Writing A Minimum Of Five Pages Of Content

Consists Of Writing A Minimum Of Five 5 Pages Of Content Completin

Consists of writing a minimum of five (5) pages (of content) completing a DSM-5 diagnosis of the following scenarios: Scenario 1: A 7-year-old child is tested at school during a group IQ testing and is assessed to have an IQ of 67. She is having a hard time keeping up with her class in reading and arithmetic. She appears to be immature in her social development and needs support with daily living skills such as proper dressing and grooming. Scenario 2: The lawyer of a young man, Albert S., suggests that Albert see a therapist because he has been so depressed about his impending divorce. Albert says he has been feeling sad, lonely, and fatigued during the last month. You determine that Albert is not suffering from a severe mental disorder; and a physical exam indicates that Albert has no physical problems. Scenario 3: Gary, a 30-year-old man, is known to be quite a "storyteller." He often brags about his accomplishments, both real and imagined. He passionately enjoys being the center of attention. Although he expects his circle of friends to be completely loyal, he lacks empathy and understanding in his relationships. Gary is preoccupied with his personal appearance and has a fear of growing old. For each scenario, the following should be answered: (1) what is the DSM-5 diagnosis; (2) what criteria did you use to come up with this diagnosis; (3) what other diagnoses did you consider and why (List 3); (4) list three (3) short-term treatment goals that you would outline in this client’s treatment plan; (5) list three (3) long-term treatment goals that you would outline in this client’s treatment plan; and (6) list three (3) treatment approaches you would use with this client.

Paper For Above instruction

In this paper, we analyze three distinct clinical scenarios through the lens of the DSM-5 to arrive at appropriate diagnoses, considering diagnostic criteria, differential diagnoses, and outlining specific treatment strategies. Each scenario presents unique psychological and behavioral presentations, necessitating tailored assessment and intervention plans. This comprehensive exploration underscores the importance of precise diagnosis and individualized treatment planning in clinical practice.

Scenario 1: Child with Intellectual and Social Developmental Challenges

The first scenario involves a 7-year-old girl who scored an IQ of 67 on a group assessment and exhibits difficulties in academic, social, and daily living skills. Based on DSM-5 criteria, the most fitting diagnosis appears to be "Intellectual Disability" (ID). The DSM-5 defines ID as deficits in intellectual functions confirmed by clinical assessment and testing, along with deficits in adaptive functioning across conceptual, social, and practical domains originating during the developmental period (American Psychiatric Association, 2013).

Criteria include deficits in reasoning, problem-solving, planning, abstract thinking, judgment, academic learning, and learning from experience, manifested in adaptive functioning deficits that impact independence. In this case, the child's low IQ score, academic struggles, immature social skills, and need for support with daily functioning satisfy these criteria. The diagnosis is supported by her developmental presentation and the need for ongoing support to function effectively in daily life.

Other diagnoses considered include:

  • Specific Learning Disorder: she struggles with reading and arithmetic, which could suggest a learning disorder, but her overall intellectual functioning and broad developmental delays support ID.
  • Autism Spectrum Disorder (ASD): social immaturity raises this consideration; however, there are no explicit social communication deficits or repetitive behaviors typical of ASD.
  • Visual or Auditory Impairments: sensory deficits may contribute to developmental delays but are not indicated here.

Short-term treatment goals include:

  • Enhance adaptive daily living skills through structured training.
  • Implement educational interventions tailored to her cognitive level to improve reading and arithmetic skills.
  • Develop social skills through social skills training and facilitated peer interactions.

Long-term goals focus on:

  • Promote independence in daily living activities such as dressing, grooming, and basic hygiene.
  • Improve academic functioning to reach a functional level suitable for mainstream integration or special education capabilities.
  • Support emotional and social development to foster self-esteem and peer relationships.

Effective treatment approaches include:

  • Behavioral interventions, such as Applied Behavior Analysis (ABA), to develop adaptive skills.
  • Speech and occupational therapy to address communication and daily living skills.
  • Behavior management strategies integrated into a comprehensive Individualized Education Program (IEP).

Scenario 2: Depression in Young Adult without Severe Mental Disorder

The second scenario involves Albert S., a young man experiencing feelings of sadness, loneliness, and fatigue over the last month, related to an impending divorce. Considering DSM-5 criteria, the diagnosis leans toward "Other Specified Depressive Disorder" or "Unspecified Depressive Disorder," given the absence of severe impairment or physical health issues. Since the symptoms are distressing but not meeting criteria for Major Depressive Disorder (MDD) — particularly the lack of pervasive impairment or duration beyond two weeks — a diagnosis of Adjustment Disorder with depressed mood is appropriate (American Psychiatric Association, 2013).

