Humanities
Purdue University Case Conceptualization Discussion

Purdue University

Question Description

I need support with this Psychology question so I can learn better.

Attached below are the requirements. Please take a look. I am not sure on the current diagnosis. I think it is PTSD, but please check and make sure it is correct. Attached below is also an example of what the other parts of the paper should consist of. Also, for the treatment plan please refer to attachment about the goals and implement accordingly. Please refer to the rubric to make sure everything is addressed. Paper needs to 3-4 pages long excluding title and reference pages. Thanks.

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Case Conceptualization Assignment Description from Syllabus Using the case vignette provided for this assignment by your instructor (in class), consider the following questions for your brief (3-4 page) case conceptualization: 1) What factors (biological, psychological, sociocultural) led to the development of the presenting concerns? In other words, how did the person’s symptoms develop? 2) What is the current Diagnosis? Support this using the same process as you are using in your discussion board postings. 3) In your paper, address each section included in the table on your syllabus (i.e. diagnosis, rationale, treatment plan, research considerations, and cultural considerations). Additional Information: • • The paper should generally be written in APA format. However, a title page or running head is not required. Please cite all sources and include a reference page. The reference page is NOT included in the minimum page requirement. Please consult the rubric attached to this assignment (found on Blackboard and included in your syllabus) for further information about expectations. General Headings that could be used for the assignment A. Presenting problem(s)/chief complaint/chief concerns B. History of presenting problem(s) and current situation (emotional symptoms, cognitive symptoms, behavioral symptoms, physical symptoms) C. Working hypotheses about how these current problems developed and are maintained (This answers question # 1 in the above section) D. Diagnostic Formulation (use the process described in the syllabus that include diagnosis, justification, research consideration, cultural consideration, etc.). This answers question # 2 in the above section. Case Info Name: Age: Race/Ethnicity: Sharon Dimetria 48 years Caucasian BACKGROUND INFORMATION: Ms. SD reported being raised by her biological parents until the age of 15 and having 2 brothers and 2 sisters. She reported substantial physical and sexual abuse as a child. She stated, “my dad sold me to men for drugs.” Also, commented that her father reportedly raped her multiple times between the ages of 6 to 8 years old. She continued to disclose that she witnessed her siblings being physically abused by her father. Ms. SD left home at the age of 15 and moved from home to home until her father was placed in prison. At that time, returned to live with her mother until she died 6 years ago. After her mother’s death, Ms. SD lived with an allegedly physically abusive boyfriend until a church friend became her legal guardian and she now lives with the church friend. Ms. S is single and has one son, age 8; whom she placed in adoption at one month old. Family history of mental illness includes a sister with depression and a nephew who committed suicide. According to Ms. SD, the highest grade completed was the 12th grade, during which she reportedly made Ds and Fs. She reports having struggled in all subjects while in school. She commented she was in special education as long as she could remember. She stated she is able to read the newspaper but struggles with understanding some of the words. Presently, Ms. SD offered she struggles with basic mathematical and reading skills. She offered she does not currently have or ever had a driver’s license. She expressed fear over driving by herself and commented she has not sought her license because, “I would fail the test.” Ms. SD reports no prior employment, stating that “I just can’t do it.” She also states that when she would try to do “odd jobs” for her guardian’s acquaintances for money, she would constantly “do it wrong” and make mistakes. Furthermore, Ms. SD and her guardian disclosed that has been reportedly receiving disability benefits over the past few years. Her guardian is her current payee and completes all money management for her. In regard to medical problems, psychiatric records indicate that she has problems with a history of hypothyroidism, migraine headaches, chronic obstructive pulmonary disease and obesity. MENTAL HEALTH HISTORY: Ms. SD is currently hospitalized. According to admission records, she was admitted for depression and anxiety symptoms, hearing voices, and for her own safety. Furthermore, has been hospitalized three times within the last year for symptoms; her most recent one month prior to the current hospitalization. Between inpatient treatments, has been seen in outpatient mental health counseling and received psychotropic medications. In her long term mental health treatment history, has been hospitalized numerous times at multiple different hospitals. Dates of hospitalizations remain unclear. When asked about her current symptoms, Ms. SD reported that she has depressed mood most of the day, feels hopeless and helpless, and believes she is a burden to others. She reported frequently having nightmares related to the trauma she experienced as a child and finds it difficult to concentrate the next day. She mentioned that she often worries about her future and believes that she won’t have a long life. She stated that she has problems falling asleep and wakes up several times each night. SUBSTANCE USE HISTORY: denies any current use of addictive substances other than drinking one or two cups of coffee per day. She denies any previous problems or issues with substance abuse, including no present use of alcohol, pain pills, marijuana, cocaine, or crank. LEGAL HISTORY: denies any current legal issues. Psychiatric records revealed one arrest for disorderly conduct; however, when was questioned about this arrest, she did not clarify the details surrounding the incident. responded, “I don’t remember.” DAILY ACTIVITIES: reports sleeping irregularly. She reports bathing or showering and brushing her teeth daily. She states that she eats once per day and at times refuses to eat. Ms. S offered that she cannot make sandwiches for herself and that her church friend makes all meals for her. She denies doing yard work and reports performing housework at a poor level, stating that she helps put away her clothes but cannot do laundry or