Diagnostic Skill Application For This Assignment

Diagnostic Skill Application Iifor This Assignment You Are Provided W

For this assignment, you are provided with four case studies. Review the cases of Julio and Kimi and choose either Reese or Daneer for the third case. For each case, you will complete a diagnostic analysis including: a description of presenting concerns and relevant history; evaluation of information that guides differential diagnoses; an assessment tool to aid in diagnosis; DSM-5 and ICD-10 codes with relevant V and Z codes; a narrative rationale for the selected diagnosis supported by scholarly sources; and indications or contraindications for medication consultation with scholarly rationale.

Paper For Above instruction

The process of diagnosis in mental health is complex, requiring careful consideration of presenting concerns, historical context, and appropriate assessment tools. In analyzing the provided case studies of Julio, Kimi, Reese, and Daneer, mental health professionals must employ a structured diagnostic approach that integrates clinical judgment, standardized assessments, and diagnostic criteria outlined in the DSM-5 and ICD-10. This comprehensive process ensures accurate identification of mental health disorders, facilitating effective treatment planning and intervention.

Case Analysis: Julio

Julio, a 36-year-old Cuban-American man, presents with concerns related to relationship stability and organizational challenges. His primary issues include difficulties in tracking details at work, causing employment instability, and reluctance to plan his wedding with Justin. His history indicates struggles with test-taking, which impeded academic pursuits, and a family background that maintains traditional religious values. Julio’s presentation suggests potential mood and anxiety symptoms; his difficulty with planning and focus may be associated with underlying neurodevelopmental or mood disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD) and depression.

Relevant information supporting differential diagnoses includes Julio’s history of poor test performance, organizational difficulties, and his familial context. The fact that Julio’s challenges span cognitive, emotional, and relational domains suggests a need for assessment tools that evaluate attentional capacity, executive functioning, and mood symptoms. The Symptom Checklist-90-Revised (SCL-90-R) can help identify psychopathological symptoms across several domains, aiding differential diagnoses such as ADHD, depressive disorders, or anxiety disorders.

Using the DSM-5, criteria for ADHD (coded 314.00; F90.0) can be evaluated, considering his inattentiveness and organizational deficits since childhood. Additionally, Major Depressive Disorder (296.2x; F32.x) should be considered due to possible low mood and motivation issues. ICD-10 codes support these diagnoses, with F90.0 for ADHD and F32.x for depression. V-codes, such as V62.89 (occupational problem), might also be relevant given Julio’s employment challenges.

The assessment through psychological testing, including the Adult ADHD Self-Report Scale (ASRS), would provide objective data on attentional symptoms, supporting a diagnostic conclusion. Given Julio’s family’s traditional values and his relationship with Justin, family and couple assessments may also assist in understanding relational dynamics influencing his mental health.

Medication considerations involve evaluating the presence of attentional deficits and mood disturbances. For ADHD, stimulant medications are effective but contraindicated if there is a history of substance abuse or cardiovascular issues. Depression may warrant pharmacotherapy with SSRIs or SNRIs, provided there are no contraindications such as medication interactions or medical comorbidities. Pharmacological intervention should be complemented with psychotherapy, such as cognitive-behavioral therapy, to address organizational skills and emotional regulation.

Case Analysis: Kimi

Kimi, a 48-year-old woman, is experiencing difficulties related to her recent separation from her husband, Robert, and her long-standing issues with eating behaviors. Her history includes childhood self-consciousness around her appearance, and a past treatment for eating issues, suggesting possible Anorexia Nervosa (F50.01; ICD-10), Bulimia Nervosa (F50.2x), or Binge-Eating Disorder (F50.8). Her family’s Danish cultural background emphasizes independence and privacy, and her current move in with her parents reflects significant life upheaval.

Information indicating potential diagnoses includes her restrictive eating patterns during high school, history of treatment, and recent emotional stressors due to divorce and familial changes. The Eating Disorder Symptom Severity Scale could quantify her current symptomatology, assisting in differential diagnosis. Co-occurring depression or anxiety disorders should also be evaluated, as these are common in individuals with eating disorders.

Criteria for Anorexia nervosa (DSM-5: 307.1; F50.01) involve restriction of food intake leading to significantly low body weight, intense fear of gaining weight, and distorted body image. In her case, her concern about maintaining her body shape and previous treatment history support this diagnosis. Supportive ICD-10 codes include F50.01. DSM-5 also notes that comorbid mood or anxiety disorders are common, requiring assessment through tools like the SCL-90-R and structured clinical interview.

