Psychopathology Major Neurocognitive Disorder Questions

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Review this vignette about neurocognitive disorders and answer the following questions:

1.    What neurocognitive disorder is most appropriate for this patient (delirium, mild neurocognitive disorder, major neurocognitive disorder)?

2.    If the patient presents with either a mild or major neurocognitive disorder, what is it most likely due to?

3.    Any other areas of concern?

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Week 12 Vignette – due by 4pm on Monday 4/4/22 Review this vignette about neurocognitive disorders and answer the following questions: 1. What neurocognitive disorder is most appropriate for this patient (delirium, mild neurocognitive disorder, major neurocognitive disorder)? 2. If the patient presents with either a mild or major neurocognitive disorder, what is it most likely due to? 3. Any other areas of concern? Felix is a 78 year old male who was referred for a neuropsychological evaluation to assess whether his cognitive capabilities have declined since his previous neuropsychological assessment in 2014. In the 2014 assessment, Felix’s results ranged from “Low Average to Average.” Between 2015 and 2017, Felix was medically hospitalized 10 times for cardiovascular issues. In 2018, Felix was diagnosed with peripheral vascular/artery disease. Since 2018, Felix has presented with increased cognitive confusion and disorganization. This confusion has led Felix to feel frustrated and to react aggressively to others. In 2018 alone, hospital staff documented 87 total incidents for Felix, half of which related to falls due to unsteady gait, and half of which related to assaults or attempted assaults. In contrast, documentation shows 13 incidents in 2014, 29 incidents in 2015, 35 incidents in 2016, and 54 incidents in 2017. Staff intervention has been required to prevent additional violent incidents. Felix’s treating psychologist has developed numerous behavior plans to reduce his aggressive acts towards staff and peers. In addition to this increased aggression, in the last several years, Felix has required more intensive staff support to assist him with day to day activities (e.g., remembering and engaging in basic grooming behaviors, taking his medications). In the present evaluation, Felix’s neuropsychological testing results fell in the ranges of “Profound, Severe, Moderate, and Borderline” impairment. His overall range of functioning, when compared to the identical 2014 testing battery, is noticeably diminished. The current data show deficits in many domains, but Felix most notably struggled in the realm of complex attention. Complex attention refers to a person’s ability to maintain information in their mind for a short period of time, manipulate that information, and respond to it in an efficient and logical manner. Difficulties with complex attention likely impeded his overall ability to encode incoming information, which in turn reduced his ability to either retrieve or recognize the same stimuli later on. These complex attentional limits precluded him from effectively completing multilayered tasks, thereby interfering with Felix’s executive functioning as well. A prime example of this was the Copy Trial on the Mini Mental Status Examination. In lieu of copying two interlocking pentagons, Felix drew two short, wavy lines side by side. The attentional demands of a seemingly simple task (visuospatial abilities, planning, graphomotor functioning) became too demanding. Presently, there is no evidence to suggest that Felix’s cognitive deficits are a direct physiological consequence of another medical condition, substance use, or exposure to a toxin. Felix additionally carries a diagnosis of schizoaffective disorder, bipolar type. Symptoms related to this diagnosis have remained fairly steady over time.
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Psychopathology- Major Neurocognitive Disorder

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Psychopathology- Major Neurocognitive Disorder
Most Appropriate Neurocognitive Disorder
Felix is 78-year-old male presenting symptoms of major neurocognitive disorder (MND).
According to DSM-5 MND is an old age symptom that often develops with substantial decline of
cognitive functioning unlike previous performance of cognitive levels in reasoning, speech,
memory, spatiotemporal perception, and intellectual functioning (Sousa, Teixeira & Paúl, 2020).
It is also connected to difficulties in different levels of functioning and changes in emotional
behavior. For an individual to be diagnosed with a major neurodevelopment disorder, he or she
must meet the DSM-5 criteria classified by symptoms such as significant cognitive decline
compared to previous performance level in learning, attentiveness, memory, perceptual-motor,
planning, and ability to understand social issues. Another symptom is, concerns from others that
the person’s cognitive functioning has significantly decreased. Besides cognitive dysfunctions
tend to interfere with a person’s daily activities.
Felix presents meet the criteria for MND since he presents several symptoms. One of the
major ...

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