Unit 5 Assignment 1: Diagnostic Skill Application I

Unit 5 Assignment 1 Diagnostic Skill Application I For this assignment,

Please review the provided case studies of Jenny and Marisol, and complete a diagnostic analysis for each. For each case, you must identify presenting concerns, describe what additional information is needed for a differential diagnosis, and select an assessment tool to aid in gathering that information. Additionally, provide DSM-5 and ICD-10 codes with supporting rationale, discuss the appropriateness of a medication consultation, and consider systemic factors impacting the client's presentation. Use scholarly sources to support your analysis and cite appropriately in APA style. The paper should be 5–7 pages, double-spaced, in Times New Roman 12-point font, and include minimum six scholarly references.

Paper For Above instruction

The diagnostic assessment of clients in clinical settings is a complex and multifaceted process that requires a comprehensive understanding of presenting concerns, appropriate use of assessment tools, and careful consideration of contextual factors. This paper undertakes a detailed analysis of two case studies—Jenny and Marisol—to elucidate the diagnostic process, incorporating DSM-5 and ICD-10 classifications, evaluation of systemic influences, and recommendations for intervention strategies including medication consultation.

Case of Jenny: Presenting concerns and systemic considerations

Jenny, a 29-year-old woman, presents with signs of depression and possible anxiety, evidenced by her recent withdrawal from social activities, feelings of hopelessness following her breakup, and her returning to her mother’s home. From her narrative, Jenny's primary concerns include feelings of aimlessness, financial stress, and familial conflicts, exacerbated by her sexual orientation and living situation. Cultural considerations involve her identity as a bisexual woman who resides with her single mother—factors that influence her social support and mental health. Systemically, her longstanding familial dynamics, including shared parenting and recent financial adjustments, are relevant to her psychological state. These factors must be evaluated to make an accurate diagnosis and tailor appropriate interventions.

Additional information needed and assessment tools

Further information regarding Jenny's mood, sleep patterns, appetite, and daily functioning is essential. Use of assessment tools like the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI) can provide quantified measures of her depressive and anxiety symptoms (Beck, Epstein, Brown, & Steer, 1988; Bardhoshi, Duncan, & Erford, 2016). These tools help delineate symptom severity and track response to treatment. Application of the differential diagnosis decision tree from the DSM-5 aids in systematically ruling out alternative diagnoses such as adjustment disorder or substance-induced mood disorder based on symptom onset, duration, and context.

DSM-5 and ICD-10 codes with rationale

Based on her presentation, a primary diagnosis of Major Depressive Disorder, recurrent episode, moderate severity (DSM-5 code: 296.32; ICD-10 code: F33.1) appears appropriate, considering her persistent depressed mood, loss of interest, and functional impairment. Comorbid anxiety symptoms may suggest an additional diagnosis of Generalized Anxiety Disorder (DSM-5 code: 300.02; ICD-10: F41.1), pending assessment results. The rationale involves her symptom profile aligning with DSM-5 criteria, including symptom duration of at least two weeks, significant distress, and impact on daily functioning.

Medication consultation considerations for Jenny

Given her depressive symptoms and functional impairment, a medication consultation may be beneficial. Evidence indicates that pharmacotherapy—if combined with psychotherapy—can enhance outcomes (Gartlehner et al., 2015). A psychiatric evaluation can determine the appropriateness of antidepressant medication, especially considering her family dynamics and potential hormonal or neurological factors influencing mood. However, cultural factors, her preferences, and her psychosocial context should inform the treatment plan, emphasizing a patient-centered approach.

Case of Marisol: Presenting concerns and systemic considerations

Marisol reports feelings of social discomfort, reluctance to date or travel, and maintains close ties with her family and longtime friends. Her presentation indicates possible social anxiety or underlying perfectionism. Cultural factors such as her Puerto Rican heritage, family expectations, and community support influence her self-perception and social functioning. Her preference for solitude may be adaptive or symptomatic of social anxiety disorder (DSM-5 code: 300.23; ICD-10: F40.!3). Her career progression and comfort in small organizations suggest resilience but also point to potential limitations in social engagement vital for broader systemic functioning.

