Summary Sheet for Diagnostic Exercises - Lab Report Example

Abnormal Psychology Name: Course: Tutor: Date: SUMMARY SHEET FOR DIAGNOSTIC EXERCISES CASE: A Axis I: Clinical disorders Amy (39) has anxiety disorders and mood disorders, Axis II: Personality disorders, mental retardation The patient has paranoid personality disorder, antisocial disorder and histrionic disorder Axis III: General medical conditions These are diseases that are closely linked physiologically to mental problems. The disorders would have impact on the victim’s moods and has direct negative effect on the choice of medications to be exposed to the patient. Amy has not experienced such conditions. Axis IV: Psychosocial and environmental problems CHECK: SPECIFY: Problems with primary support group: Yes, Amy experienced a restricted social life Problems related to the social environment: Yes, she interacted minimally throughout her life Educational problems: No, her parents supported her throughout her studied Occupational problems: Yes, she shifted from one job to another more frequently Housing problems: No, her parents provided with this basic need throughout her childhood Economic problems: No, her parents were stable. Immediately, she completed her nursing course, she landed in a job Problems with health care access: No, she access the appropriate health care services when need be Interactive problems with legal system/crime: No, up to date, she has not committed any crime Other psychosocial and environmental problems: Yes, she is unable to maintain positive relationship with friends and her husband Axis V: Global assessment of functioning scale Score: .31-60 Time frame: 1-3 weeks Case A: Justification and discussion Axis I: Clinical disorders Amy (39) is has mood disorders, anxiety disorders and schizophrenia among other psychotic problems. Amy made an appointment with the doctor in the quest of ending anxiety that has marred her relationships with other people especially men and her superiors. In health practice, the presenting problem of the patient acts as basis of diagnosis (American Psychiatric Association [DSM-IV-TR], 2000) The patient is suffering from mixed episode disorder. This is depicted by the fact that she has a severe mood disturbance that has caused serious impairment in her occupational functioning, social activities and relationships with others. Amy pursued nursing course not according to her wish but because she wanted to please her mother. Since she accomplished her course, she has worked in three different hospitals and GP. She has been on and off in the job market following her compulsive behaviours and personal belief that she was incompetent (DSM-IV-TR, 2000) Amy is suffering from manic disorder as indicated by the fact that she has exhibited abnormal and persistent irritable and elevated mood. In her racing thoughts, Amy feels that she is inferior and stupid. She depicts excessive involvement in foolish activities such as admiring the minister father. This is an involvement that would create problems to her life (DSM-IV-TR, 2000) Amy has a manic disorder as indicated by increase in goal-directed activity. She has persistently continued with her education. After nursing course she enrols BA-DipEd. She is focused in achieving more in her academics as indicated by her assertion that she would resume to her studies after giving birth (DSM-IV-TR, 2000) Amy feels worthless and inappropriately guilty and this shows that she is suffering from major depressive disorder. She thinks of herself in a very negative and unrealistic ways. She manifests her current activities with the failures and believes that she is incompetent in undertaking the nursing duties. In life, Amy has been personalising of trivial events. She has unidealistic sense of personal responsibility as indicated by the fact that she believes that she cannot control her negligence during the course of nursing practice, and this could lead to harming her clients (DSM-IV-TR, 2000) Amy has a bipolar disorder. In most cases, manic episode indicates that a patient is suffering from bipolar condition. Amy has experienced distinct period of elevated mood and racing thoughts. She has bipolar condition due to the fact that she can be easily distracted and she is incapable of making correct judgment. In the family settings, Amy protects her children from father’s criticism when they are in mess (DSM-IV-TR, 2000) Amy has a social phobia disorder. Her mother was so remorse because of the fact that her husband was a minister. Amy was brought up in this setting hence she adapted some of the features. At later stage of life, she admired and liked the father-minister but fear of humiliation in the social situation made her distant herself from the matter. She is forced to move out of the church in order to avoid the social conflict. Axis II: Personality disorders and Mental Retardation Amy depicts various notations indicating problematic aspects of her personality order. These are enduring patterns that are portrayed by an individual behaviour. At some point in time, Amy’s behaviour deviated markedly from family expectations and her behaviour became pervasive and inflexible. She isolated herself from the rest of her peers and family members. She was very lonely at younger age, a feature which does not normally occur among children at early stages of their development. Her personality disorder is indicated by the fact that her behaviour is not stable she was lonely at younger stage but relate well with her peers during adolescent (DSM-IV-TR, 2000). Amy depicts pervasive pattern behaviour characterized by interpersonal deficits. This is marked by the fact that she experienced acute discomfort in relationships, cognitive distortions and reduced capacity for social life. She believes that she is