Psychopathology and Diagnostic Reasoning: Excessive Alcohol Use

Psychopathology and Diagnostic Reasoning
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Subjective Section
Chief Complaint: The patient has presented to the counselor's office following several excessive alcohol use episodes. She expresses her distress and discomfort in dealing with and interacting with people, including her students. She states that alcohol has an influence on her that is different than other people.
HPI: The patient's name is Ally Chen, a forty-four-year-old female born and raised in Philadelphia. She is currently not taking any medication and has been referred to the counselor due to severe alcohol use, which is now affecting her social and career life. She denied drug use, though it is noted that she had DUI at twenty-one years. She appears to be very irritated with the interview, though she manages to tell how alcohol use has taken a considerable toll on her. She has been getting overly drunk and has missed classes for twenty-two days. She had had confrontations with her friends, especially when she thought one of them failed to wake her up, while another told her when she was drunk in class. She is repulsive and impatient and refuses to open up about her personal life, which looks like she is in denial, and claims it is okay. She feels demotivated with her teaching job.
Past Psychiatric History
General Statement: Basically, the patient did not mention any previous treatment course or experience with her alcohol use. She, however, states that it runs in her family, and her father was an alcoholic and used to attend AA meetings.
Hospitalizations: the patient does not give an account of a hospitalization experience. She has, however, hinted that she started drinking at an early age though moderately, and her intake increased after completing grad school and more after she started working.
Medication Trials: No record of medications that she has tried.
Psychotherapy/Previous Psychiatric Diagnosis: according to how the patient responds throughout the entire sessions, it is more likely that she did not find the psychotherapy helpful. However, she shows signs that she is aware that her alcohol consumption level is abnormal and most likely an alcohol use disorder.
Substance Use History: the patient takes alcohol daily when she is mostly alone. During school functions, she sometimes takes it, in an amount she describes as just a few wine glasses a day. The few glasses translate to five to six glasses, which intoxicates her, but she believes that the drinking habit does not affect her in the same way that people do. The last time she took alcohol was probably when she attended a party at one of the faculty members' houses, where she intoxicated herself and failed to wake up on time for work.
Family Psychiatric/Substance Use History: The patient's father was also an alcoholic and used to attend AA meetings. However, her mother was not, and she was supportive.
Social History: The patient was born and raised by her two parents in Philadelphia. She reports being an only child. She is currently divorced and a mother to a four-year-old boy who lives with his father. She has a Ph.D. in biology and a master’s degree in high s...