Question

To complete each assignment, you will need to read the case study. Assume that the client described in each case study meets criteria for a DSM-5 disorder. You will then consult the DSM-5 criteria and write 1-2 detailed paragraphs in which you assign a primary diagnosis for the client and justify that diagnosis. In this section you should reference EACH of the DSM-5 criteria for the diagnosis you are assigning and provide evidence from the case study for or against the presence of that criterion. If you have no information for a particular criterion you should specify this. For example, if the DSM-5 criteria specify that the symptoms cannot be accounted for by a medical condition and you have no evidence that the client has a medical condition that would explain their symptoms, you should state this. Next, write a paragraph in which you provide an example of at least one related diagnosis that you are ruling out based on the information you have. This is a process called “differential diagnosis.” As you know, the categories provided in the DSM-5 do not represent “true” categories in nature, and often clients will often have symptoms in multiple categories. As a clinician, you need to rule out other categories or explanations for the symptoms. For example, if someone is experiencing panic attacks in the wake of a traumatic event, you might consider the diagnoses of Posttraumatic Stress Disorder, Acute Stress Disorder, or Panic Disorder. The DSM-5 criteria will help you figure out which is the most appropriate diagnosis, and you should specify why you are ruling out another disorder, providing specific justification for ruling it out. The best disorders to rule out are those that share features or symptoms described in the case but are not the best diagnosis for the client. Finally, you will write one paragraph in which you may specify the use of a psychosocial treatment, a psychoactive medication, or both. You must briefly describe how this treatment works and you must justify your choice of treatment based on the research evidence for the efficacy of the treatment.

Case Paper #4

Sharon is a 19-year-old, single, European American college student who was brought to the emergency room because she had been vomiting for the past 24 hours and had been unable to drink water or consume any food; she was treated for dehydration and released. The previous night she had gone out drinking at the local college bar, Barney’s. After about three hours of consuming an indeterminate amount of alcohol, she lost consciousness and was brought home to her apartment by her roommates. Sharon reports that this is the first time she has ever lost consciousness due to alcohol consumption. She typically drinks to intoxication only once or twice a week. On a typical “drinking” night she will drink 7-8 beers, shots, or other alcohol drinks. She reported that she does drink much more than when she first came to college, but she has built up a tolerance so she can now drink 7-8 drinks without becoming seriously impaired. Sharon also reported that occasionally she will drink at home, in her apartment. She stated that she drinks 1-2 drinks before bed to help herself get to sleep because she has had difficulty sleeping for the past two months. In addition, she sometimes has one drink in the morning to help her “deal with things.” When asked whether there were any significant life events associated with her increase in drinking, Sharon stated that she has been struggling for after she had a “bad breakup” with her boyfriend from high school eight weeks ago. Since the breakup she has felt very sad and lonely almost every day. She has not really felt motivated to be around people (she stated that she drinks in part to get up the “courage” to be around people) and she feels she has lost interest in most of her usual activities and school. The breakup also led her to feel worthless, she stated, “I feel like no one will ever love me again.” She stated that she may be drinking more to alleviate the sadness she feels about the breakup, but she feels she could stop drinking at any time if she needed to. She reported that she does not feel that her drinking affects her functioning significantly. She does sometimes skip classes on Fridays due to hangovers, and her relationships with her roommates have become tense because she will sometimes behave impulsively or need “taking care of” when she is drunk. Sharon expressed insight that her drinking is probably not helping her deal with the breakup in a healthy way, but that she is fine with her current level of alcohol intake because she feels she needs “something to help me get through this.” She admitted that since the breakup she has occasionally has passive thoughts of suicide but that she has no intention to act on those thoughts, and that drinking sometimes makes those thoughts “go away.”

Answer 1

Primary diagnosis:

The present case meets the DSM V criteria for Alcohol use disorder of moderate type severity as she shows more than two symptoms which are necessary to make the diagnosis for alcohol use disorder. She was Found in the emergency room after an episode of severe binge drinking. She also reported that being sick from drinking often interfered with taking care of her college programme.

Moroever, she shows the typical symptom of drug tolerance as she reported that she now Had to drink much more than before to get the same effect. While she reported that she does not feel that her drinking affects her functioning significantly, her relationships with her roommates have become tense because of her impulsive behaviour she under the intoxication of alcohol and she maintains her drinking habit despite the fact that she is unable to attend classes due to frequent hangover effects.

Differential diagnosis:

Her alcohol dependence is related to feelings of depression and loss of love relationship. Since the breakup she has felt very sad and lonely and she stated that she may be drinking more to alleviate the sadness she feels about the breakup. Thus, while a differential diagnosis of depressive mood disorder is made as she reported symptomatic patterns such as feelings of worthlessness, lack of interest in social group and other routine activities and suicidal thoughts. However, her feelings of depression are linked to her breakup and it is not generalised across her everyday routine functioning. Moroever, her feelings of sadness have further reinforced her drinking behaviour making alcohol abuse as the primary clinical problem.

Treatment Plan:

The treatment system for the present would be made based on her age, life condition and emotional,cognitive functioning. As the case shows a fair amount of insight into her condition and is emotionally sensitive to her past experiences, individual psychotherapy is found to be highly suitable to encourage her towrads a drug based de addiction programme along with behaviour modification. Cognitive-behavioral therapy directs individuals in treatment to recognize and stop negative patterns of thinking and behavior such as her feelings of worthlessness and being unloved as a result of generalisation of her past experiences in he rlove rleationhsip, be aware of the emotional stressors for her and target the feelings that lead to alcohol use so that the she can avoid them. An individual centered approach to therapy would focus on reducing or stopping her substance use, promote skill building in social, interpersonal, emotional and professional realms in order to help her identify and cope with stress and ensure gretaer commitment to a recovery plan.