Amelie Smith: Anxiety Assessment: Psychological Assessment

952 Words4 Pages
Psychological Assessment Report
(Confidential Information)
Name: Amelie Smith Referral:
Date of Birth: 3/14/1994 Age: 20 and 1 month
Gender: Female Ethnicity: Caucasian
Test Administrator: Kari L. Miller
Dates/Tests administered:
04/04/2014 Beck Depression Inventory (BDI-II)
04/04/2014 Hamilton Anxiety Rating Scale (HAM-A)

Referral
Amelie Smith is a 20 year old, married, Caucasian female who was referred by her gynecologist at her 2 week post-partum checkup. Mrs. Smith admitted to feeling down, and not herself as well as excessively worrying about things as small as grocery shopping. Mrs. Smith told her doctor she experienced what she thought was an anxiety attack.

Background Information
Educational: Amelie Smith successfully completed high school in 2012. She received average grades throughout high school and graduated with a 2.9 GPA. Amelie took general courses and never had the need to be in any kind of special education classes.
Social/Emotional: Amelie admitted to having few friends. She reported that she feels too anxious to make new friends and doesn’t think people will like her. She stated that she refused to go into stores alone.
Family History: Amelie was born in rural Pennsylvania. She has one brother and parents who have been married for 22 years whom she has lived with since she was born. Amelie is 3 years older than her brother and reported everyone got along in the household. Amelie got pregnant at the age of 16 by who is now her husband. He joined the United States Marine Corps and she stayed in Pennsylvania with her family while he was stationed in Okinawa, Japan and so that she could finish high school. They were married in 2012 and in 2013 Amelie, her husband, and their daughter m...

... middle of paper ...

... therapy immediately with one session per week. The therapist should concentrate on teaching Amelie how to handle stress along with breathing techniques for reducing anxiety. Amelie should be instructed to take her medications and to never go off the medications prescribes without her doctor’s permission.

Diagnosis
Axis I: 296.89 Bipolar II, Current episode: Major Depressive Episode, Severe with Postpartum Onset.
300.02 Generalized Anxiety Disorder
Axis II: No diagnosis
Axis III: None reported
Axis IV: Moving away from family, spouse active duty military (gone often), 2 weeks postpartum.
Axis V: GAF on discharge = 45

Reference
American Psychiatric Association. (2002). Diagnostic and Statistical Manual of Mental
Disorders (4th ed., text rev.). Washington, D.C: Author.

    More about Amelie Smith: Anxiety Assessment: Psychological Assessment

      Open Document