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2 pages/≈550 words
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APA
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Health, Medicine, Nursing
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English (U.S.)
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Topic:

Primary Diagnosis: Social Phobia or Social Anxiety Disorder

Essay Instructions:

Purpose:
Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.
Scenario:
J.T. is a 20 year-old who reports to you that he feels depressed and is experiencing a significant amount of stress about school, noting that he’ll “probably flunk out.” He spends much of his day in his dorm room playing video games and has a hard time identifying what, if anything, is enjoyable in a typical day. He rarely attends class and has avoided reaching out to his professors to try to salvage his grades this semester. J.T. has always been a self-described shy person and has had a very small and cohesive group of friends from elementary through high school. Notably, his level of stress significantly amplified when he began college.
You learn that when meeting new people, he has a hard time concentrating on the interaction because he is busy worrying about what they will think of him – he assumes they will find him “dumb,” “boring,” or a “loser.” When he loses his concentration, he stutters, is at a loss for words, and starts to sweat, which only serves to make him feel more uneasy. After the interaction, he replays the conversation over and over again, focusing on the “stupid” things he said. Similarly, he has a long-standing history of being uncomfortable with authority figures and has had a hard time raising his hand in class and approaching teachers. Since starting college, he has been isolating more, turning down invitations from his roommate to go eat or hang out, ignoring his cell phone when it rings, and habitually skipping class. His concerns about how others view him are what drive him to engage in these avoidance behaviors.
After conducting your assessment, you give the patient feedback that you believe he has social anxiety disorder, which should be the primary treatment target. You explain that you see his fear of negative evaluation, and his thoughts and behaviors surrounding social situations, as driving his increasing sense of hopelessness, isolation, and worthlessness.
Questions:
Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers.
1. Generate a primary and differential diagnosis using the DSM-5 criteria.
2. Develop a biopsychosocial plan of care for this client.
3. Compare and contrast fear, worry, anxiety, and panic.
-The class book is: Durand, V. M., Barlow, D. H., & Hoffman, S. G. (2018). Essentials of abnormal psychology ISBN: 9781337619370

Essay Sample Content Preview:

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1 Generate a primary and differential diagnosis using the DSM-5 criteria.
Primary Diagnosis: Social Phobia or Social Anxiety Disorder
Social phobia is characterized by significant distress following at least one social situation where the individual is unprotected from other people’s scrutiny. The social circumstance almost always incites the person’s anxiety. An example of this is social interaction, performing in front of other people, or being observed by an audience. The distress or trepidation is significantly out of proportion from the presented peril or intimidation of the circumstance, making the individual avoid such situations. The patient’s reactions must not be explained by using substances or other psychiatric or medical disorders (Center for Behavioral Health Statistics and Quality, 2016).
In this case, the patient stutters, sweats, and loses concentration because he feels uneasy when starting an interaction due to the fear of humiliation. In college, the anxiety was significantly amplified. This shows that his anxiety is out of proportion to the actual threat of communication or clarification. The symptoms are directed to social phobia, mainly because the patient was not using substances or was diagnosed with a medical condition with similar symptoms.
Differential Diagnosis: Avoidant Personality Disorder
It has a similar presentation with social phobia. Based on DSM-5, the individual must have a constant reaction of avoiding social contact, an impression of personal inadequacy, and being hypersensitive to rejection or criticism. It must present with at least four of the following: 1) Evasion of activities associated with the job when it requires interpersonal contact due to the threat of criticism or rejection; 2) Reluctance to involvement unless they are assured that they are wanted; 3) Does not entertain close relationships; 4) Assesses oneself as unappealing, socially incompetent, or inferior; 5) Unwillingness to partake in activities secondary to fears of humiliation (Zimmerman, 2021).
2 Develop a biopsychosocial plan of care for this client.
The main symptom of the patient is the fear of humiliation during social int...
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