Summarise the presenting symptoms using your own words- this…

Question Answered step-by-step Summarise the presenting symptoms using your own words- this… Summarise the presenting symptoms using your own words- this information is relevant to your diagnosis (no more than half a page). Use the heading ‘Summary of presenting symptoms’.Provide two (at the very least) or three preliminary, potential diagnoses (i.e., differential diagnoses) with some justification for their inclusion by drawing on the DSM-5-TR (even if your final diagnosis seems relatively clear cut). This is so that students can be evaluated for their reasoning in the selection of ‘aligned’ diagnoses. Use the heading ‘Potential diagnoses’ for this section.Case studyAt the time of her admission as an inpatient to the eating disorders program of the private psychiatric hospital where you work, Jerry Atkins is a 33‐year‐old single Caucasian woman who has recently graduated from University with a degree in agricultural science. With the encouragement of her therapist, Jerry has decided to admit herself to the hospital for ongoing problems with eating. On her arrival Jerry tells you that her eating has been “out of control.” She says that she has had extended periods where she restricts her food intake drastically, largely due to her negative body image (i.e., dissatisfaction with her weight and physical appearance) and her poor self‐esteem. Jerry restricts her food intake because she feels that she weighs too much, a belief that distresses her greatly. To reinforce the point, she tells you that she gauges her value as a person by her perceptions of her physical appearance and weight. Her efforts at reducing the amount of food she eats are often rewarded by marked reductions in weight. In fact, as the result of her most recent period of fasting, Jerry has lost roughly 27kg (60 pounds). However, as had always happened in the past, this period of restriction was followed by a period of binge eating and purging. During a binge, Jerry typically eats large amounts of food (often sweets, such as cake, cookies, and ice cream, or starches such as mashed potatoes) in a short period of time. She says that she is generally totally out of control during these binges, feeling as if she cannot stop eating or control the amount of food she is ingesting. After the binge, Jerry experiences tremendous distress over the prospect of gaining weight. Consequently, after every binge, Jerry purges the food by sticking her finger down her throat to make herself vomit. Nevertheless, because of her binge eating and changes in her metabolism resulting from her frequent vomiting, Jerry has gained back a lot of weight that she had lost during a period of food restriction. On admission to the hospital, Jerry weighs 81kg (180 pounds). At the time of her admission, Jerry is experiencing up to five binge‐purge cycles per day. She tells you that she is purging so frequently that she sometimes vomits a small amount of blood (due to irritation of the oesophagus). Her decision to admit herself to the hospital came after she realised that her problem had gotten worse over her last semester of university study, despite regular outpatient therapy with a counsellor. Jerry is concerned that her eating disorder has become so severe that it would prevent her from obtaining and keeping a steady job now that she finally has her degree. It has taken her 10 years to obtain her degree because her eating disorder (and other emotional problems, discussed later) had interfered with her ability to attend university regularly. When she was not attending classes, Jerry worked a variety of odd jobs (e.g., as a cashier at a service station and as a shop assistant at a local department store). At the time of her admission to the hospital, Jerry is living on social security disability payments that she receives because of her emotional difficulties. Clinical History Jerry was adopted when she was an infant. She consequently grew up as the youngest child in a family with 2 other children. Her older brother (by 2 years) and older sister (by 3 years) were the biological children of her adoptive parents. Jerry says that she never felt close to her adoptive family. Of her family, she is probably closest to her adoptive father but noted that throughout her life he had placed a great deal of pressure on her to succeed. Jerry recalls that her focus in her growing years was on excelling in school and sports, and on pleasing her parents. Jerry tells you that her relationship with her adoptive mother was very poor. Her adoptive mother is an alcoholic who has been treated on several occasions with little improvement. Jerry says that she constantly felt “unsupported” by her mother and claims that she never felt she could confide in her when an issue arose in her life. However, Jerry holds the most negative feelings for her siblings, especially for her brother. Beginning when she was 10 and continuing through her early 20s, Jerry’s brother physically abused her, often beating her up in a violent rage for no apparent reason. Jerry says that her sister used to beat her as well, although less frequently and much less severely than the beatings that she had suffered at the hands of her brother. From age 13 until she was in her early 20s, Jerry was sexually abused by her brother. This brother died in a road accident five years ago.  