vacuuming because “I don’t know how.” Ms. S stated she does not manage her own finances and becomes confused at the grocery store about the cost of everyday items. According to Ms. S, her church friend does the grocery shopping. For recreation, reports watching T.V. and going to Wal-mart. Socially, she reports a few friends and acquaintances from her church. Assignment Components Rubric Item1: Provide the correct DSM-5 diagnosis, written in the correct DSM-5 format. Unsatisfactory 0-69 (total) Emerging 70-79 (total) Proficient 80-89 (total) Exemplary 90-100 (total) Max Points 100 (total) Provides a DSM-5 diagnosis that fails to account for the symptoms described in the case provided OR fails to provide a DSM-5 diagnosis. Provides a DSM-5 diagnosis that accounts for some, but not all, of the symptoms described in the case provided OR provides a DSM5 diagnosis that accounts for many of the symptoms listed but is not written in the correct DSM-5 format. Provides a DSM-5 diagnosis that accounts for most of the symptoms described in the case AND is written in the correct DSM-5 format. Provides a DSM5 diagnosis that accounts for all of the symptoms described in the case AND is written in the correct DSM-5 format AND is the least pathologizing diagnosis that fully accounts for the symptoms provided in the case. 20 (this item) Does not provide a rationale for the diagnosis given OR provides a rationale that is irrelevant to the case provided. Provides a rationale for the diagnosis given that is somewhat relevant to the case provided. Provides a rationale for the diagnosis given that is relevant to the case provided. Provides a rationale for the diagnosis given that is relevant, clearly articulated, and comprehensive. 20 (this item) Does not provide a discussion of differential diagnosis OR provides a discussion of differential diagnosis that is irrelevant to the case provided. Provides a discussion of differential diagnosis that is partially irrelevant to the assigned case or includes only one other diagnosis that was considered. Develops a treatment plan that is partially relevant to the case and includes at least one goal and objective. Provides a relevant discussion of differential diagnosis that includes at least two other diagnoses that were considered and ruled out. Provides a relevant and comprehensive discussion of differential diagnosis that includes at least two other diagnoses that were considered and ruled out. Develops a treatment plan that is relevant to the case and includes at least three goals, each with objectives that are clearly articulated. 10 (this item) Provides a list of at least two counseling interventions that are partially relevant to the Provides a list of at least three counseling interventions that are relevant to the case and Provides a list of counseling interventions for each objective listed that are relevant to the 10 (this item) AC: K1, L1 CMHC: C2, G1, K1, L1 Rubric Item 2: Provide a relevant rationale for the DSM-5 diagnosis you assigned to the case. AC: L1 CMHC: C4, K3, L1 Rubric Item 3: Provide a discussion of the differential diagnosis for the assigned case. AC: L2 CMHC: K1, L2 Rubric Item 4: Develop a treatment plan that includes at least three goals, each with clear objectives. Does not develop a treatment plan OR develops a treatment plan that is not relevant to the case provided. Develops a treatment plan that is relevant to the case and includes at least three goals and objectives. CMHC: C2, G1 Rubric Item 5: Provide a list of counseling interventions appropriate for the treatment plan Does not provide a list of counseling interventions OR provides a list of counseling interventions that 10 (this item) developed. AC: K3 CMHC: C2, G1, K2 Rubric Item 6: Discusses recent, relevant research regarding the diagnosis and treatment of the case provided. are not relevant to the case or the goals and objectives. case and objectives. objectives. case and clearly articulated. Does not discuss research related to the case OR discusses research that is not relevant to the case. Provides a minimal discussion of at least one research article, related to diagnosis or treatment, that is relevant to the case provided. Discusses at least two recent research articles, related to diagnosis or treatment, and relevant to the case provided. Discusses at least three recent research articles that are related to diagnosis or treatment, and clearly articulated and relevant to the case provided. 10 (this item) Does not discuss cultural considerations OR discusses cultural considerations that are not relevant to the case provided. Provides a minimal discussion of at least one cultural consideration that is relevant to the case provided. Provides a discussion of at least two cultural considerations that are clearly articulated and relevant to the case provided. Provides a comprehensive discussion of at least three cultural considerations that are clearly articulated and relevant to the case provided. 10 (this item) Writing is unclear and disorganized and rereading to solidify understanding is frequently necessary. Although an attempt at ethical scholarship is attempted, it is sloppy or incomplete throughout. Spelling, grammar, or punctuation errors severely interfere with readers’ comprehension. Citations in text and at the end of the document are not in the correct APA format. Writing is somewhat clear and is somewhat organized, although rereading to solidify understanding is occasionally necessary. It demonstrates an attempt at ethical scholarship in accurate representation and attribution of sources, but errors are occasional or minor. Writing has good spelling, grammar, and punctuation, but Writing is generally clear and in an organized manner. It demonstrates ethical scholarship in accurate representation and attribution of sources; and generally displays accurate spelling, grammar, punctuation. Errors are few, isolated, and do not interfere with reader’s comprehension. Citations in text and at the end of the document are in correct. Many Writing is clear, concise, and in an organized manner; demonstrates ethical scholarship in accurate representation and attribution of sources; and displays accurate spelling, grammar, and punctuation. Citations in text and at the end of the document are in correct APA format. CMHC: C2, C4, G1, K2 Rubric Item 7: Discuss any cultural considerations relevant to the case including potential areas for bias, misinterpretation, and/or cultural impacts on the client’s experience of diagnosis and/or treatment. CMHC: D1 Academic Writing Write in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources (i.e. APA); and display accurate spelling, grammar, and punctuation. 