Application Case Study: Substance Use And Adolescents

Application Case Study Substance Use And The Adolescentover The Pas

Consider the characteristics of the client. Which specific characteristics might you consider important in developing a diagnosis? Consider your rationale for assigning particular diagnoses on the basis of the DSM. Also, think about what other information or people you may need to include in the assessment in order to make an accurate diagnosis.

Paper For Above instruction

The increasing prevalence of substance use disorders among adolescents necessitates a thorough evaluation rooted in established diagnostic criteria, primarily the DSM-5 (American Psychiatric Association, 2013). Developing an accurate diagnosis requires a comprehensive understanding of the adolescent's unique characteristics, contextual factors, and environmental influences. This paper discusses the critical client characteristics relevant to diagnosis, justifies the diagnostic process based on DSM-5 criteria, outlines additional information necessary for an accurate assessment, and identifies other individuals whose insights can enhance the diagnostic process.

Client Characteristics and Their Importance in Diagnosis

Adolescents presenting with substance use concerns are characterized by a complex interplay of biological, psychological, and social factors. Key characteristics to consider include age, developmental stage, family history, mental health comorbidities, socioeconomic status, peer influences, cultural background, and the pattern and severity of substance use.

Age and developmental stage influence the adolescent's cognitive and emotional maturity, which impacts their understanding of substance-related risks and their capacity for decision-making (Burrow-Sanchez, 2006). Family history can indicate genetic vulnerabilities and environmental modeling of substance use, thereby serving as important risk factors (Slutske et al., 2013). Mental health issues such as depression, anxiety, or conduct disorder often co-occur with substance use, complicating diagnosis and treatment (Doughty & Hunt, 1999). Socioeconomic status and peer influence can shape access to substances and peer pressure dynamics, which are critical in understanding both initiation and maintenance of use (Burrow-Sanchez, 2006). Cultural factors may affect the presentation and perception of substance use disorders, necessitating culturally sensitive assessment approaches (Escobar & Vega, 2006). The specific pattern of substance use—frequency, duration, substances used—and signs of intoxication or withdrawal are also vital diagnostic considerations.

Rationale for Diagnosis Based on DSM-5 Criteria

Diagnosing substance use disorders in adolescents must align with DSM-5 criteria, which emphasize a pattern of problematic substance use leading to clinically significant impairment or distress (American Psychiatric Association, 2013). The DSM-5 combines substance dependence and abuse into a unified diagnosis of Substance Use Disorder (SUD), characterized by criteria such as impaired control, social impairment, risky use, and pharmacological criteria including tolerance and withdrawal.

In applying DSM-5 criteria, the adolescent's developmental stage is critical; for example, the manifestation of symptoms may differ from adults, and certain criteria such as hazardous use or failure to fulfill major role obligations might be observed differently due to adolescent responsibilities (Jones et al., 2012). A comprehensive assessment of symptom severity—mild, moderate, or severe—is essential for tailoring appropriate treatment strategies. For instance, persistent use despite social or interpersonal problems signals a higher severity level requiring intensive intervention.

In the case study, if the adolescent demonstrates persistent use leading to academic decline, peer relationship issues, or legal consequences, these align with DSM-5 criteria for SUD. Additionally, co-occurring mental health conditions must be distinguished to differentiate primary disorders from substance-induced conditions.

Additional Information Needed for Accurate Diagnosis

To refine the diagnosis, further information regarding the adolescent's substance use history—including age of onset, frequency, quantity, context, and duration—is necessary. Psychological assessments to evaluate comorbid conditions like depression, anxiety, or behavioral disorders are crucial, as these may influence or be influenced by substance use (Helwig & Holicky, 1994). Family history of substance use and mental health issues can shed light on genetic vulnerability and environmental factors.

Medical history, including prior hospitalizations, injuries, or medical conditions related to substance use, adds context to the diagnosis. School records and academic performance can reveal functional impairment. Peer and social network assessments help understand the influence of the adolescent's environment.

In addition, substance screening tools and biological measures such as blood or urine tests provide objective data regarding recent use and substance type, corroborating self-reports and clinical observations. Moreover, cultural background and the adolescent’s perception of substance use are vital to ensure culturally sensitive assessment and accurate diagnosis.

Individuals to Include in the Assessment and Their Rationale

Involving multiple individuals in the assessment process enhances diagnostic accuracy. Family members or guardians are integral to understanding familial and environmental influences, behavioral patterns, and monitoring compliance with treatment recommendations (Gloria & Peregoy, 1996). Parental reports can provide insights into early substance use initiation, behavioral changes, and familial dynamics.

Teachers and school counselors are valuable sources of information regarding the adolescent's academic performance, peer interactions, and behavioral issues. Their observations can reveal signs of substance use impact on school functioning.

Peers and social contacts, when appropriate and with consent, can shed light on the adolescent’s social environment and peer substance use patterns. While confidentiality limits direct engagement, understanding peer influences is essential for contextualizing the adolescent's behavior.

Mental health professionals involved in prior assessments or ongoing treatment contribute crucial diagnostic information, especially regarding co-morbid psychiatric or behavioral conditions. Medical professionals provide data on physical health status and substance testing results.

Incorporating a multidisciplinary team—comprising psychologists, psychiatrists, medical providers, school personnel, and family members—ensures a comprehensive evaluation that captures the multifaceted nature of adolescent substance use disorders.

Conclusion

Diagnosing substance use disorder in adolescents requires careful consideration of age-appropriate characteristics, developmental factors, and contextual influences. Utilizing DSM-5 criteria as a foundation, clinicians must gather extensive information from multiple sources, including the adolescent, family, educators, and medical providers, to achieve an accurate diagnosis. This comprehensive approach informs targeted intervention strategies that address the adolescent's unique needs, supporting recovery and resilience.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
• Burrow-Sanchez, J. J. (2006). Understanding adolescent substance abuse: Prevalence, risk factors, and clinical implications. Journal of Counseling & Development, 84(3), 283–290.
• Escobar, J. I., & Vega, W. A. (2006). Cultural issues and psychiatric diagnosis: Providing a general background for considering substance use diagnoses. Addiction, 101(Suppl), 40–47.
• Gloria, A. M., & Peregoy, J. J. (1996). Counseling Latino alcohol and other substance users/abusers: Cultural considerations for counselors. Journal of Substance Abuse Treatment, 13(2), 119–126.
• Helwig, A. A., & Holicky, R. (1994). Substance abuse in persons with disabilities: Treatment considerations. Journal of Counseling & Development, 72(3), 227–233.
• Jones, K., Gill, C., & Ray, S. (2012). Review of the Proposed DSM-5 Substance Use Disorder. Journal of Addictions & Offender Counseling, 33(2), 115–123.
• Slutske, W., Ellingson, J., Richmond-Rakerd, L., Zhu, G., & Martin, N. (2013). Shared genetic vulnerability for disordered gambling and alcohol use disorder in men and women: Evidence from a national community-based Australian Twin Study. Twin Research and Human Genetics, 16(2), 525–534.