Additional diagnostic considerations and assessment tools

Further data on her social interactions, emotional regulation, and possible panic symptoms are needed. The Symptom Checklist-90-Revised (Derogatis, 1977) can elucidate her psychological symptom profile across multiple domains, including somatization, anxiety, and depression. Application of a differential diagnosis decision tree helps distinguish social anxiety disorder from avoidant personality disorder or other mood disorders. Incorporating family assessments—using tools like the Systematic Family Assessment Measure by Hamilton and Carr (2016)—can clarify family dynamics contributing to her social withdrawal.

DSM-5 and ICD-10 classification with supporting rationale

Marisol's symptoms align with Social Anxiety Disorder (DSM-5 code: 300.23; ICD-10: F40.1), characterized by excessive fear of social situations, avoidance, and distress impacting her daily life. Her longstanding family support system suggests that systemic factors are either protective or contribute to her current presentation. Her diagnosis is supported by her history of social withdrawal and avoidance, as well as her consistent preference for small, familiar settings over broader social or travel engagements.

Medication referral considerations for Marisol

Psychopharmacological therapy might be appropriate if her anxiety significantly impairs functioning or if comorbid conditions such as depression are identified during assessment (Craske et al., 2017). A referral to a psychiatrist for medication evaluation can be beneficial, especially if cognitive-behavioral therapy (CBT) along with pharmacotherapy is indicated for comprehensive management of her social anxiety symptoms. Her cultural background should be considered in clinician communication and treatment planning to ensure culturally sensitive care.

Systemic influences on eating disorder development (Case of Nancy)

The mental health assessment of Nancy, dealing with an eating disorder, underscores the influence of broader systemic factors such as sociocultural standards of thinness, media exposure, family attitudes, and peer pressures. According to the sociocultural model, societal ideals and media glorification of thinness significantly contribute to body dissatisfaction and disordered eating behaviors (Thompson & Stice, 2001). Family dynamics, including parental attitudes towards food, body image, and dieting, serve either as risk factors or protective factors. For instance, overemphasis on appearance or control within familial relationships can foster restrictive eating behaviors. Additionally, media perpetuates unrealistic body standards, leading to internalization of thin ideals and increased risk of bingeing or purging behaviors (Harrison & Hefner, 2014). Recognizing these systemic influences is vital for developing culturally and contextually appropriate treatment interventions, incorporating systemic family therapy, psychoeducation, and media literacy strategies.

Conclusion

In conclusion, comprehensive diagnostic assessment involving understanding presenting concerns, systemic influences, appropriate assessment tools, and current diagnostic criteria is essential for effective client treatment planning. Integrating clinical judgment with evidence-based tools and considering cultural and systemic factors enhances diagnostic accuracy and guides tailored interventions, including medication where indicated. Continuous scholarly engagement and cultural sensitivity remain paramount in delivering effective mental health care.

References

• Beck, A. T., Epstein, N., Brown, G., & Steer, R. (1988). Beck Anxiety Inventory. Psyctests.
• Gartlehner, G., et al. (2015). Comparative effectiveness of antidepressants for major depressive disorder. Journal of Clinical Psychiatry.
• Craske, M. G., et al. (2017). Cognitive-behavioral therapy for anxiety disorders. Psychotherapy.
• Harrison, K., & Hefner, V. (2014). Media exposure, self-objectification, and body dissatisfaction among adolescent girls and young women. Body Image.
• Thompson, J. K., & Stice, E. (2001). Thin-ideal internalization: Mounting evidence for a new risk factor for body dissatisfaction. Journal of Social and Clinical Psychology.
• Derogatis, L. R. (1977). Symptom checklist-90–revised. Psyctests.
• Hamilton, E., & Carr, A. (2016). Systematic review of self-report family assessment measures. Family Process.
• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• World Health Organization. (2016). International Classification of Diseases (10th ed.).
• Additional scholarly sources as needed to support diagnostic rationale and systemic considerations.