Diagnostic Skill Application I

Diagnostic Skill Application I
The Case of Marisol:
Marisol is a 40-year-old single female from a tight-knit Puerto Rican family. She is employed full time as a data analyst for a technology company. She has steadily progressed in her career by working for relatively small companies, where her role allowed her to work relatively independently. Unfortunately, working for small organizations was less stable financially, so she has been working for a larger company for the past four years. Interacting with a larger work group has challenged her comfort zone. She prefers to spend time with a network of close friends she has known most of her life, with whom she visits one-on-one. Her family lives in the area, and she sees them frequently. Her parents and older brother have always provided a support system and practical help. She enjoys quiet evenings alone or at the home of her brother and his family. Her friends and family privately wonder why she has never dated or wanted to travel.

Interview of Marisol
Marisol: I don’t know why it happens to me but anytime I go out with friends or do something related to work, I get so panicky and I get so anxious. I can’t think. It’s ridiculous. I know it’s irrational. I know that, I don’t know, maybe I don’t know. I get all excited, I get panicky, I don’t want to see people. I think they’re all looking at me. I go to a function, I walk in and as soon as I walk in, I’m walking out the door. I get all flustered. I mean, it’s hard to be like this. I don’t want to be this way. I fear what people are gonna say about me, to me. It’s something like I could walk out of a restaurant and the toilet paper is in my skirt or something and I got spinach in my teeth.
Now, does that happen? I’m always looking to check that nothing’s there. Like now, coming to talk to you, I couldn’t even get out of my car because I knew that they had so many people in the lobby. I want to be different. It’s affected me so badly, I was up for a promotion and I couldn’t even take it because it required me to talk to everyone and what were they gonna say about me? I don’t know. What were they gonna say?

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The Case of Jenny:
Jenny is a 29-year-old single female who lives with her mother. She is bisexual, but is not currently dating. Jenny was recently in a relationship with a man, and they lived together briefly. They parted amicably when they just did not seem to be enjoying being together. Jenny moved back in with her mother, Barbara, to allow her boyfriend to take in a roommate to cover her share of the rent. She works as a bank teller and makes a modest income. She felt moving back home would allow her to provide some financial help to her mother. Jenny’s mother raised her as a single parent. Jenny and Barbara have shared many ups and downs over the years. Things were never easy, but they always made it through. Barbara is becoming increasingly concerned that Jenny is giving up on life and needs to snap out of it.
Interview Jenny
Jenny: It’s just been happening for a long time. It seems like it’s been forever, but I guess it’s been at least the last several months. I feel like my mom has been hounding me about stuff for a long time, so maybe it’s been longer. I don’t know, but I really try to go … I really try, I felt like I tried to do so many different things to feel better, and I just can’t feel better. It’s just this dark cloud constantly follows me around, and no matter what I do, everything goes wrong. My mom thinks it’s just so easy. Go out with your friends, or go out on a date, or you just need to be out around people, but I don’t even know what I would say to people, because I just have no motivation to even be around them, so when you don’t have motivation to be around people, what do you say? Sometimes I’m just too tired because I don’t know how this is possible, but I’m in bed a lot. When I get home from work, I take a nap. It’s, I don’t know, usually until like eight o’clock.
Then I’ll get up, and I’ll try to eat a little something, but I never really feel all that hungry, and then what else is there to do? I just go back to sleep, but I still feel tired all the time, and it’s really tough for me to make it through the day. It seems like everything I try to do just doesn’t work out, and everybody just tells me to, why don’t you just go shopping, or why don’t you do this, or you need to eat better, or you got to get out of bed, or you got to find something you enjoy doing, but I’m just not … I just have no energy, and that’s what they don’t get. I just have no energy. It seems like a long time ago, I loved doing some things, and I loved going outdoors, and take walks, and I liked going out with my friends, but now, nothing. It seems like nothing’s interesting, nothing’s … It just seems like things are hopeless, and the more effort I make, the worse things get.
I don’t work on the weekend, so I end up sleeping a lot, and a lot of times I just think, “What’s the point? Why even bother?” I don’t know what I can do. I don’t know, so I just think, why bother? I don’t like when I think that, but I just can’t help it, and I try to talk to my mom, but she just doesn’t want to hear it, and she just thinks I’m … I think the word lazy has come out of her mouth at least 50 times just this past week, so I just don’t know what to do from here.

For each case study, you will complete a descriptive diagnosis using tools you select from the list of assessment tools provided later in the assignment. Each case requires the following information to be addressed:
• Identify presenting concerns from the client’s perspective as described in the video and accompanying narrative. Include relevant cultural and systemic considerations that frame the client’s presentation.
• Describe what information has been provided in each case that helps to determine which disorders are appropriate for consideration (differential diagnoses) for a final diagnosis. Evaluate how at least one assessment tool, which is listed in the List of Assessment Tools resource, will aid in obtaining further information to back up your final diagnosis. The Differential Diagnosis Decision Tree may be helpful to guide this process.
• Present DSM-5 and ICD-10 codes, including relevant Z codes.
• Provide a descriptive rationale for the DSM diagnosis that best fits the information provided including relevant ICD codes. This should be written in a narrative form using complete sentences. Support your rationale with scholarly sources. Optional readings found in the course syllabus may be particularly relevant.
• Determine if a medication consultation is appropriate and provide a rationale with support from scholarly sources.