The maladaptive response to a significant stressor (divorce) with symptoms like sadness and fatigue aligns with Adjustment Disorder. The DSM-5 specifies that the disturbance causes marked distress or impairment but does not meet full criteria for MDD, and symptoms are typically less severe and transient.

Other diagnoses considered include:

  • Major Depressive Disorder (MDD): ruled out because symptoms are not persistent or severe enough.
  • Generalized Anxiety Disorder: symptoms overlap but appear primarily in response to situational stress rather than pervasive anxiety.
  • Circle of Grief or Bereavement-related Disorder: not appropriate, as this diagnosis is mainly reserved for grief reactions, not divorce.

Short-term treatment goals include:

  • Assist Albert in developing coping strategies to manage feelings of sadness and loneliness.
  • Enhance social support networks to reduce feelings of isolation.
  • Monitor mood symptoms to determine if further intervention is necessary.

Long-term goals involve:

  • Strengthen resilience to future stressors and promote emotional regulation skills.
  • Encourage engagement in meaningful activities and social connections.
  • Assess and address any emerging symptoms of a major depressive episode if they develop.

Treatment approaches might include:

  • Cognitive Behavioral Therapy (CBT) to challenge negative thought patterns and develop healthy coping mechanisms.
  • Brief supportive psychotherapy focusing on emotional expression and problem-solving.
  • Referral for psychiatric evaluation if symptoms escalate or persist beyond three months.

Scenario 3: Narcissistic Traits and Personality Features in a Middle-Aged Man

The third scenario features Gary, a 30-year-old with prominent narcissistic traits: boasting, craving admiration, lacking empathy, preoccupations with appearance, and fears of aging. DSM-5 diagnoses that align include "Narcissistic Personality Disorder" (NPD). The criteria for NPD encompass a pervasive pattern of grandiosity, need for admiration, and lack of empathy, beginning by early adulthood and present in various contexts (American Psychiatric Association, 2013).

Gary’s behaviors—exaggeration of achievements, obsession with personal appearance, entitlement, and interpersonal difficulties—fit the diagnostic criteria for NPD, including a grandiose sense of self-importance, fantasies of success, and lack of empathy.

Alternative diagnoses considered are:

  • Borderline Personality Disorder: less evidence of unstable interpersonal relationships or impulsivity that characterizes BPD.
  • Histrionic Personality Disorder: some superficiality and need for attention are shared but lacks the pervasive entitlement and grandiosity specific to NPD.
  • Body Dysmorphic Disorder: preoccupation with appearance but not necessarily intertwined with narcissistic traits.

Short-term treatment goals include:

  • Reduce the maladaptive pursuit of admiration through psychoeducation.
  • Develop awareness of interpersonal difficulties and the impact of narcissistic traits.
  • Enhance emotional regulation and reduce defensiveness.

Long-term goals involve:

  • Foster genuine empathy and improve interpersonal functioning.
  • Address underlying self-esteem issues and fears of aging.
  • Develop healthier self-concept and realistic self-appraisal.

Treatment approaches suitable for Gary include:

  • Schema Therapy to address deep-seated self-esteem and interpersonal patterns.
  • Psychodynamic psychotherapy focusing on insight into narcissistic defenses and underlying vulnerabilities.
  • Group therapy to facilitate feedback and increase empathy for others.

Conclusion

Accurate DSM-5 diagnosis is a cornerstone of effective mental health treatment, guiding clinicians in selecting appropriate interventions. The complex presentations in each scenario demonstrate the necessity of comprehensive assessment, differential diagnosis, and individualized treatment planning. Tailoring treatment goals and approaches to each client’s unique presentation enhances the likelihood of positive therapeutic outcomes and long-term psychological well-being.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  • Kumar, S. (2014). Intellectual disability and developmental delays: Assessment and management. Journal of Clinical & Diagnostic Research, 8(10), NE01–NE04.
  • Lezak, M. D., Howieson, D. B., Bigler, E. D., & Tranel, D. (2012). Neuropsychological assessment (5th ed.). Oxford University Press.
  • American Psychiatric Association. (2013). Adjustment Disorders. In Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
  • Millon, T., & Davis, R. (1996). Disorders of personality: DSM-IV and beyond. John Wiley & Sons.
  • Zanarini, M. C. (2012). The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and personality disorders: Implications for clinical practice. The Journal of Clinical Psychiatry, 73(8), 1084–1086.
  • Rowan, A. (2014). Personality disorders: A comprehensive review. Journal of Psychiatric Practice, 20(2), 123–131.
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  • Tan, S. Y., & Sander, J. (2016). Treatment of Narcissistic Personality Disorder: Literature review and clinical considerations. Journal of Psychotherapy & Psychosomatics, 85(4), 251–263.

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