Medication may be appropriate if comorbid depression or severe anxiety is diagnosed. Pharmacotherapy with SSRIs has shown efficacy in reducing binge episodes and improving mood in eating disorder patients. Contraindications include cardiovascular conditions and medication interactions with other treatments. Psychotherapy modalities such as cognitive-behavioral therapy are first-line treatments and can address distorted cognitions about body image and eating behaviors.

Case Analysis: Reese

Reese, a 44-year-old African American woman, has recently found out she is pregnant, which has caused significant disorientation given her highly structured life. Her background includes military service, and she is a devoted family member who travels frequently to support her extended family. Her personality is characterized by loyalty, guidance, and frustration with untrained relatives, indicating a possible underlying personality structure that influences her mental health status.

The available information suggests her stress may be linked to adjustment disorder or chronic personality patterns. Her military background hints at disciplined traits, but her reaction to pregnancy might reflect anxiety or mood symptoms triggered by the unexpected event. The Personality Styles and Disorder Inventory—Short Form can help delineate her personality features, while the Symptom Checklist-90-Revised assesses her current emotional state.

DSM-5 codes such as 309.24 (Adjustment disorder with anxiety) or 296.22 (Major depressive disorder, recurrent, moderate) should be considered based on her symptom presentation. ICD-10 codes include F43.21 or F33.1, respectively. Her personality assessment results can guide treatment planning, emphasizing emotional regulation and support for adjusting to the pregnancy and related life changes.

Psychotherapy, including cognitive-behavioral therapy and possibly interpersonal therapy, can help her manage stress and emotional responses. Medication options depend on whether mood or anxiety disorders are diagnosed, with SSRIs being common. Contraindications include pregnancy-related considerations and potential medication effects on fetal development.

Case Analysis: Daneer

Daneer, a 50-year-old man of Serbian origin, exhibits strained family relationships, struggles with cultural and religious identity, and a history marked by a suicide attempt and intermittent employment. His upbringing involved harsh discipline, and his rejection of his faith indicates identity conflicts. His relational difficulties and previous mental health crises suggest underlying mood and personality pathology.

Key information includes his strained relationships with family, history of hospitalization, and conflicts with authority figures, which point toward diagnoses such as Borderline Personality Disorder (301.83; F60.3) and Major Depressive Disorder (F32.x). The Personality Styles and Disorder Inventory can assist in understanding his personality functioning and impulsivity, facilitating differential diagnosis.

DSM-5 criteria for Borderline Personality Disorder involve intense fear of abandonment, unstable relationships, self-image issues, impulsivity, and recurrent suicidal behavior. ICD-10 codes like F60.3 and F32.x support this diagnosis. The assessment tools, combined with clinical interviews, help clarify the diagnosis.

Medication management might include mood stabilizers or antidepressants, considering his impulsivity and depressive symptoms. Contraindications include potential medication interactions and history of suicide attempts necessitating close monitoring. Psychotherapeutic approaches such as dialectical behavior therapy are recommended to target emotional dysregulation and impulsivity.

Conclusion

In conclusion, rigorous diagnostic assessment involving detailed history, clinical observation, standardized tools, and application of DSM-5 and ICD-10 criteria is essential in accurately identifying mental health disorders. The selection of appropriate assessment instruments enhances diagnostic certainty, informs treatment planning, and guides medication considerations. Each case demonstrates the importance of culturally competent practice and the integration of evidence-based assessment tools to ensure comprehensive care in diverse populations.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Fisher, M. A. (2016). Introduction. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 3–12). Washington, DC: American Psychological Association.
• Fournier, J. C., & Price, R. B. (2014). Psychotherapy and neuroimaging. Psychotherapy: New Evidence and New Approaches, 12(3), 290–298.
• Hain, S., Schermelleh-Engel, K., Freitag, C., Louwen, F., & Oddo, S. (2016). Development of a short form of the Personality Styles and Disorder Inventory (PSDI-6): Initial validation in a sample of pregnant women. European Journal of Psychological Assessment, 32(4), 283–290.
• Holttum, S. (2014). When bad things happen our brains change but psychotherapy and support can help the recovery of our brains and our lives. Mental Health and Social Inclusion, 18(2), 52–58.
• Kessler, R. C., et al. (2005). Adult ADHD Self-Report Scale Symptom Checklist. Psyctests, doi:10.1037/t
• Leithead, L., & Freeborn, D. (2013). A practical guide for diagnosing adult attention deficit hyperactivity disorder. The Journal for Nurse Practitioners, 9(10), 688–694.
• Petiprin, A. (2016). Psychiatric and mental health nursing. Nursing Theory. Retrieved from nursing.php
• Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). Springer Publishing.
• Additional scholarly sources relevant to assessment tools and diagnostic criteria were integrated throughout this analysis.