Analyze And Apply Critical Thinking Skills In Psychop 171068

Analyze And Apply Critical Thinking Skills In The Psychopathology Of M

Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research. ax is a 66-year-old Caucasian female whose wife has encouraged her to seek treatment. She has never been in therapy before, and has no history of depression or anxiety. However, her alcohol use has recently been getting in the way of her marriage, and interfering with her newly-retired life. She describes drinking increasing amounts over the last year, currently consuming approximately a six-pack of beer per day. She notes that this amount “doesn’t give me the same buzz as it used to.” She denies ever experiencing “the shakes” or any other withdrawal symptoms if she skips a day of drinking.

Jax comments that her wife is her biggest motivation to decrease her alcohol use. She tells Jax that she gets argumentative and irritable when she drinks, though she does not always remember these incidents. She has also fallen while intoxicated twice, causing bruises both times and hitting her head on one of the occasions. Describe the presenting problems/issues. Is there any information that was not provided that you would need to formulate a diagnosis?

Generate a primary and differential diagnosis using the DSM-5 and ICD-10 codes. What physiological and psychological processes lead to substance dependence? Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

Paper For Above instruction

The case of Jax, a 66-year-old Caucasian woman presenting with increased alcohol consumption, irritable behavior, accidental falls, and concerns from her wife, reflects significant issues related to substance use disorder, particularly alcohol dependence. The analysis of her presenting problems underscores the importance of understanding both her primary and differential diagnoses, as well as the physiological and psychological mechanisms underpinning her dependence on alcohol.

Jax’s behaviors—escalating alcohol intake over the past year, tolerance indicated by her comment that her usual amount no longer produces the same “buzz,” and alcohol-related falls—point toward Alcohol Use Disorder (AUD). According to the DSM-5, AUD is characterized by a problematic pattern of alcohol use leading to clinically significant impairment or distress, as evidenced by a combination of criteria including tolerance, unsuccessful attempts to cut down, continued use despite harm, and withdrawal symptoms (American Psychiatric Association, 2013). In Jax’s case, her increasing consumption, fall incidents, and behavioral changes suggest a moderate to severe AUD, given her functional impairments and physical consequences. Her drinking pattern, approximately a six-pack of beer daily, aligns with moderate alcohol intake, but the development of falls and memory issues indicates escalation and possible dependence.

The primary diagnosis, based on DSM-5 criteria combined with ICD-10 coding, would be F10.20 (Alcohol dependence, uncomplicated). However, the presence of physical injuries from falls and behavioral issues might also suggest a more severe form—F10.21 (Alcohol dependence, in remission). To differentiate, the clinician would need more detailed information about her history of alcohol-related problems, unsuccessful attempts to cease drinking, and withdrawal experiences, though her denial of withdrawal symptoms suggests that she may not be physically dependent yet, or is in early stages of dependence.

In addition to primary diagnosis, differential diagnoses should include:

• F10.10 (Alcohol abuse): If Jax’s pattern of drinking does not meet dependence criteria but causes significant impairment.
• F41.1 (Generalized Anxiety Disorder): To rule out anxiety symptoms contributing to alcohol use as self-medication, which is common among older adults.
• F32.1 (Moderate depressive episode): To assess for underlying depression, often comorbid with alcohol dependence in older populations.

The physiological pathways contributing to alcohol dependence involve complex neurobiological processes, primarily centered around the brain’s reward circuitry. Alcohol modulates neurotransmitter systems, including gamma-aminobutyric acid (GABA), glutamate, dopamine, and serotonin, resulting in enhanced inhibitory signaling and decreased excitatory activity (Koob & Le Moal, 2008). Activation of the mesolimbic dopamine pathway mediates the pleasurable effects of alcohol, reinforcing continued use. Chronic alcohol consumption induces neuroadaptive changes, such as upregulation of excitatory receptors and downregulation of inhibitory ones, leading to tolerance—a need for increased alcohol to achieve the same effect (American Psychiatric Association, 2013). These changes support dependence, with physiological withdrawal symptoms manifesting when alcohol levels decrease.

Psychologically, alcohol dependence is reinforced by negative reinforcement—relief from stress, anxiety, or depressive symptoms—which motivates continued use. This process is reinforced through learned associations or conditioned responses between environmental cues and drinking behaviors (Sinha, 2008). Cognitive factors, such as craving and impaired executive function, further perpetuate dependence by reducing an individual’s ability to resist urges to drink, especially under stress or emotional distress.

In summary, Jax’s case illustrates a complex interplay of physiological neuroadaptations and psychological reinforcement mechanisms that underpin alcohol dependence. Understanding these processes is crucial for designing effective intervention strategies, including behavioral therapies and pharmacological treatments, aimed at reducing dependence and supporting recovery (Levental et al., 2014). Addressing co-occurring mental health disorders and social factors, such as her motivation from her wife, are equally important to formulating a comprehensive treatment plan.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Koob, G. F., & Le Moal, M. (2008). Addiction and the brain antireward system. Annual Review of Psychology, 59, 29-53.
• Levental, I., et al. (2014). Neurobiological mechanisms of alcohol dependence: Evidence from clinical and preclinical studies. Neuropharmacology, 75, 377-397.
• Sinha, R. (2008). Chronic stress, drug use, and vulnerability to addiction. Annals of the New York Academy of Sciences, 1141(1), 105-130.
• Volkow, N. D., & Morales, M. (2015). The brain on drugs: From reward to addiction. Cell, 162(4), 712-725.
• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Heilig, M., et al. (2010). Neurobiology of alcohol dependence: Focus on glutamatergic and GABAergic systems. Alcohol Research & Health, 33(3), 233–245.
• McLellan, A. T., et al. (2000). Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. JAMA, 284(13), 1689–1695.
• Tabak, N., et al. (2016). Psychological factors in alcohol dependence: The role of stress, coping, and social support. Addictive Behaviors, 58, 12-18.
• Zahr, N. M., et al. (2014). Brain morphology in alcohol dependence: Evidence from neuroimaging studies. Alcohol, 48(1), 102–113.