stupid and useless on the basis of her inability to pursue certain activities. In the family setting, Amy lacks the capacity to close relationships. After 17 years of marrying Paul, Amy started moving from homes to churches frequently. She felt desperate because she could not be accepted by people and friends living within her surrounding (Suler, 2009). Amy experiences disproportionate social apprehension which is persistent throughout her lifetime. During her nursing practice, the excessive social experience might have occurred due to paranoid fears and personal negative judgments. Axe III: General Medical Conditions These are conditions that arise due to physiological mental problems, and have negative impacts on decisions, attitudes and moods on the choice of the drug an individual has be subjected to. After realizing that she had excessive anxiety, Amy went to the doctor and was exposed to hypnotherapy. She had no influence on the type of medication she was subjected to, and this indicated that she is not suffering from any mental problem. Amy is ever conscious. This indicates that she is not suffering from physiological effects of general medical condition. In most cases, patients experiencing disturbed consciousness and frequent changes in cognition are associated with delirium condition. However, Amy is conscious and has experienced no changes in cognition. This indicates that the patient is not experiencing any mental problems (DSM-IV-TR, 2000). Axe IV: Psychosocial and environmental problems At early stages of early life, Amy perceived her father as reserved and that her mother was always negative (Mayer, 1996). She could not social with her peers at younger stage, however, this changed during her teenage life. She has been shifting from one job area to another due to her compulsive behaviour. Axis V: Global Assessment of Functioning Scale Amy case scored 31-60. This is because of the fact his condition is not very serious but calls for medical attention. The patient should be a candidate of outpatient care for a period of three weeks. Judgment Amy’s case fulfils criteria for the major axis I than II. Basing on Axis III, IV and V, Amy’s condition is not serious hence does not require urgent medical attention. She experiences most of the clinical disorders. Despite these few personality disorder features, Amy has not displayed any mental retardation. At the time, her brain has been functioning fully and has been able to reason appropriately. Critically, she has not experienced any impairment as such (DSM-IV-TR, 2000). SUMMARY SHEET FOR DIAGNOSTIC EXERCISES CASE: B Axis I: Clinical disorders Jim has anxiety disorders and mood disorder Axis II: Personality disorders, mental retardation Anti-social personality and acute stress disorders that can likely to cause mental retardation Axis III: General medical conditions Delirium, dementia, anxiety disorder, sleep disorder Axis IV: Psychosocial and environmental problems CHECK: SPECIFY: Problems with primary support group: He lacked total parental love from both parents Problems related to the social environment: He smoked marijuana after being influenced by his friends Educational problems: He went to different schools. He was expelled in high school following his unbecoming behaviour Occupational problems: Unstable: he has been moving from one job to another Housing problems: Unstable: As a family, they have been moving from one city to another Economic problems: He was brought up by step father hence could not get all the basic needs. He encountered serious economic problems when he was in school Problems with health care access: He experienced little problems in accessing the drugs Interactive problems with legal system/crime: He has been accused of robbery Other psychosocial and environmental problems: Poor relationship with others especially in the learning environment. Axis V: Global assessment of functioning scale Score: 10-30 Time frame: 2-3 months Justification and discussion Axis I: Clinical disorders Jim is experiencing numerous clinical disorders such as anxiety and mood disorders Jim has obsessive compulsive disorder. This condition is normally characterized by obsessions and compulsions which results in marked anxiety. Over time, Jim has been on and off drug abuse. He took marijuana at early age after being influenced by his social friends. He quit smoking of the substance when he moved to Northern beaches. However, he started smoking it again after meeting a supplier of the drug. He has continued with this behaviour and he has now advanced to hard drugs such as heroin. Obsessive compulsive disorder is a class of anxiety disorders that are normally incurred by people (DSM-IV-TR, 2000). The victim is suffering from substance-induced anxiety disorder. This condition occurs due to negative physiological effects of using particular drug substance Suspiciously, the patient could be suffering from borderline personality disorder. Patients with this condition display instabilities in interpersonal relationships. This is usually experienced after teenage and the symptoms present in variety of contexts. Jim has abandoned his long term girlfriend. This was followed by extensive use of drugs in an attempt to forget what was preceding his bad character. Despite this occurrence, Jim did not opt for self-mutilation (DSM-IV-TR, 2000). Jim has been very impulsive in the past years especially in areas which could cause great deal of harm on personal life. The patient has been spending so much on drugs. When he ran short of money he opted for robbery, and this potentially damaged his self-image. Borderline personality disorder is also seen when the patient drove reckless Axis II: Personality disorders and mental retardation Jim’s condition does not reflect acute personality disorder and