Depressive Disorder Diagnosis and Assessment
Read the following vignette, keeping in mind the importance of knowing symptoms, and their duration and severity:
Christina is a 25-year-old Mexican American woman who has been working as an elementary school teacher since she graduated from college three years ago. Although she does well at her job, she has been feeling low ever since she left college. When she took this teaching position, she had to relocate to a city over four hours away from her family and the house she grew up in. Even though she has made some new friends, Christina still feels disconnected and lonely. She is also concerned about her mother, who has been diagnosed with a serious health condition.
For the past month, Christina has felt much worse. She reports feeling very sad and tired most of the time and is having difficulty concentrating at work. She says that she does not have enough energy to accomplish the things she would like to do. She admits to overeating to “unwind” after school, and is concerned she is sleeping too much on the weekends. She also has very low self-esteem, despite being well-liked at her school and receiving good performance evaluations.
Christina describes her life as “heading nowhere” and says that lately she has felt extremely hopeless. She wonders if she will ever feel as happy as she did when she was in college. She does not have a history of ever feeling worse than this, and is in good health.
Based on the information presented, address the following questions in your discussion post using headings to match content in each bullet point:
What depressive disorder diagnosis would you consider assigning to Christina? Describe the process you used for making this decision, including your use of the “Differential Diagnosis by the Trees” from the DSM-5 Handbook of Differential Diagnosis (linked in Resources).
Describe how the Beck Depression Inventory-II would aid in making a diagnosis for this client. (See pages 62–63 of Abnormal Psychology).
What Z code or codes would you consider for Christina? How would including these systemic considerations help you understand Christina’s presenting symptoms and consider your treatment approach?
DSM-5 mood disorders. American Journal of Psychotherapy, 70(4), 383–392.
McTate, E. A., & Leffler, J. M. (2017). Diagnosing disruptive mood dysregulation disorder: Integrating semi-structured and unstructured interviews. Clinical Child Psychology and Psychiatry, 22(2), 187–203.
Strong, T. (2015). Diagnoses, relational processes and resourceful dialogs: Tensions for families and family therapy. Family Process, 54(3), 518–532.
Walsh, J. (2016). The utility of the DSM-5 Z-codes for clinical social work diagnosis. Journal of Human Behavior in the Social Environment, 26(2), 149.
Use the DSM-5 to read the following:
In Section II, “Other Conditions That May Be a Focus of Clinical Attention.”
Review this reading, which details V and Z Codes; these codes detail systemic influences that may impact the diagnosis and treatment of disorders.
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