Psychological Multi-Axis Diagnostics - Assignment Example

? Using DSM IV-TR For Diagnosis: Case Analysis Lois Part I Multi Axial Diagnosis Axis I: Diagnosis: Major Depressive disorder, recurrent; In full remission: Code: 296.36 Rationale: Lois displays a number of symptoms which can be tied to major depressive disorder. A1. For instance, she has a continual low mood and never in a good or positive mood. A2. She also has low energy levels and the loss for pleasure for anything including things she used to enjoy. It is evident that Lois has lost the ability to experience pleasure. A3. She has lost interest in things she used to enjoy such as sex and going to shopping and no longer derives pleasure from these things. This is an indication that Lois is suffering from major depressive disorder. Continued disappointments have also led to her gloomy moods which have led to mental issues such as major depressive disorder. A4. Lois also displays some important signs of major depressive disorder such as being unable to function at work. She has already lost her job as a certified nurse due to drug abuse. A.5. The drug abuse although not a cause of the disorder can also be an important indicator to the fact that Lois is suffering from a depressive disorder as dependence on drugs or alcohol is very common with people with depressive disorders. People with depressive disorders always turn to drugs or alcohol as a way to soothe the pain of being emotionally and socially isolated. A5. Lois has also exhibited suicidal tendencies and has tried to commit suicide a number of times even though it was with the intension of being rescued. This indicates that she is seeking for attentions and love. Axis II: Diagnostics: Paranoid personality disorder Code: 301.0 Rationale: Paranoid personality disorder is evident in Lois’ life and this can be seen in a number of ways. A. She has shown paranoid behaviour always looking at the environment around her with paranoia. She also thinks that her vaginal area is smelly. This can be a sign of paranoia, probably caused by the fact that she has been involved with many sexual partners and she could be feeling that they have been leaving her due to her sexual flaws. B. Lois has also shown signs that are evident in people with paranoid personality disorder which includes affixing on a certain belief that other people are judging her or that other people intend to harm her, either emotionally, physically or in any other way. C. She seems not to be able to trust those who she may have any belief that they might hurt her. D. She has displayed a lot of paranoia with regard to trusting white staff at the hospital and she seems to believe that these people intend to harm her even though there are no apparent reasons why they may want to do so. Additional details These feelings of paranoia and failing to be able to trust people can be seen as being caused by her past experiences such as being hurt by people close to her. Her childhood may explain why Lois developed paranoid personality. Having been abused by her father for instance can be seen as a major cause of this. She has been hurt by those closest to one’s life can lead to difficulties in trusting leading to paranoid personality disorder and thus make the individual to always feel paranoid. Lois’ paranoia is also evident in her inability to have meaningful social and emotional involvement. Paranoia has made her to be so much on her guard that she can’t be able to let loose and have a meaningful relationship. Axis III: No Diagnosis Rationale: Not Applicable Axis IV: Problems with primary support group, occupational and economical problems Rationale: Environment and psychosocial issues can be seen as contributing to Lois’s problems. There have been a number of factors which have affected the way Lois has progressed. A. She has lost her job as a certified nurse due to her substance abuse and this has definitely placed a big financial burden on her and this can be seen as contributing to her mental issues due to her not being able to provide adequately for her family. B. She has been hurt by family members who are close to her can be a major contributing factor to her problems. In the information provided about Lois, it was clear that she was sexually abused by her own father as a child. C. The environment in which she was brought up in was not very conducive and it is possible that most of her problems can be traced back to her childhood issues which were caused by a poor environment. D. Apart from being abused by her father sexually, her daughter has accused her (Lois’s) live-in boyfriend of sexually abusing her. This incidence may have affected her in a number of ways. First, it is a reminder that of her sexual abuse by her father. Secondly, she is too confused to want to end her relationship with this boyfriend because he is probably the only person who at least pretends to care about her. This must be causing her a lot of anxiety and probably forcing her to the corner where she has to revisit the bad relationship with her father. Axis V: GAF 10/100 Rationale: Lois is not able to meet her obligations as a parent and as a person in society. She is too dependent on drugs and other substances and cannot focus on anything, not even her medication. When she is being treated by a psychiatrist, she tries to be mischievous like a teenager and also tries promiscuity with her therapist. As a parent, she chooses to keep a boyfriend who is a threat to her daughter’s life and health. Above all, she has lost her job and had her licence has been withdrawn from her. She is completely unable to function in terms of her social life and in terms of her professional life. As a result, she can only be rated as a patient with a score of 1-10/100 in the Global Assessment of Functioning (GAF) scale. According to (PsyWeb, 2013), people who fall on the 1-10 range are those who are too dependent ton others to perform their routine chores and may even neglect even the most basic of things such as personal hygiene. Lois seems to show this kind of personality and has failed completely as a parent and as an individual to show any form of cognitive responsibility. Part II: Bio-psychosocial Risk and Resilience Assessment Table 1: Bio-psychosocial Risk and Resilience Assessment for the onset of the disorder Risk Influences Protective Influences Biological Lois cold be genetically predisposed to mental disorders Her dependent on drugs may lead to more mental disorders such as dementia and delirium Although Lois could be genetically predisposed mental disorders, her history may indicate that she is capable of overcoming these issues. She has been able to complete her course as a professional nurse and have a family. Lois is still able to function physiologically and this can be good for her heath if she is able to continue eating healthily Psychological Lois has gone through traumatizing episodes such as being molested by her father at an age as early as 6 years. Lois shows a deep desire to be socially successful. Although she is not successful as a parent, she shows deep love for a daughter. Social Lois is unable to have successful social relations Lois is trying as much as possible to reaction out. She has a family which could be used as part of her therapy. Techniques to elicit additional strengths in Lois’ Lois has a number of strengths which would be necessary in her recovery. One thing that I would recommend would be to strongly direct her to her strengths and the good things which can be said about her. Her graduation as a nurse is one thing. I would also point out to the fact that contrary to what she may be feeling, she had done a lot better. While pointing to the fact that there are those things that she has done wrongly, I would strongly point to the fact that her current situation is not completely her fault. Lois had a bad childhood, a childhood stolen from her by her own father. I would point to this and indicate that the fact that she managed to overcome these issues and go on to graduate as a certified nurse is an indication that she can do better. Most people going through mental disorders always feel that the situation in their lives is their fault and that they are at a dead end. Giving her hope and making it clear to her that with correct therapy she can be able to overcome these issues and have a normal life will help her in the road to recovery. Lois must also be having bad feelings as regards to her failure as a parent. I would like to mention to her that despite the fact that she has made gross mistakes as a parent, she is a good parent as shown by her deep worry and anxiety caused by her daughter’s claim about her boyfriend. Reference: PsyWeb. (2013, June 06). Axis V - Global Assessment of Functioning Scale: Depression and Mental Health Resources. Retrieved july 06, 2013, from http://www.psyweb.com/DSM_IV/jsp/Axis_V.jsp Read More