10 (this item) errors somewhat interfere with readers’ comprehension. Citations in text and at the end of the document are mostly in the correct APA format. Total useful ideas are present. APA format. 100 DSM-5 Diagnosis: Schizophrenia 295.90 (F20.9) Rationale for Diagnosis: Client meets multiple criteria for Schizophrenia. Criteria A: client experiences auditory hallucinations when she states she has been “instructed to kill herself by accusatory, commanding voices” and also when she states “they are talking to me”. Client presents disorganized speech by answering questions monosyllabically and is unable to articulate coherently the details of her experience. Client also displays negative symptoms such as diminished emotional expression when she presents with an indifferent and flat affect (American Psychiatric Association, 2013). Criteria B: For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset. Client is withdrawn, academics have declined, client has also become isolative and maintains no relationships with former friends and has not attempted to make any new ones. Contact with family is sporadic (American Psychiatric Association, 2013). Criteria C: Continuous signs of the disturbance persist for at least 6 months. Client’s parents state since starting university client began displaying symptoms, which would indicate the time frame of transition from college to university being over 6 months (American Psychiatric Association, 2013). Criteria D: Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because no major depressive or manic episodes have occurred concurrently with the active-phase symptoms (American Psychiatric Association, 2013). Criteria E: The disturbance is not attributable to the physiological effects of a substance or another medical condition as client’s toxicology report was negative (American Psychiatric Association, 2013). Differential Diagnosis: Schizoid personality disorder (premorbid). I believe criteria of this disorder could have been met prior to the onset of schizophrenia in the client thereby being premorbid. Client presented symptoms described in criteria A of schizoid personality disorder such as having a flattened affect, lacks close friends or confidants, is isolative and distant from family and personal relationships and also seems to choose solitary activities (First, 2014). Schizophreniform Disorder There is room to consider schizophreniform disorder but more information is required to rule out whether client may instead have schizophreniform disorder as the major difference between schizophrenia and schizophreniform disorder is schizophreniform is of a shorter duration, whereby the disturbance is present less than 6 months and in schizophrenia it requires 6 months of symptoms (First, 2014). Brief psychotic disorder Again more information is required from client as when exactly the symptoms have occurred and the duration as brief psychotic disorder Is characterized by a total duration of psychotic symptoms of at least 1 day but less than 1 month (First, 2014). Psychotic disorder due to another medical condition: this may be ruled out too since the client does not suffer from another medical condition (First, 2014). Major depressive disorder and Bipolar I and II disorder with psychotic features. There would have been room to consider these two disorders if there was a presence of psychotic symptoms that occur exclusively during Manic or Major Depressive Episodes (First, 2014). Schizoaffective Disorder too may have been considered but client does not meet criteria for a major depressive or manic episode (First, 2014). Treatment Plan Treatment recommendations for schizophrenia vary according to the course and phase of the disorder. During an acute psychotic episode, the goal of treatment is to provide safety to the patient and others, reduce psychosis and other symptoms (e.g., aggression, depression), and to return the person to the best possible level of functioning (Reichenberg & Seligman, 2016). Since the client is in an acute phase, a stay in hospital will be needed. Sometimes a technique called rapid tranquilization is used. A fast-acting medication that relaxes the patient will be used to ensure that they do not harm themselves or others (Patel, Cherian, Gohil & Atkinson, 2014). In the maintenance phase, while the client is in remission, the goal is to promote recovery and stability and reduce the likelihood of relapse (Reichenberg & Seligman, 2016). Treatments during this phase are likely to focus on social skills, selfesteem, and relapse prevention. In all phases, the best treatment includes a combination of pharmacological and psychosocial interventions. Antipsychotic medications are first-line medication treatment for schizophrenia. They have been shown in clinical trials to be effective in treating symptoms and behaviors associated with the disorder (Patel, Cherian, Gohil & Atkinson, 2014). Pharmacotherapy together with cognitively oriented psychotherapy, individually or in group format, to reduce severity of symptoms is beneficial. The treatment plan of 4-6 months, goals and interventions that would be beneficial for this client include: Goal 1: Control or eliminate active psychotic symptoms so that functioning is positive and medication is taken consistently. Objective: Cooperate with services focused on stabilizing the current acute psychotic episode. 1) Intervention: Refer the client for an immediate evaluation by a psychiatrist regarding her psychotic symptoms and a possible prescription for antipsychotic medication. 2) Intervention: Coordinate voluntary or involuntary hospitalization since the client is a threat to herself. Objective: Obtain immediate, temporary support or supervision from friends, peers, or family members. 1) Intervention: Develop a crisis plan to provide support and supervision to the client on an intensive basis. 2) Intervention: Coordinate access to round-the-clock, professional consultation (eg., 24hour professionally staffed crisis line) to caregivers and the client (Jongsma, Peterson & Mark, 2003). Goal 2: Increase goal directed behaviors. Objective: Provide behavioral, emotional, and attitudinal information toward an assessment of specifiers relevant to the DSM-5 diagnosis, the efficacy of treatment, and the nature of the therapy relationship. 1) Intervention: Assess the clients level of insight (syntonic vs dystonic) toward the presenting problems, (eg., demonstrates good insight into the problematic nature of the described behavior, agrees with others’ concern, and is motivated to work on change; demonstrates ambivalence regarding the problem described and is reluctant to address the issue as a concern; or demonstrates resistance regarding acknowledgeme ...
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Final Answer

