Please see attachment
I have been submitting case studies that we had to come with the diagnosis however, with this assignment we have to make the case. Please see attachment for one of the case studies you used to complete a previously assignment for me. Please do not copy the case study I am attaching it for referencing only.
See assignment below:
This is a “reverse” case assignment. Imagine that you have just been assigned a new client in Internship. From what you have been told, the diagnosis for the client, made by his/her psychiatrist, is Post Traumatic Stress Disorder, Persistent Depressive Disorder (Dysthymia), and Alcohol Use Disorder.
You are to write up a “history” for this client, that will leave the reader with no choice but to agree with these diagnoses. As you report in your case study presenting “issues” or concerns that confirm/align with the diagnostic criteria for one of the diagnoses above, point that out in your narrative. For example, if “Ms. Allen reports having nightmares about the accident 3 or 4 times per week.” This meets the criteria for PTSD “recurrent distressing dreams of the event.” (citation)
You must provide background information such as demographic data, physical/biological/psychological/social history (ie: health, prior health, prior mental health history including prior treatment, medications, history of suicide attempts, suicidal thoughts/intent/attempts, family and work history, and so on. As in the other case examples you have been working on these past weeks, you must “make the case” for the client’s having been diagnosed the way he/she has been. In other words, you must include in your narrative how these disorders came about and what was going on in the client’s life, that ultimately ended up manifesting in these diagnoses. If you like, you can formulate a basic treatment plan, though it is not required.
This paper should be in APA format, with a cover page and reference page. PLEASE REFER TO THE APA FORMAT RESOURCES. Use your textbook and your DSM 5. If you wish to use any other sources, that’s fine but remember that “.com” websites are not academic sources. Three double-spaced pages of narrative is the minimum and the upper limit is 4 pages at most. Write clearly, concisely and be specific!
Assignment will be submitted for plagiarism
Case Example
“Knee Pain” **
“Peter Winters, a 46 year old white minister, was referred to the psychiatry outpatient department by his primary care doctor for depressive symptoms and opioid misuse in the setting of chronic right knee pain.
Mr. Winters injured his right knee playing basketball 17 months earlier. His mother gave him several tablets of hydrocodone-acetaminophen that she had for back pain, and he found this helpful. When he ran out of the pills and his pain persisted, he went to the emergency room. He was told he had a mild sprain. He was given a 1 month supply of hydrocodone-acetaminophen. He took the pills as prescribed for 1 month, and his pain resolved.
After stopping the pills, however, Mr. Winters began to experience a recurrence of the pain in his knee. He saw an orthopedist, who ordered imaging studies and determined there was no structural damage. He was given 1 month supply of hydrocodone-acetaminophen. This time, however, he needed to take more than prescribed in order to ease the pain. HE also felt dysphoric and “achy” when he abstained from taking the medication, and described a “craving” for more opioids. He returned to the orthopedist, who referred him to a pain specialist.
Mr. Winters was too embarrassed to go to the pain specialist, believing that his faith and strength should help him overcome the pain. He found it impossible to live without the pain medication, however, because of the dysphoria, and muscle aches when he stopped the medication. He also began to “enjoy the high” and experienced intense craving. He began to frequent emergency rooms to receive more opioids, often lying about the timing and nature of his right knee pain, and even stole pills from his mother on two occasions.. He became preoccupied with trying to find more opioids, and his work and home life suffered. He endorsed low mood, especially when contemplating the impact of opioids on his life, but denied any other mood or neurovegetative symptoms. Eventually, he told his primary care doctor about his opioid use and low mood, and that doctor referred him to the outpatient psychiatry clinic.
Mr. Winters had a history of two lifetime major depressive episodes that were treated successfully with escitalopram by his primary care doctor. He also had a history of an alcohol use disorder when he was in his 20’s. He managed to quit using alcohol his own after a family intervention. He smoked to packs of cigarettes daily. His father suffered from depression, and “almost everyone” on his mother’s side of the family had “issues with addiction.” He had been married to his wife for 20 years, and they had two school-age children. He had been a minister in his church for 15 years. Results of a recent physical examination and laboratory testing performed by his primary care physician had been within normal limits.
On mental status examination, Mr. Winters was cooperative and did not exhibit any psychomotor abnormalities. He answered most questions briefly, often simply saying “yes” or “no.” Speech was of a normal rate and tone, without tangentiality or circumstantiality. He reported the his mood was “lousy,” and his affect was dysphoric and constricted. He denied symptoms of paranoia or hallucinations. He denied any thoughts of harming himself or others. Memory, both recent and remote, was grossly intact.
**Barnhill, J.W., (Ed.). 2014.
Case Example A Car Wreck
Dylan, a 15-year-old high school student, was referred to a psychiatrist to deal with the stress from being involved in a serious automobile accident, Dylan was riding in the front passenger seat when, as the car was pulling out of a driveway, it was struck by an oncoming SUV that was speeding through a yellow light. The car he was in was hit squarely on the driver’s side, which caused the car to roll over once and come to rest right side up. The collision of metal on metal made an extremely loud noise. The driver of the car, a high school classmate, was knocked unconscious for a short period and was bleeding from a gash in his forehead. Upon seeing his injured friend, Dylan became afraid that his friend might be dead. His friend in the back seat of the car was frantically trying to unlatch her seat belt. Dylan’s door was jammed, and Dylan feared that their car might catch fire while he was stuck in it. After a few minutes, the driver, Dylan, and the other passenger were able to exit through the passenger doors and move away from the car. They realized that the driver of the SUV was unharmed and had already called the police. An ambulance was on its way. All three were transported to a local emergency room, where they were attended to and released to their parents’ care after a few hours.
Dylan had not had a good night’s sleep since the accident. He often awoke in the middle of the night with his heart racing, visualizing oncoming headlights. He was having trouble concentrating and was unable to effectively complete his homework. His parents, who had begun to drive him to and from school, noticed that he was anxious every time they pulled out of a driveway or crossed an intersection. Although he had recently received his driving permit, he refused to practice driving with his father. He was also unusually short-tempered with his parents, his younger sisters, and his friends. He had recently gone to see a movie but had walked out of the theater before the movie started; he complained that the sound system was too loud. His concerned parents tried to talk to him about his stress, but he would irritably cut them off. After doing poorly on an important exam, however, he accepted the encouragement of a favorite teacher to go to a psychiatrist.
When seen, Dylan described additional difficulties. He hated that he was “jumpy” around loud noises, and he could not shake the image of his injured and unresponsive friend. He had waves of anger toward the driver of the SUV. He reported feeling embarrassed and disappointed in himself for being reluctant to practice driving. He stated that about 5 years earlier, he had witnessed the near-drowning of one of his younger sisters. Also, he mentioned that this past month was the first anniversary of his grandfather’s death.
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