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Strengths and weaknesses of the psychiatric classification system
Describe the main types of mental ill health according to the psychiatric classification system
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Provide your diagnostic impressions (based on either the DSM-5 or DSM-IV-TR) for this individual. In narrative form, please describe how the individual meets the diagnostic criteria for the disorder(s) chosen in addition to the differential diagnostic thought process that you used to reach your hypotheses. Be sure to include any additional (missing) information that is needed to either rule out or confirm your differential diagnoses. As the evaluator, before arriving at a possible diagnosis, the evaluator must establish whether or not Danita’s behavior is not induced by her substance use and whether or not malingering is involved. After those things has been rule-out, Danita’s current presentation and data from the vignette, may support the …show more content…
In order to meet criteria A, Danita Johnson must also have difficulty in mathematical reasoning and concepts. Danita stated that she could not do math the way other kids could do it. This statement states that her academic skills are below those of her chronological age. This statement also meets criteria B of the specific learning disorder. As stated before, her academic skills are below those of her chronological age. Due to her challenges, it appears that Danita dropout of school which further interfere with her academic …show more content…
It appears that Danita meets criteria 1 “inattention” with six or more symptoms which has persisted longer than six months. These symptoms are avoidance, difficulty sustaining attention in tasks, does not follow instruction, forgetful in daily activities, often fails to give close attention, and often does not seem to focus when spoken to directly (American Psychiatric Association, 2013). Danita Johnson avoidance behavior was displayed when she stated that she does not plan to work anymore. It was difficult for her to understand her job’s instruction, so she avoids this task by not working anymore. It also appears that she had difficulties sustaining given tasks. This behavior is displayed when she dropout of school and her misunderstanding in job related instructions. This behavior also falls under not following direction, forgetting task, and giving close attention. These things appear to complicate Danita, and therefore she avoids the whole situation. Although Danita meets criteria 1 of the differential diagnosis, Danita did not meet six symptoms of criteria 2 “Hyperactivity and impulsivity.” Yes, Danita has displayed impulsivity that has led her behavior to violate social morals, but due to the limited information given in the vignette, attention-deficits/hyperactivity must be ruled
Denise also displays impulsivity in more than two self-damaging areas (Criterion 4). She has a history of binge drinking, shoplifting, and spending too much money. There is a history of suicide attempts, suicidal gestures, and self-mutilation (Criterion 5). Most recently she presented at the emergency room which self-inflicted cuts which required stitches and a small overdose of Ativan. Denise displays instability and reactivity of mood (Criterion 6). She is often depressed, but is occasionally filled with energy and rage. Denise has expressed chronic feelings of emptiness (Criterion 7) beginning during her teenage years, and stated that it feels like she “doesn’t exist.” Finally Denise has difficulty controlling her intense anger (Criterion 8). One employer fired her for throwing a drink at a customer after becoming so angry. For these reasons, Denise should be diagnosed with Borderline
Ashley has a previous diagnosis of Attention Deficit Hyperactive Disorder and Oppositional Defiant Disorder. Ashley has poor judgment, is impulsive, and is defiant toward authority figures and peers. This affects Ashley’s ability to achieve to her fullest potential academically, and have positive interactions with adults, or peers. She also displays low frustration tolerance, and is easily triggered in situations and by other people. Her impulsive reactivity often worsen situations, especially due to the lack of insight Ashley has about her behaviors. Ashley’s inability to regulate her emotions heightens her reactivity in triggering situations. Her sexual acting out, and reason for referral can be attributed to her poor judgment, and inability to control her
This would assume that her drive for attention is marked by current feelings of worthlessness, and that worthlessness is caused by depression. It would also assume that her suicide threats are the result of actual suicidal feelings. I do not believe that her threats are credible at this point. For these reasons, I narrowed down the possible diagnoses, and eliminated major depressive disorder.
...oermann et al, 2005). This has a tendency to lead to an insecure sense of one’s self. (Hoermann et al, 2005) A person with this disorder has a difficult time being reliable. This can be from constant career change, relationships and goals. These essential changes occur without any warning. (Hoermann et al, 2005)
Mary has suffered with her illness for over 10 years. She has previously been diagnosis with a Cluster B type Personality Disorder. Mary comes across as narcissistic, self-engrossed and can be very demanding at times. Mary suffers from anxiety and is prone to panic attacks in relation to her PD diagnosis. At times Mary has been known to make ...
