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Psychology
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DSM-5 Psychology Case History, Signs, and Symptoms

Essay Instructions:

Please keep your responses focused on what is presented in the vignettes. Do not add information but use your creativity to support what you see in the vignettes as written. Avoid elaborations and assumptions. This assignment MUST be typed, double-spaced, in APA style, and must be written at graduate-level English.

Use the reading assignments thoroughly in an integrative discussion. Include evidence-based research to support the textbook information. Remember to reference all work cited or quoted in APA format
You are encouraged to use the DSM-5 Level 2 Assessment Measure(s), located under resources, to formulate your diagnosis:
All discussions must take into account the legal and ethical considerations, as well as issues of culture and human diversity that may pertain to the vignettes below. Legal and Ethical information is in Chapter 16 of the course text. Cultural information is covered throughout the course text and DSM 5. You may use alternative cultural resources to enhance your work.

Please review the Sample Vignette Analysis located under Resources
Your assignment should be 5-6 pages plus a title and reference page.

Do not include the vignette in your responses
Jane is a 19-year old women. She presents as markedly underweight, with significant agitation. Both of her parents are present for the intake session. Her mother is an attractive Japanese woman of slight build. Her father is a Latino who appears deeply concerned about his daughter. Jane is their only child.

The parents report that when Jane was 2-years old, she was sexually abused by an older cousin that was diagnosed with autism. While this cousin has not been part of Jane’s life since, this remains a family secret and no legal action was ever taken due to the cousin’s mental illness. The parents do believe this affected Jane and are hoping to approach this issue and find resolution and healing. They have approached their family doctor who has known Jane all of her life. He suggested that the family seek counseling and consider hospitalization for Jane.

Reportedly, Jane has been erratic, impulsive and self-destructive throughout much of her life. Her parents report that Jane suffers from mood swings, angry outbursts and has alienated most of her friends. She has a history of self-abuse and suicidal ideation. While Jane has reportedly never made an attempt on her life, her parents have always been cautious and concerned. Jane has a history of cutting her wrists, but the parents report this was superficial and did not require medical attention. Jane denies doing this at present.

Jane has also been struggling with anorexia and bulimia since age 12. They have taken her to doctors and therapists with no success. In the past few months, Jane has lost a significant amount of weight, is not sleeping and is “talking crazy”. The parents often find Jane up all night having conversations with herself that make no sense. Jane’s mother begins to cry as she expresses a fear that her daughter is using drugs and worries that she will overdose and die. At this point, Jane starts wringing her hands and looking around the room and asks if she can be excused to use the restroom.

Formulate a Differential Diagnosis for Jane. Consider what comorbid disorders may exist and what additional information you may need to confirm your diagnostic impression. Choose one provisional diagnosis for Jane. Support your diagnostic impressions by walking thru the DSM-5 diagnostic criteria (letter by letter) for the proposed diagnosis and match each DSM-5 criterion with vignette content. (See Sample Vignette Analysis located under Resources for guidance)
Choose two (2) theoretical models and explain how each may conceptualize Jane’s clinical presentation. From the perspective of each theoretical model, discuss how you would provide clinical treatment. Integrate vignette content to illuminate your treatment approach.

You must discuss legal, ethical, and cultural considerations related to your diagnostics and treatment.

Essay Sample Content Preview:

Differential Diagnoses
Author’s Name
Institutional Affiliation
Differential Diagnoses
Case History, Signs, and Symptoms
Jane is 19 years old, who is currently underweight and previously has been diagnosed with anorexia and bulimia for which she received numerous ineffectual treatments. She also has a history of sexual abuse by her cousin at the age of 2 years which had a significant effect on her. Currently, she has an erratic and agitated affect with anger outbursts and an unstable mood. She has also been self-destructive with episodes of self-harm, self-abuse and suicidal ideation. She has currently distanced herself from friends, sleeps less and is found to be talking gibberish to herself.
Potential Diagnoses and Comorbidity
Jane’s symptoms can be linked to multiple DSM-5 disorders for which a differential diagnoses are discussed below. One of the potential diagnose can be Bipolar Disorder which is characterized by a manic episode primarily distinguished through elated, irritable or expansive mood. Other symptoms include feelings of grandiosity, insomnia, talkativeness, distractibility, psychomotor agitation and indulging in harmful activities (American Psychiatric Association, 2013). Jane displays one of the major symptoms of Bipolar Disorder i.e. mood swings and an irritable mood. Her problems are related mostly related to affect which can be equalized with Bipolar Disorder as it is also a mood-related disorder. Some of her symptoms also relate to the depressive episode i.e. losing significant weight, self-harm, agitation and suicidal ideation. While some symptoms match the diagnosis a detailed history and current symptomatology have to be probed to define mood episodes, their duration, intensity and frequencies.
Some of Jane’s symptoms also point towards the diagnosis of Schizophrenia but due to slight inclination towards it, a specifier of Bipolar Disorder i.e. with a psychotic episode might be considered a better area to discuss than a full-blown schizophrenia diagnosis. A psychotic episode may accompany a bipolar episode characterized by disconnection or dissociation from reality, lack of insight, hallucinations, delusions, disorganized thought patterns, aggression, and erratic mood. Jane’s symptoms of self-talk, mood swings, temper outbursts, self-directed aggression and lack of insight corroborate with the signs of a psychotic episode but the absence of major symptoms such as delusions, hallucinations, disorganized speech or thought patterns nullify the diagnosis.
Included in Bipolar Disorder is a depressive episode as well but Jane’s symptoms also need to be ruled out from the diagnosis of Major Depressive Disorder (MDD). It is defined by a depressed mood and loss of interest in pleasurable activities (APA, 2013). Significant weight loss, insomnia, agitation, distancing from friends and family, self-harm and suicidal ideation are Jane’s symptoms which also match the diagnosis of MDD. On the contrary, major symptoms of depressed mood and anhedonia were not reported regarding Jane, hence, the diagnosis can be ruled out after more elicitation of information.
Some evidence of Post-Traumatic Stress Disorder can also be seen. Criterion A of the disorder states that ...
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