mental retardation. However, the following justification can be made. Jim is facing anti-social personality disorder. Evidently, James has depicted pervasive pattern of violation of the laws of the society. Firstly, he has engaged is drug abuse, an act which is against the expectations and the culture of the society. He has also committed robbery in an attempt to acquire money to purchase the hard drugs. He has failed to conform to social norms and values in respect to lawful behaviours, and this has grounded for his arrest. Antisocial personality disorder is indicated by the fact that Jim is incapable of planning for the future. He has depicted element of impulsivity as indicated by squandering of his finance. Following this behaviour, the mother has taken an initiative of taking control of his finance (DSM-IV-TR, 2000). Jim suffered from acute stress disorder. He can recall some of the traumatic events that experienced in the past. The incident that happened when he was driving resulted in intense fear of the patient (Suler, 2009). Jim has been trying hard to change his life through number of ways. At one point he sought a counsellor after realizing that he had overused the hard drugs. However, Jim has experienced difficulties in adjusting to a life situation considering status as a drug abuser. This condition is normally referred to as psychiatric disorders. The memories about his girlfriend cannot fade away easily (DSM-IV-TR, 2000). Axis III: General medical conditions The behaviour of the victim changed drastically after he was exposed to methadone. At night, he could hear some strange noise, an indication that he had mental problems. Having run short of money for purchasing the hard drugs, he went into a small store and took $100 without considering the repercussions. After getting the money, he felt shocked for the wrong doing. After second thought, he called the police and who arrested him. This is an action that can only be performed by mad people. Therefore, Jim must be suffering from mental disorders (DSM-IV-TR, 2000). Notably, Jim’s mental problem is attributed to physiological impacts of medical condition i.e. the methadone. This is apparent by the prominent anxiety of the patient, compulsions, obsessions and panic attacks. When Jim experienced initial depression and anxiety, he was given a trial course of medication. While he was using the drugs, the depression and anxiety ceased. He later used heroin extensively and was referred to a different doctor who prescribed anti-depression medication. However, Jim anxiety problem continued. Therefore, this shows that the reoccurrence of the anxiety symptoms can be attributed to medical condition as prescribed by the doctors (DSM-IV-TR, 2000). Jim also encountered sleep disorder emanating from general medical condition. This condition was sufficient enough that it warranted for a clinical attention. Axis IV: Psychosocial and environmental problems His parents’ relationship was marred by frequent break ups and make ups. At early stages of his life, he enjoyed total paternal love; however, his mother divorced his biological father. Her mother moved from place to place due to unstable relationship He smoked marijuana and other hard drugs after being influenced by the social friends. His school life was not smooth because he earned expulsion in high school. His high school education almost deteriorated because of economic crisis. He faces the law after breaking into the small store. Axis IV: Global Assessment Functioning Scale Jim’s condition calls for immediate medical care. He should be a candidate of inpatient care for at least two months The medical practitioner should attend the patient for about two months. Judgment Jim’s case calls for immediate medical attention. The patient has both full properties of axis I and Axis II. Therefore, Jim is suffering from both clinical problems such as anxiety disorders and mood disorders among others and personality mental disorders. Both these features call for immediate medication. According to axis III and IV, Jim’s condition can be rated 1-30 because of the fact that he needs immediate medical condition. Jim is a candidate for inpatient care because of the fact that he is not functioning very well He should stay for at least three weeks in the hospital (DSM-IV-TR, 2000). SUMMARY SHEET FOR DIAGNOSTIC EXERCISES CASE: C Axis I: Clinical disorders Mild mood disorders and anxiety disorders Axis II: Personality disorders, mental retardation Few personal disorders but no mental disorders Axis III: General medical conditions No identifiable general medical condition Axis IV: Psychosocial and environmental problems CHECK: SPECIFY: Problems with primary support group: No, the family supports her in pursuing her health needs Problems related to the social environment: No, she has maintained positive relationships with her peers who have continuously supported her in meeting her health needs Educational problems: N/A Occupational problems: N/A Housing problems: No, she has been living with her parents Economic problems: N/A Problems with health care access: NO, she access health care services when need be Interactive problems with legal system/crime: No Other psychosocial and environmental problems: N/A Axis V: Global assessment of functioning scale Score: 70 Time frames: 6-12 months Justification and discussion Axis I: Clinical disorders Anorexia Nervosa: - This is a condition which affects mostly females. It is characterized by inability by an individual to maintain desired body weight. In most cases, individuals would like to have the bodies weigh approximately 85% of the expected weight. At age of 12, Jane had acquired more than 50 kg, a condition which is considered abnormal and unhealthy to many. This implies that the young girl had loss