Disco Di have shown these symptoms during her time when she ran away from her parents because they would not pay attention to her. She got into drugs use, had many promiscuous relationships with boys. Her relations with these boys were full off passion and chaotic with many violent arguments. She would seek out excitements such as getting drunk and go dancing where she would leave with strange men then have intercourse. After being admitted to a hospital, she would always expect and demanded that people would always have to pay attention to her. Also, I believe this because in the journal “Histrionic Personality Disorder” it stated “Histrionic PD is indicated when people exaggerate their emotions and go to excessive lengths to seek attention” (Crawford et al, 2007) and this is indicated when Disco Di ran away from home because she believed her parent did not pay enough attention to her. Next, the diagnostic feature of her other disorder, borderline personality disorder, is that mark of instability of mood, unstable relationships, chronic feeling of emptiness and recurrent threats of
Peter Dickinson, a 28-year-old Caucasian male was referred to an outpatient mental health clinic by his current girlfriend of one year, Ashley. Ashley reported that about six months ago, she noticed changes in Peter’s behaviors after the announcement of his parents’ divorce proceedings. Peter is a motivated hard worker who devotes himself to his career and is currently working as a defense attorney at a small firm. However, he described himself as “obsessive” about his work in which he was afraid to make errors and would spend a lot of time worrying about failing the assignment rather than completing it. Since he spends a lot of time worrying about his work, he had little leisure time for friends and romantic relationships. Peter has also always felt anxious and is a “worrier”. After Peter’s parents’ divorce proceedings began, Peter had troubl...
The psychiatrist recommended that she be admitted to a mental hospital for women, where she can rest and recover. Another sign of the Borderline Personality Disorder is c...
Frances, A., & Ross, R. (1996). DSM-IV case studies a clinical guide to differential diagnosis. Washington, DC: American Psychiatric Press, Inc.
The physician will question the patient about any stressors she may be contending with at home or work prior to her entering the hospital. The physician will order lab tests and speak with the patient to understand the psychological factors; a referral will be made for making a final diagnosis. After the physician reviews both lab tests and the psychological factors, a referral will be made for the patient to see a clinician. The referral will focus on obtaining support and stabilization. The clinical assessment will gather information using written forms as a first step, including releases to speak with family members. The second step would be to invite the family along with the client in an effort to obtain a better understanding of existing medical conditions along with any past mental disorders. Abuse as a child or abuse as an adult will be determined. The clinician will evaluate if the client is portraying any signs due to alcoholism or a drug addictions. An example of one question her clin...
When considering the 5 D’s of abnormality, he possesses characteristics of them all. For dysfunction, he experiences social dysfunction by being unable to create and maintain relationships. He also experiences emotional dysfunction by having a fear of being alone, bouts of crying, and feelings of low self-worth. Physiological symptoms such as insomnia,
The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been used for decades as a guidebook for the diagnosis of mental disorders in clinical settings. As disorders and diagnoses evolve, new versions of the manual are published. This tends to happen every 10 years or so with the first manual (DSM-I) having been published in 1952. For the purpose of this discussion, we will look at the DSM-IV, which was published originally in 1994, and the latest version, DSM-5, that was published in May of 2013. Each version of the DSM contains “three major components: the diagnostic classification, the diagnostic criteria sets, and the descriptive text” (American Psychiatric Association, 2012). Within the diagnostic classification you will find a list of disorders and codes which professionals in the health care field use when a diagnosis is made. The diagnostic criteria will list symptoms of disorders and inform practitioners how long a patient should display those symptoms in order to meet the criteria for diagnosis of a disorder. Lastly, the descriptive text will describe disorders in detail, including topics such as “Prevalence” and “Differential Diagnosis” (APA, 2012). The recent update of the DSM from version IV-TR to 5 has been controversial for many reasons. Some of these reasons include the overall structure of the DSM to the removal of certain disorders from the manual.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the comprehensive guide to diagnosing psychological disorders. This manual is published by the American Psychiatric Association (APA) and is currently in its fifth revision. Moreover, the manual is utilized by a multitude of mental health care professionals around the world in the process of identifying individuals with disorders and provides a comprehensive list of the various disorders that have been identified. The DSM serves as the essential resource for diagnosis of mental disorders based off of the various signs and symptoms displayed by individuals while also providing a basic reference point for the treatment of the different disorders. The manual attempts to remain scientific in its approach to identifying the underlying symptoms of each disorder while meeting the needs of the different psychological perspectives and the various mental health fields. The DSM has recently gone through a major revision from the DSM-IV-TR to the DSM-5 and contains many significant changes in both the diagnosis of mental disorders and their classifications.
The first to be posited is, major depressive disorder (MDD), which is a mood disorder, mainly characterized by gross deviations in a person’s mood, mood being a more persistent period of affect or emotionality (Barlow, 2002). A major depressive episode needs to be present, and the criteria according to the DSM 5 by the American Psychiatric Association (2013) is a period of at least two weeks of a persistent depressed mood including at least four or more of the other listed symptoms, of which Santana complies with the diminishment of interest in almost all activities for most of the day, she has a decrease in appetite, a loss of energy, hypersomnia and a diminished ability to concentrate nearly every day. Her symptoms caused significant distress and impairment in her social, emotional and educational functioning and are not due to any direct physiological effects of a substance or medical condition, as none is mentioned in the case study. She thus can be diagnosed of having a major depressive episode with anxious distress as she worries uncontrollably. The occurrence of her major depressive episode is not better explained by any psychotic fidisorders such as schizoaffective disorder.
Journal of Attention Disorders. 17(2), 141-141. pp. 141-