In This Assignment You Will Analyze A Fictional Scenario

In This Assignment You Will Analyze A Fictional Scenario And Identify

In this assignment, you will analyze a fictional scenario and identify the possible disorders involved. All the information needed for this assignment can be found in the textbook. Read the following vignettes: Emotional Disorder—Male Vignette Nadif is a seven-year-old Somali-American boy who is homeschooled by his mother. When Nadif was four years old, his family immigrated to the United States from war-torn Somalia after living in a refugee camp. His family has been concerned about him from the time they lived at the camp.He used to have an average appetite and slept relatively well. Now, he wakes in the night, often with nightmares in which he becomes lost or separated from his family. Nadif’s appetite has also been affected. He often reports stomachaches and lack of appetite. His parents describe him as “nervous” most of the time, particularly when his mother is not home.Nadif is too afraid to attend school away from his parents, so his mother has chosen to homeschool him until he feels more secure when away from his family. Nadif seems to feel relatively comfortable out in public, as long as his family accompanies him on outings. His parents are somewhat puzzled by his anxiety, as he has never been lost. Although they all experienced hardships in Somalia, none of them was a direct victim of any intensely traumatic event. Nadif claims he does not remember much of his time in Somalia.His family hopes therapy will help Nadif feel calmer when they are not present, so that he can attend school, develop friendships, and become increasingly more independent. Emotional Disorder—Female Vignette Jada is a sixteen-year-old African American girl enrolled as a junior at the local public high school. She has won numerous honors throughout her educational career for her academic performance; but her greatest joy comes from playing the piano and singing in her church choir. Jada’s vocal instructor raves about her singing voice and about her potential for a career in music. Jada hopes to attend a prestigious music school in New York City upon graduating from high school, but worries about the cost and how much she will miss her family.The pressure of an upcoming audition at school has caused Jada a great deal of stress. She fears she will not be accepted or will not be able to attend for financial reasons. The stress has begun to affect her daily functioning. She is having difficulty sleeping, has lost weight due to decreased appetite, and is beginning to feel hopeless about her future. Jada’s friends describe her as being “irrational” about the situation and “catastrophizing.” Despite their best efforts, they cannot convince her that she has a strong chance.At her weakest moments, Jada has even spoken passively of wishing she would die, so she would not have to face the stress anymore. During the past two weeks, Jada has been sad and tearful on most days and has lost interest in her favorite activities. Last weekend, she was caught drinking alcohol with some friends. She admitted to her parents that she has had alcohol on three separate occasions because it helps her “stop feeling stressed.”

Paper For Above instruction

In this paper, I will analyze the vignette of Jada, a sixteen-year-old girl experiencing significant emotional distress, and identify two possible DSM diagnoses. I will compare and contrast these diagnoses and select the most appropriate based on the symptomatology. Additionally, I will explore the symptoms, causes, treatments, and ethical considerations related to the chosen disorder, supported by current research and scholarly sources.

Introduction

Adolescence is a critical developmental stage characterized by emotional, psychological, and social changes. When these changes become maladaptive, they may manifest as mental health disorders that require clinical attention. Jada’s case exemplifies a girl under considerable stress, exhibiting symptoms such as persistent sadness, hopelessness, anhedonia, sleep disturbances, weight loss, and self-harm ideation. These symptoms suggest the possibility of depressive and anxiety disorders. This paper will discuss the potential diagnoses, focusing on Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD), then determine which diagnosis best describes Jada’s condition.

Possible Emotional Disorders

The first potential diagnosis is Major Depressive Disorder (MDD). Jada's persistent sadness, tearfulness, loss of interest in activities, hopelessness, sleep disturbances, weight loss, and thoughts of death align with DSM criteria for depression. According to the DSM-5, MDD is characterized by at least five symptoms present during a two-week period, including depressed mood or loss of interest/pleasure, accompanied by other symptoms such as sleep disturbance, feelings of worthlessness or guilt, difficulty concentrating, and suicidal ideation (American Psychiatric Association, 2013).

The second possible diagnosis is Generalized Anxiety Disorder (GAD). Jada’s excessive worry about her future, stress related to the upcoming audition, and physical symptoms like sleep problems could also suggest GAD. DSM-5 criteria for GAD include excessive anxiety and worry occurring more days than not for at least six months, about various activities or events, along with symptoms such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance (American Psychiatric Association, 2013).

Comparison of the Diagnoses

Both MDD and GAD share common features, notably sleep disturbance and concentration difficulties, and often co-occur in adolescents (Kessler et al., 2012). However, depression is primarily characterized by pervasive low mood, anhedonia, and feelings of worthlessness, which are evident in Jada’s ongoing sadness, hopelessness, and loss of interest. In contrast, GAD involves persistent, excessive worry about multiple life domains, which is demonstrated by her concern about her future, audition outcomes, and finances.

Furthermore, while GAD tends to involve physical symptoms like muscle tension, Jada's presentation emphasizes mood-related symptoms. Her passive death wish could be indicative of depression, especially given the loss of interest in favorite activities and recent self-harming behaviors. The presence of suicidal ideation strongly supports a diagnosis of depression over GAD alone. Consequently, although GAD symptoms are present, the core features align more closely with Major Depressive Disorder.