Attached.

Running head: CASE CONCEPTUALIZATION

Case Conceptualization
Name
Institution of Affiliation
Date

1

CASE CONCEPTUALIZATION

2

History of Presenting Problem and Current Situation
Ms. Sharon Dimetria has challenges with reading since she can read and fail to understand
what the article is about. She also has difficulties understanding simple mathematics. Ms. Sharon
Dimetria also fears driving, and she has never sought to get a driving license. It is also reported
that Ms. Sharon Dimetria has never been employed, and she feels she might not be able to do the
work correctly. Sharon Dimetria cannot perform simple house chores like laundry, and she cannot
make a sandwich for herself. Sharon Dimetria has depression, and she feels helpless and hopeless
most of the time. It is reported that she also feels she is a burden to other people. Another
symptom she portrays is lack of sleep since she can have nightmares, and this ruins her day. The
nightmares Sharon Dimetria has are connected to the physical and sexual abuses she witnessed
and experienced as a child. This essay is about diagnosing Ms. Sharon Dimetria and formulating
treatment options for her condition.
Working Hypotheses
The symptoms portrayed by Ms. Sharon Dimetria are mainly due to her childhood
experiences. It is reported that Ms. Sharon Dimetria was repeatedly raped by her father when she
was six to eight years. Ms. Sharon Dimetria also witnessed her father abusing her siblings. This is
the reason she experiences nightmares at night, and that causes her to have irregular sleep patterns.
These nightmares are connected to the abuse that she underwent as a child. Another possible
source of the nightmares she has is the relationship she had with an abusive person. Ms. Sharon
Dimetria was physically abused by her boyfriend before she was rescued by her present guardian.
Another factor to note is that there is a history of mental disorders in her family, as evidenced by
the fact that her sister had depression, and she has a nephew who committed suicide.

CASE CONCEPTUALIZATION

3
Diagnostic Formulation

Rationale for Diagnosis
The symptoms displayed by the client indicate that she is suffering from Major
Depressive Disorder. During the entire period of hospitalization, Ms. Sharon Dimetria is reported
to be having depressed moods. According to APA (2013), people with MDD experience
depressed moods frequently. It is reported that Ms. Sharon Dimetria was depressed while in the
hospital, as evidenced by the fact that she felt helpless and hopeless while in the hospital. Ms.
Sharon Dimetria also believes that she is burdening other people. Another feature of MDD that
Ms. Sharon Dimetria displays are feelings of worthlessness. Indecisiveness. Ms. Sharon Dimetria
is not sure of what to do, and that is why her guardian makes most of the decisions on her behalf.
It is reported that Ms. Sharon Dimetria is unable to manage her finances, and the guardian
manages them for her. She also gets confused at the grocery store, and therefore her guardian is
the one to shop for grocer...

agneta (51451)
UCLA

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