Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY:…
Question Answered step-by-step Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY:… Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.Chapter 15, “Diagnosing Substance Misuse and Other Addictions” (pp. 238-250)American Psychiatric Association. (2013). Substance related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm16Gowin, J. L., Sloan, M. E., Stangl, B. L., Vatsalya, V., & Ramchandani, V. A. (2017). Vulnerability for alcohol use disorder and rate of alcohol consumption. American Journal of Psychiatry, 174(11), 1094-1101. doi:10.1176/appi.ajp.2017.16101180Reus, V. I., Fochtmann, L. J., Bukstein, O., Eyler, A. E., Hilty, D. M., Horvitz-Lennon, M., … Hong, S.-H. (2018). The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. American Journal of Psychiatry, 175(1), 86-90. doi:10.1176/appi.ajp.2017.1750101Stock, A.-K. (2017). Barking up the wrong tree: Why and how we may need to revise alcohol addiction therapy. Frontiers in Psychology, 8, 1-6. doi:10.3389/fpsyg.2017.00884Optional ResourcesBest, D., Beckwith, M., Haslam, C., Haslam, S. A., Jetten, J., Mawson, E., & Lubman, D. I. (2016). Overcoming alcohol and other drug addiction as a process of social identity transition: The social identity model of recovery (SIMOR). Addiction Research and Theory, 24(2), 111-123. doi:10.3109/16066359.2015.1075980Hagman, B. T. (2017). Development and psychometric analysis of the Brief DSM-5 Alcohol Use Disorder Diagnostic Assessment: Towards effective diagnosis in college students. Psychology of Addictive Behaviors, 31(7), 797-806. doi:10.1037/adb0000320Helm, P. (2016). Addictions as emotional illness: The testimonies of anonymous recovery groups. Alcoholism Treatment Quarterly, 34(1), 79-91. doi:10.1080/07347324.2016.1114314Petrakis, I. L. (2017) The importance of identifying characteristics underlying the vulnerability to develop alcohol use disorder. American Journal of Psychiatry, 174(11), 1034-1035. doi:10.1176/appi.ajp.2017.17080915Hom, M. A., Lim, I. C., Stanley, I. H., Chiurliza, B., Podlogar, M. C., Michaels, M. S., … Joiner, T. E., Jr. (2016). Insomnia brings soldiers into mental health treatment, predicts treatment engagement, and outperforms other suicide-related symptoms as a predictor of major depressive episodes. Journal of Psychiatric Research, 79, 108-115. doi:10.1016/j.jpsychires.2016.05.008 Provide the full DSM-5 diagnosis for the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may need clinical attention). Keep in mind a diagnosis covers the most recent 12 months.Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.Describe the assessment(s) you would use to validate the client’s diagnosis, clarify missing information, or track her progress.Summarize how you would explain the diagnosis to the client.Explain how you would engage the client in treatment, identifying potential cultural considerations related to substance use.Describe your initial recommendations for the client’s treatment and explain why you would recommend MAT or ABT.Identify specific resources to which you would refer the client. Explain why you would recommend these resources based on the client’s diagnosis and other identity characteristics (e.g., age, sex, gender, sexual orientation, class, ethnicity, religion, etc.). CASE of SUSAN Intake Date: October 2021 IDENTIFYING/DEMOGRAPHIC DATA: This was an emergency, voluntary admission for this 28-year-old single white female. This was her?fourth psychiatric hospitalization. Susan lives with a 24-year old female roommate in New York City. She has a bachelor’s degree in art history and is employed by a major New York museum. Susan is of Jewish ancestry. CHIEF COMPLAINT/PRESENTING PROBLEM: “My therapist said?I was decompensating?because I broke my leg, and I was despondent.” HISTORY OF PRESENT ILLNESS: Susan reported she began a Noom diet and, although she was supposed to be eating 600 calories a day, she was?only eating between 200 and 400 calories?a day. She also admitted?to purging and frequent use of laxatives. Susan reported her weight was being monitored, and she had lab work done to be sure she remained healthy. In 3 months, Susan lost approximately 80 pounds. Susan reports she has a very stressful job. She stated that approximately?one month prior?to admission, she started to “decompensate” and had difficulty maintaining control at work. She had?several altercations with coworkers. One week prior to admission, Susan reported her?NA sponsor?”said something nasty, and?I lost it.”