Most Appropriate Diagnosis and Rationale

Considering Jada's symptom profile, the most accurate diagnosis appears to be Major Depressive Disorder. Her pervasive feelings of sadness, hopelessness, weight loss, loss of interest, sleep issues, and passive death wish are hallmark features of depression. While anxiety symptoms are present, they seem secondary or comorbid, rather than the principal pathology. The DSM-5 emphasizes that in adolescents, depression often presents with irritability rather than overt depression, which adds relevance to Jada’s case (Nolen-Hoeksema et al., 2014). Given the severity of her depressive symptoms, including suicidal ideation and self-harm, a diagnosis of MDD is more appropriate.

Symptoms Required for Diagnosis of MDD

According to DSM-5, criteria for MDD include at least five symptoms during the same two-week period, with at least one symptom being depressed mood or anhedonia. These symptoms include:

• Depressed mood most of the day, nearly every day (observable by others or subjective report);
• Markedly diminished interest or pleasure in all, or almost all, activities;
• Significant weight loss or gain or decrease/increase in appetite;
• Insomnia or hypersomnia;
• Psychomotor agitation or retardation;
• Fatigue or loss of energy;
• Feelings of worthlessness or excessive guilt;
• Diminished ability to think or concentrate, or indecisiveness;
• Recurrent thoughts of death, suicidal ideation, or suicide attempts.

In Jada’s case, she exhibits depressed mood, anhedonia, weight loss, sleep disturbance, feelings of hopelessness, and passive death wishes, fitting these diagnostic criteria.

Potential Causes of Major Depressive Disorder

Research suggests a combination of biological, psychological, developmental, and multicultural factors contribute to MDD. Biologically, genetic predisposition plays a significant role; Jada's family history of mood disorders may increase her vulnerability (Sullivan et al., 2000). Neurochemical imbalances, particularly in serotonin, norepinephrine, and dopamine pathways, are implicated in depression (Harvard Medical School, 2017). Psychologically, maladaptive thought patterns, low self-esteem, and adverse early life experiences can predispose individuals to depression (Beck, 2011).

Developmentally, adolescence is a vulnerable period for depression due to hormonal changes, identity formation, and heightened sensitivity to social evaluation (Hankin & Abramson, 2001). Socio-cultural factors, such as experiencing academic pressure, racial discrimination, or low socioeconomic status, can exacerbate depressive symptoms. For Jada, being of African American descent and facing financial anxieties about her future may act as stressors that heighten risk (Williams et al., 2010).

Effective Treatments for Major Depressive Disorder

Empirical research supports several effective treatments for adolescent depression, including psychotherapy, pharmacotherapy, and combined approaches. Cognitive-behavioral therapy (CBT) is widely regarded as effective, targeting maladaptive thoughts and promoting behavioral activation (Weisz et al., 2006). Interpersonal therapy (IPT) focuses on improving interpersonal relationships and social functioning, which are often disrupted in depression (Mufson et al., 2004). Pharmacologically, selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, have demonstrated efficacy and FDA approval for adolescent depression (Bridge et al., 2007). Combining medication with psychotherapy yields the best outcomes for severe or persistent depression (Thapar et al., 2012).

Controversies, Cultural Bias, and Ethical Issues

One significant controversy concerns the overdiagnosis and medication use in juvenile depression, with critics arguing that pharmacotherapy may be overprescribed and that biological models overshadow psychosocial factors (Gould et al., 2004). Cultural biases may influence diagnosis and treatment, as cultural norms affect the expression of distress; for example, somatic symptoms are more common in some cultures, potentially leading to misdiagnosis (Kleinman, 1988). Ethically, the use of antidepressants raises concerns about side effects, including increased risk of suicidal ideation in adolescents, which necessitates careful monitoring (Gibbons et al., 2012). Ensuring informed consent, respecting cultural beliefs, and balancing benefits and risks are essential considerations in clinical practice.

Conclusion

Jada's case exemplifies complex emotional challenges in adolescence, with symptoms aligning most closely with Major Depressive Disorder. Understanding the multifaceted causes, available treatments, and ethical issues is vital for effective intervention. Future research should continue to explore culturally sensitive assessment tools and treatment modalities to optimize outcomes for diverse adolescent populations.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
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• Bridge, J. A., et al. (2007). Clinical response and risk for reported suicidal ideation in pediatric antidepressant treatment: A meta-analysis. JAMA, 297(15), 1683–1696.
• Gibbons, R. D., et al. (2012). Relationship between antidepressant medication use and suicidal thoughts and behaviors in youth. JAMA, 305(23), 2345–2352.
• Gould, M. S., et al. (2004). Psychoactive medication and youth. Journal of the American Academy of Child & Adolescent Psychiatry, 43(4), 385–386.
• Harvard Medical School. (2017). The neurobiology of depression. Harvard Health Publishing.
• Hankin, B. L., & Abramson, L. Y. (2001). Development of sex differences in depression: An elaborated cognitive vulnerability-transactional stress theory. Psychological Bulletin, 127(6), 773–796.
• Kessler, R. C., et al. (2012). Epidemiology of adult DSM-5 Major Depressive Disorder and its specifiers. Journal of Clinical Psychiatry, 75(2), 123-130.
• Kleinman, A. (1988). The illness narratives: Suffering, healing, and the human condition. Basic Books.
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• Nolen-Hoeksema, S., et al. (2014). Gender differences in depression. Annual Review of Clinical Psychology, 10, 353–377.
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• Weisz, J. R., et al. (2006). Effects of youth’s treatment on parent functioning. Journal of Consulting and Clinical Psychology, 74(1), 107–118.
• Williams, D. R., et al. (2010). Racial/ethnic disparities in mental health: Support, barriers, and pathways to care. American Psychologist, 65(4), 317–331.