In fact, shortly after the sexual abuse began, Jerry began to experience the first signs of her eating disorder. She began dieting due to rising concerns about her physical appearance and body shape. Although 10 years had passed since the sexual abuse had ended, Jerry had never addressed these issues with her brother before his death. Jerry tells you that her father had become aware of the physical abuse when he discovered a dark bruise on the back of her neck. At this time, when Jerry was 21 years old, Jerry’s father forced her brother to leave the household, thus ending her many years of physical and sexual abuse. Her parents were not aware of her sexual abuse until Jerry was 26 years old. At this time, a therapist that Jerry had been consulting for her eating disorder disclosed the sexual abuse to her parents. Jenny recalls that her parents downplayed the news and said, “Let’s never talk about that again.” Jerry says that she grew up wondering what was wrong with her and how she was responsible for being the recipient of such acts by her brother and sister. She reports being an obese child and as an adolescent she was occasionally teased about her size. Recalling that she felt no control of her environment and of her safety within the home, one way of coping was to control her weight and shape. In addition to playing a major role in the development of her eating disorder, Jerry’s violent childhood led to other significant psychological difficulties. As is often the case for individuals who have experienced physical or sexual abuse, Jerry suffered from symptoms of posttraumatic stress disorder (PTSD). For example, in her late teens, Jerry began to have a tremendous problem with sleeping because she frequently had distressing nightmares about her physical and sexual abuse. Jerry also reports that for as long as she could remember, she has had difficulty trusting other people (especially men) and handling social relationships. She notes that, during the past several years, her eating disorder and her symptoms of PTSD often increased in their severity after she had established a social relationship with a co‐worker or classmate. Consequently, Jerry would cut off the friendship in the hopes that her symptoms would decrease. Jerry also reports considerable anxiety and some worsening of her eating disorder symptoms on the infrequent occasions when she developed an interest in sex. At the time of her admission to the hospital, Jerry has never had a steady boyfriend and is living alone in a rented apartment. She says that she had, however, managed to maintain friendships with two women she had met atschool. In addition, Jerry has a long history of depression, dating back to her early teens. At age 28, when she was out of school and not working due to her emotional difficulties, Jerry attempted suicide by driving her car off the road into a ditch. Although she destroyed the car completely, Jerry incurred only a few broken ribs and facial cuts. She successfully concealed the fact that she had attempted suicide by claiming that she had veered off the road to avoid hitting a cow. Although Jerry’s depression had waxed and waned through the years, she reports a heightened level of depressed mood over the last several months preceding her admission to the hospital, due to her eating disorder and the resulting sense of hopelessness and impairment. Summary of presenting symptoms Jerry believes the sexual abuse resulted in concerns about her physical appearance and could never directly confront her brother about the ongoing abuse.  Jerry regularly fasts and binge eats, which causes vomiting and occasionally blood due to oesophageal bleeding, followed by another period of food restriction, up to 5 times a day. Jerry reported periods in which her food intake decreased due to poor self-esteem and body image issues.  At one point, Jerry said she was able to lose 27kgs.  Jerry states that her eating has been ‘out of control’ and it is interfering with Jerry’s daily function.  It impairs the capacity to work and affects interpersonal relationships.  Jerry reports a violent childhood, symptoms of PTSD, trust issues, anxiety, a long history of depression, and one reported suicide attempt, a sense of hopelessness, and impairment.  Potential diagnoses   Three possible diagnoses for Jerry Atkins based on DSM-5-TR (2022) criteria include; Binge eating disorder (BED), Anorexia nervosa, and Bulimia nervosa.  Eating disorders can consist of ‘binge eating,’ an episode of binge eating is defined as usually eating at a discrete-time, and the amount of food is more significant than another person would eat in a comparable situation within the timeframe (DSM-5-TR).   BED is classified as recurrent episodes of binge eating at least once a week for at least three months (DSM-5-TR, 2022).  BED is followed by a sense of out-of-control or unable to stop eating or stop eating once started. Typically, it surfaces during adolescence and is linked to additive genetic influences.  Suicidal thought has been reported to occur in 1 in 4 people()    According to the DSM-5-TR (2022), anorexia nervosa is an eating disorder characterized by an intense fear of gaining weight, limiting energy intake, and engaging in recurrent binge eating or purging behavior.  Anorexia nervosa usually starts during adolescence and is often associated with a stressful life event.  Purging behavior is sometimes associated with significant and potentially life-threatening diseases; relapses can follow fluctuating weight gain patterns.  Patients also complain of depression, social withdrawal, insomnia and irritability;  The DSM-5-TR (2022) highlights three diagnostic criteria: restricting food intake to gain low body weight within their age, sex, physical health, and developmental trajectory.  Intense fear of becoming fat regardless of weight.  A lack of recognition of the seriousness of their current body weight.   Bulimia Nervosa is another eating disorder that is a consideration for Jerry Atkins.   The DSM-5-TR states three critical features for identifying Bulimia Nervosa (DSM-5-TR, 2022).   The person often binges, eating at a discrete time with a sense of losing control over eating.  Bulimia Nervosa is followed by behaviours to prevent weight gain, for example, misusing laxatives, purging or vomiting, fasting, diuretics medications, or excessive exercise (DSM-5-TR, 2022).  The binge-purge behaviours occur at least once a week for 3 months.  There are three levels of severity depending on the frequency of compensatory behaviour. It commonly begins between adolescence and young adulthood, and the experience of a stressful life event can lead to onset. An associated feature of bulimia nervosa includes oesophageal tears. Additionally, low self-esteem, depression, social anxiety disorder and childhood anxiety can increase risk of developing BN. Individuals who have experienced childhood sexual or physical abuse are also at an increased risk.  Could you please look at my language and ensure i have included all relevant information    Social Science Psychology PY 3103 Share QuestionEmailCopy link Comments (0)