sleeping,significantly diminished concentration, and is irritable. Inaddition, several times a day she has “attacks†that involveinvolve “full terror.†The episodes last for about 10-15 minuteseach, and usually involve profuse sweating, muscle tension,increased heart rate, feelings of dizziness, trembling, intensefear, and crying. When asked what triggers these episodes, Lindasays that they usually occur when she is at home alone with herinfant son or when she has memories of his delivery, during whichshe suffered a rare complication (she learned after delivering thatboth she and her baby could have died during the delivery). Shetries very hard not to think about the delivery, but images andmemories of it pop into her head frequently. In addition to theseepisodes of “terror,†Linda says that since her son’s birth shefeels worthless, ashamed, and guilty for not “bringing him into asafe world.†She also states that she feels sad much of the time,and is detached from her son (she does not feel she has bonded wellwith him). Linda has started to sometimes call out sick from workwhen she has the sense that she is “having a bad day†and mighthave an episode, and she says she is increasingly withdrawing fromher son because she finds that being with him triggers her anxiety.She says that she feels “utterly alone†and avoids hanging out withother mothers of infants because she finds they cannot relate toher experiences. Linda does not use any substances or have anymedical conditions that could explain these episodes.