control over her fatness and she believes that this could distort her body shape. Jane is encountering serious problems in adjusting into the state of a normal body weight (DSM-IV-TR, 2000) The fact that she refused to maintain body weight above the normal weight. She has opted to weight loss in an attempt to achieve the desired weight. Individuals with anorexia nervosa get disturbed with their bodies looks and how the weight affects Jane’s evaluation in the family and in the society indicates that she is suffering from this condition (DSM-IV-TR, 2000) Jane has a panic disorder. Firstly, she feared for a body weight. At past, Jane had high anxiety of reducing her body weight. When she started dieting, the weight loss program was not promising, and this exposes her great deal of fear. Two years later, she experienced drastic body loss. She lost about 25kg and now she is very thin. She ends up getting worried about her health condition (DSM-IV-TR, 2000) Jane is suffering from mood disorders as evident by the fact that she is disturbed by body weight problems. She is fairly down sometime because of her body weight. Her feelings are extreme and this forced her to seek for ways of reducing her weight. Jane has manic disorder as indicated by her focus on maintaining right body weight as her main objective. After realizing that she was overweight, she considers dieting in order to achieve the expected body weight. After two years of dieting, Jane realized that her body weight was beyond normal, and attracted attention of her parents. She sought medical attention in order to attain the expected (DSM-IV-TR, 2000) Amy has a manic disorder as indicated by increase in goal-directed activity. She has persistently continued with her education. After nursing course she enrols BA-DipEd. She is focused in achieving more in her academics as indicated by her assertion that she would resume to her studies after giving birth. Jane has been so unhappy and fairly down in the past one year. This is a sign of mood disorders namely depressive disorder. She cannot concentrate in her activities, pay attention to issues in the family or hold conversation with the family members. Jane has a generalized anxiety disorder. This is indicated by excessive anxiety and sustained worries. In the past months, Jane has been unhappy and feeling low. These reveal that the victim might be suffering from anxiety disorder (DSM-IV-TR, 2000) There are high chances that Jane is suffering from specific phobia disorder. Her body weight is the basis of her problems, and this has caused great deal of fear in her life and the lives of her parents. In the second year of dieting, she realized that the weight loss program was beyond her control. She started developing fears that there was in her body that would not allow her gain weight. This created a lot of stress and fears in her life (DSM-IV-TR, 2000) Axis II: Personality disorders and mental retardation Jane’s body weight problem has generated some personality disorders. However, no mental disorders have been noticed. Anti-social personality disorder: Her body weight problem has caused more troubles in her life. She has developed pervasive pattern of behaviour following her weird body. She is deceitful i.e. she has repeatedly lied to her parents that she is taking the right quantity of food as prescribed by the doctor. This disorder is also evident by the fact she has directed all energy and efforts towards maintaining her body weight thus compromising other useful activities such as education and economic activities. She only stays in the house to perform errand duties which are not recommended for her. The anti-social behaviour is pronounced when she becomes irresponsible as indicated by failure to honour economic obligations (Suler, 2009). Axis III: General Medical Conditions Jane has not experienced any disorders that are closely related to mental problems. As such, she is not likely to have negative impact on functioning or moods. She is very conscious of what is happening around her and the problem she is encountering. Therefore, general medical condition would be ruled out (DSM-IV-TR, 2000). Axis IV: Psychosocial and environmental problems Jane’s parents are very supportive and concern as evident when they sought her medical doctor to check her condition She has maintained positive relationships with her peers who have continuously supported her in meeting her health needs (Mayer, 1996). Axis V: Global Assessment of Functioning Scale Jane does not reveal any compulsive characteristic hence does not require any immediate medical attention. She qualifies to be a candidate for outpatient care. Jane’s weight problem can get normalized within a period of 6-12 months. Judgment The case meet major properties of axis I and axis II is rejected completely because she has not encountered personality disease and mental retardation. Jane is not suffering from any mental disorder Jane’s case does call for medical necessity hence can be a candidate of outpatient care. The clinical disorders she is suffering are mild. The personality conditions are not very severe hence does not demand for inpatient care. Fortunately enough, the patient has not experienced any mental problems because of the fact that she still conscious. Body weight is a disorder that can take even 6-12 months for normalcy to be achieved. However, this depends on individual initiative to take the recommended diet (DSM-IV-TR, 2000) References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC. Mayer, M. (1996). Psychosocial and Environmental Problems. Retrieved April 6, 2011, from http://www.craconferences.com/uploads/PsySociEnvProbOnline.PDF. Suler, J. (2009). Personality Disorders. Retrieved April 6, 2011, from http://users.rider.edu/~suler/pdffiles/perdis.pdf. Read More

