Luisa is a 38-year-old office manager referred to therapy by her employer through the company’s employee assistance program. Her boss has become increasingly concerned, as she has noticed that Luisa seems to be on edge quite often over the last several months.
Approximately nine months ago, Luisa learned that her husband was having an extramarital affair. Upon her discovery of the relationship, Luisa’s husband abruptly left their marriage of six years, filed divorce papers, and moved in with his girlfriend. Since this time, Luisa has begun to experience significant anxiety around simple and routine tasks. She’s often consumed with worry about mistakes at work and finds herself tense and fatigued quite often. Luisa has also begun to worry excessively about money and to scrutinize every penny she spends. She consistently seeks reassurances from her coworkers and family, but with little positive effect.
Increasing fear has caused Luisa to isolate over the past three months. She avoids going out even during the daytime. She states that she feels scared and vulnerable walking her dog around the block. Her fear is that something horrible will happen and no one will come to her rescue. She knows that this is irrational but feels that so much of her anxiety is beyond her control.
Luisa stated that she had been sad for a few weeks after her husband left, but denies thoughts of self-harm or for revenge to her husband. She does not have a history of alcohol or substance abuse. Her sleep has been erratic but her physical health has been relatively normal. Her score on the Beck Anxiety Inventory was 27, indicating a severe level of anxiety.
In the discussion, address the following, using headings to match content in each bullet point:
• Review the questions in domain IV of the Level I Cross-Cutting Symptom Measure in the Assessment Measures of the DSM-5. Describe how each of the three items would be scored. What additional information is needed to rate these items?
• At the same link, scroll down to locate the WHODAS. Which assessment domains may provide required information to fully assess the extent of Luisa’s symptoms?
• Explain the DSM disorder that appears to be most accurate for Luisa and include your rationale.
DSM-5 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Arlington: American Psychiatric Publishing
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