Case Study: Veepurpose Analyze And Apply Critical Thinking S

Case Study Veepurposeanalyze And Apply Critical Thinking Skills In T

Describe the presenting problems.

Generate a primary and differential diagnosis using the DSM5 and ICD 10 codes.

Discuss which cluster the primary diagnosis belongs to.

Formulate and prioritize a treatment plan.

Sample Paper For Above instruction

Introduction

Vee, a 26-year-old African-American woman, presents with complex psychopathological symptoms that warrant thorough analysis and intervention. Her history reveals longstanding self-injurious behaviors, suicidal ideation, mood instability, identity disturbances, and relationship challenges. These symptoms collectively suggest the presence of a significant mental health disorder. Understanding her presenting problems, diagnosing accurately, and developing a comprehensive treatment plan are crucial steps toward facilitating her recovery and improving her quality of life.

Presenting Problems

Vee’s constellation of symptoms includes non-suicidal self-injury, recurrent suicidal attempts, chronic suicidal ideation, emotional lability, identity disturbances, impulsivity, and unstable interpersonal relationships. Her self-injurious behaviors, specifically cutting her arms and legs, reflect an attempt to regulate overwhelming emotions and manage psychological distress (Klonsky et al., 2014). Her previous overdose attempts indicate a history of severe suicidality, further emphasizing the critical risk she faces (American Psychiatric Association [APA], 2013). Her report of feeling relief through suicidal thoughts and her mention of "zoning out" during stress suggest dissociative tendencies and emotional dysregulation. Vee’s rapid shifts in self-identity—changing hobbies, styles, jobs—mirror identity disturbance characteristic of certain personality disorders (Linehan, 2015). Her impulsive gift-giving and fluctuating feelings towards her partner reflect affective instability and fears of abandonment, which are hallmark features of borderline personality disorder (BPD) (Gunderson, 2014). Additionally, her history of promiscuity before her current relationship indicates impulsivity and difficulties with impulse control. These overlapping issues necessitate a nuanced clinical approach to diagnosis and intervention.

Diagnosis

Primary diagnosis (DSM-5): Borderline Personality Disorder (BPD) (296.9X or F60.3). BPD is characterized by pervasive instability in relationships, self-image, affect, and impulsivity that begins in early adulthood. Vee's pattern of identity disturbance, impulsivity, affective instability, chronic feelings of emptiness, and intense fear of abandonment support this diagnosis (APA, 2013).

Differential diagnosis considerations.

  • Major Depressive Disorder (MDD): While she exhibits suicidal ideation and emotional distress, her symptoms are more consistent with pervasive patterning seen in personality disorder rather than episodic depression (ICD-10: F32.xx).
  • Post-Traumatic Stress Disorder (PTSD): Absence of trauma-related re-experiencing or avoidance behaviors reduces its likelihood, although her dissociation suggests possible trauma history.
  • Bipolar Disorder: No clear evidence of mood episodes that meet criteria for mania or hypomania; mood fluctuations are more consistent with personality disorder rather than bipolar spectrum disorders.

Cluster Classification

BPD is classified within Cluster B in the DSM-5, which encompasses dramatic, emotional, or erratic disorders. Cluster B disorders include antisocial, borderline, histrionic, and narcissistic personality disorders. Vee’s symptoms exhibit the hallmark features of Cluster B, such as emotional dysregulation, impulsivity, intense fear of abandonment, and unstable relationships (Gunderson & Zanarini, 2012).

Treatment Plan

Prioritized Interventions:

  1. Establish a Therapeutic Alliance: Building trust with Vee is essential given her fear of abandonment and fluctuating relationships. Rapport lays the foundation for effective therapy.
  2. Dialectical Behavior Therapy (DBT): Evidence-based for BPD, DBT targets emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness skills (Linehan, 2015). It aims to reduce self-injury, impulsivity, and suicidal behaviors.
  3. Medication Management: While no pharmacological cure exists for BPD, mood stabilizers (e.g., lamotrigine), atypical antipsychotics (e.g., aripiprazole), or antidepressants can help manage mood swings and impulsivity (McMain & Pos, 2017).
  4. Address Comorbidities: Screening and intervention for trauma-related issues or comorbid mood disorders should be integrated into treatment.
  5. Safety Planning: Immediate safety measures include developing crisis intervention strategies and monitoring for suicidal ideation or self-harm behaviors.
  6. Health Promotion: Encouraging Vee to develop stable routines, pursue meaningful activities, and strengthen social support networks supports recovery and resilience.

Long-term goals include reducing self-injurious behavior, stabilizing mood and identity, improving interpersonal functioning, and fostering self-awareness. Collaboration among mental health professionals, ongoing assessment, and culturally sensitive interventions are essential for effective management.

Conclusion

Vee’s case exemplifies the complexity of personality disorders, particularly BPD, and its profound impact on various life domains. Accurate diagnosis and tailored treatment interventions, grounded in evidence-based practices like DBT, can facilitate her journey toward recovery. Recognizing her unique psychosocial context and fostering an empathetic therapeutic environment are crucial elements in addressing her multifaceted needs and enhancing her overall functioning.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  • Gunderson, J. G., & Zanarini, M. C. (2012). Borderline personality disorder. The American Journal of Psychiatry, 169(2), 131-138.
  • Klonsky, E. D., Muehlenkamp, J. J., Lewis, S. P., & Walsh, Z. (2014). Self-injury and suicidality. In D. C. S. J. (Ed.), The self-injurious behavior in adolescents: Evidence-based interventions and protocols (pp. 3-22). Guilford Publications.
  • Linehan, M. M. (2015). DBT skills training manual. Guilford Publications.
  • McMain, S., & Pos, E. (2017). Pharmacotherapy for borderline personality disorder. Journal of Clinical Psychiatry, 78(6), 677-682.
  • Gunderson, J. G. (2014). Borderline personality disorder: Ontogeny of a diagnosis. American Journal of Psychiatry, 171(7), 687-689.
  • Gunderson, J., & Zanarini, M. (2012). Borderline personality disorder. The New England Journal of Medicine, 366(5), 434-439.
  • Linehan, M. M. (2015). Skills training manual for treating borderline personality disorder. Guilford Publications.
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  • World Health Organization. (2016). ICD-10: International statistical classification of diseases and related health problems (10th revision).

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