?According to her mother, the sponsor made a reference to Susan being overweight. Susan reported that she was angry and “hit everything?I knew I couldbut that did not help.” She then?kicked a brick wall, fracturing her right leg. Susan also reported being under stress due to applying for her master’s degree in art history and difficulties with her boyfriend. Susan complained of?depression with insomnia?and sleeping only a few hours per night,?feeling confused, decreased concentration, irritability, anger, and frustration. She admitted to?suicidal ideation. She complained of?feeling paranoid over the past few weeks and believed the police were after her and that she heard them outside her door. She believed the police had her under surveillance. Susan also?complained of a fear of dirt, taking time to frequently bathe and brush her teeth, which slowed her down many times. PAST PSYCHIATRIC HISTORY: Susan’s mother reported that Susan saw a clinical social worker briefly when Susan was 10 years old because she was acting out. Susan reported that she was hospitalized at a New York hospital 3 years ago for 3 months. Six months after that, Susan took an overdose of Halcion and was treated at the same hospital, and then was transferred to a state hospital. After discharge in the next month, Susan attended a partial hospitalization program for drugs and alcohol every day for 5 weeks. She also saw a psychiatrist for 2 years. Two years after that, Susan saw a clinical social worker and psychiatrist and continues to the present with them. Susan reported a?history of bulimia?since the age of 17 bingeing, purging, and the use of laxatives. She reported she?had not purged for 3 years until she began the Noom diet?3 months ago. Although Susan is currently not bingeing, she?admitted to purging and using laxatives.? SUBSTANCE USE HISTORY: Susan admitted to?using marijuana, cocaine, opiates, and hallucinogens in the past. She denied IV drug use but admitted to “skin popping” cocaine. Susan has abused alcohol in the past. According to her mother, Susan has also abused?prescription medications in the past. Susan reported that she has been clean and sober for the past 2 years and?attends AA and NA meetings regularly. She also complained of panic attacks and reported that she controlled them by taking Klonopin, but there was?no clear information about this. PAST MEDICAL HISTORY: Susan is allergic to penicillin and has a lactose intolerance. She wears glasses for reading. FAMILY HISTORY INCLUDING MEDICAL AND PSYCHIATRIC: Susan’s parents were married when her mother was 19 years old, and Susan was born the following year. Susan’s mother described Susan as a wonderful, even-tempered, and happy baby. Two years later, Susan’s sister was born. Mother stated Susan became stubborn and difficult. Susan’s mother stated her marriage was conflicted because she has a communication problem with her husband and he was “never an active parent.” When Susan was 12 years old, her parents separated for 2 weeks. Susan reported her mother quit college after Susan’s birth and returned to college after her sister’s birth. She said her father worked all the time, and there was a housekeeper who cared for the children. The family moved to Arizona when Susan was in sixth grade, where she began using marijuana that she reported stealing from her parents. The family returned to New York when Susan was in seventh grade. CURRENT FAMILY ISSUES AND DYNAMICS: Susan is currently applying for admission to graduate school and has taken some courses toward her master’s degree. Susan lived in Connecticut during college had many friends and was active in NA and AA. Susan indicated she was happy living in Connecticut and felt returning to New York was “a stupid mistake.” Susan reported that she currently has?financial problems?because of money owed to her therapist and the hospital in New York. MENTAL STATUS EXAMINATION: Susan presented as an obese, somewhat disheveled, white female who had a cast on her right leg. She was relaxed but very restless during the interview. Her facial expression was mobile. Her affect during the interview was constricted and her mood?dysphoric. Later her affect became full range and her mood very liable. Susan’s?speech was pressured?and often circumstantial or tangential, and she spoke in a loud voice. At?times her thinking was logical, and at other times it was illogical. Susan denied hallucinations but?complained of hearing policemen outside her?door prior to admission. She denied homicidal ideation and initially?admitted to suicidal ideation but then denied this. Susan was oriented to person, place, and time. Her fund of knowledge was excellent. Susan was able to calculate serial sevens easily and accurately. She repeated 7 digits forward and 3 in reverse. Her recent and remote memory was intact, and she recalled 3 items after five minutes. Susan was able to give appropriate interpretations for 3 of 3 proverbs. Her social and personal judgment was appropriate. Susan’s three wishes were: “To be skinny, to have a big house where I can take in all the stray cats, and for a million more wishes.” When asked how she sees herself in 5 years, Susan replied, “Hopefully graduating from graduate school.” Social Science Psychology SOCW 6090 Share QuestionEmailCopy link Comments (0)