In most cases, manic episode indicates that a patient is suffering from bipolar condition. Amy has experienced distinct period of elevated mood and racing thoughts. She has bipolar condition due to the fact that she can be easily distracted and she is incapable of making correct judgment. In the family settings, Amy protects her children from father’s criticism when they are in mess (DSM-IV-TR, 2000) Amy has a social phobia disorder. Her mother was so remorse because of the fact that her husband was a minister.

Amy was brought up in this setting hence she adapted some of the features. At later stage of life, she admired and liked the father-minister but fear of humiliation in the social situation made her distant herself from the matter. She is forced to move out of the church in order to avoid the social conflict. Axis II: Personality disorders and Mental Retardation Amy depicts various notations indicating problematic aspects of her personality order. These are enduring patterns that are portrayed by an individual behaviour.

At some point in time, Amy’s behaviour deviated markedly from family expectations and her behaviour became pervasive and inflexible. She isolated herself from the rest of her peers and family members. She was very lonely at younger age, a feature which does not normally occur among children at early stages of their development. Her personality disorder is indicated by the fact that her behaviour is not stable she was lonely at younger stage but relate well with her peers during adolescent (DSM-IV-TR, 2000).

Amy depicts pervasive pattern behaviour characterized by interpersonal deficits. This is marked by the fact that she experienced acute discomfort in relationships, cognitive distortions and reduced capacity for social life. She believes that she is stupid and useless on the basis of her inability to pursue certain activities. In the family setting, Amy lacks the capacity to close relationships. After 17 years of marrying Paul, Amy started moving from homes to churches frequently. She felt desperate because she could not be accepted by people and friends living within her surrounding (Suler, 2009).

Amy experiences disproportionate social apprehension which is persistent throughout her lifetime. During her nursing practice, the excessive social experience might have occurred due to paranoid fears and personal negative judgments. Axe III: General Medical Conditions These are conditions that arise due to physiological mental problems, and have negative impacts on decisions, attitudes and moods on the choice of the drug an individual has be subjected to. After realizing that she had excessive anxiety, Amy went to the doctor and was exposed to hypnotherapy.

She had no influence on the type of medication she was subjected to, and this indicated that she is not suffering from any mental problem. Amy is ever conscious. This indicates that she is not suffering from physiological effects of general medical condition. In most cases, patients experiencing disturbed consciousness and frequent changes in cognition are associated with delirium condition. However, Amy is conscious and has experienced no changes in cognition. This indicates that the patient is not experiencing any mental problems (DSM-IV-TR, 2000).

Axe IV: Psychosocial and environmental problems At early stages of early life, Amy perceived her father as reserved and that her mother was always negative (Mayer, 1996). She could not social with her peers at younger stage, however, this changed during her teenage life. She has been shifting from one job area to another due to her compulsive behaviour. Axis V: Global Assessment of Functioning Scale Amy case scored 31-60. This is because of the fact his condition is not very serious but calls for medical attention.

The patient should be a candidate of outpatient care for a period of three weeks. Judgment Amy’s case fulfils criteria for the major axis I than II. Basing on Axis III, IV and V, Amy’s condition is not serious hence does not require urgent medical attention.

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