Template:

Unit and Assignment Title
Review paper guidelines on page requirements and number of sources required. Unless citing a classic work, aim to cite research articles and texts published within the past 5 years. When you finish writing your paper, reread it to check for errors and make sure your ideas flow well.
Presenting Concerns: Case of Jenny
Provide a summary of the most relevant symptoms that seem to be causing Jenny the most distress or danger because they deviate from normal and represent dysfunction. Include how these symptoms may have a biological or neurological basis. The Distinguished criterion is
“Identifies the main symptoms observed in people who are experiencing psychological disorders and provides specific examples to support the explanation.” This should be presented in full sentences formatted in a paragraph.

Differential Diagnosis: Case of Jenny
Summarize how you moved through the process of selecting the diagnoses that are possibilities that need to be considered. Use the appropriate decision tree from the Differential Diagnosis by the Trees: DSM-5 Handbook of Differential Diagnosis.
The Distinguished criterion is “Identifies the methods used for differential diagnosis in two case studies including the application of a DSM decision tree.” This should be presented in full sentences formatted in a paragraph.

Symptom Checklists: Case of Jenny
You are encouraged to consider the List of Assessment Tools at the end of this document described in the optional articles listed. The Distinguished criterion is “Describes the application of specific symptom checklists appropriate to each case with clear connection to the differential diagnosis.”

Systemic Assessments: Case of Jenny
You are encouraged to select an assessment described in Hamilton and Carr (2016) assuming that Jenny presents for treatment with her mother. The Distinguished criterion is “Describes the application of specific assessments relevant to marriage, couple, and family therapy appropriate to each case supported by scholarly literature.”

DSM and ICD Diagnosis: Case of Jenny
Address the Distinguished criterion “Applies the current DSM and ICD to the diagnosis of a focus client seen in family therapy and an additional family member, and providing support for diagnostic choices”. List the code for both the current DSM and ICD. A chart listing ICD codes that correspond to DSM can be found at: https://www.psychiatry.org. After you list the diagnosis and applicable V or Z codes that provide a context, explain how you came to decide the diagnosis is appropriate in a paragraph.

Medication Referral/Consultation: Case of Jenny

Address the Distinguished criterion “Describes the role of psychopharmacological medications for appropriate medical referral and consultation and incorporates relevant examples.” Describe whether a referral for a medication consultation is appropriate for Jenny specifically. This should be presented in full sentences formatted in a paragraph citing scholarly sources.

Presenting Concerns: Case of Marisol
Provide a summary of the most relevant symptoms that seem to be causing Marisol the most distress or danger because they deviate from normal and represent dysfunction. Include how these symptoms may have a biological or neurological basis. The Distinguished criterion is
“Identifies the main symptoms observed in people who are experiencing psychological disorders and provides specific examples to support the explanation.” This should be presented in full sentences formatted in a paragraph.

Differential Diagnosis: Case of Marisol
Summarize how you moved through the process of selecting the diagnoses that are possibilities that need to be considered. Use the appropriate decision tree at from the Differential Diagnosis by the Trees: DSM-5 Handbook of Differential Diagnosis.

The Distinguished criterion is “Identifies the methods used for differential diagnosis in two case studies including the application of a DSM decision tree.” This should be presented in full sentences formatted in a paragraph.

Symptom Checklists: Case of Marisol
You are encouraged to consider the List of Assessment Tools at the end of this document described in the optional articles listed. The Distinguished criterion is “Describes the application of specific symptom checklists appropriate to each case with clear connection to the differential diagnosis.”

Systemic Assessments: Case of Marisol
You are encouraged to select an assessment described in Hamilton and Carr (2016) assuming that Marisol presents for treatment with her brother and parents. The Distinguished criterion is “Describes the application of specific assessments relevant to marriage, couple, and family therapy appropriate to each case supported by scholarly literature.”

DSM and ICD Diagnosis: Case of Marisol
Address the Distinguished criterion “Applies the current DSM and ICD to the diagnosis of a focus client seen in family therapy and an additional family member, and providing support for diagnostic choices.” List the code for both the current DSM and ICD. A chart listing ICD codes that correspond to DSM can be found at the APA website listed in the assignment resources. After you list the diagnosis and applicable V or Z codes that provide a context, explain how you came to decide the diagnosis is appropriate in a paragraph.

Medication Referral/Consultation: Case of Marisol
Address the Distinguished criterion “Describes the role of psychopharmacological medications for appropriate medical referral and consultation and incorporates relevant examples.” Describe whether a referral for a medication consultation is appropriate for Marisol specifically. This should be presented in full sentences formatted in a paragraph citing scholarly sources.

References
Hamilton, E., & Carr, A. (2016). Systematic review of Self‐Report family assessment measures. Family Process, 55(1), 16-30. doi:16)10.1111/famp.12200
Path Analysis of the SCL-90-R Exploring Use in Outpatients Assessment ( 2014) Grande, Newmeyer, Underwood & Williams III
Anxiety Symptom Checklist
PREVATT, F. et al. Anxiety Symptom Checklist. PsycTESTS, [s. l.], 2015. DOI 10.1037/t39906-000. Disponível em: http://search.ebscohost.com.library.
Beck Anxiety Inventory
Beck, A. T., Epstein, N., Brown, G., & Steer, R. (1988). Beck Anxiety Inventory[Database record]. APA PsycTests.

Symptom Checklist-90 Revised ( SCL-90 R)
DEROGATIS, L. R. Symptom Checklist-90–Revised. PsycTESTS, [s. l.], 1977. DOI 10.1037/t01210-000. Disponível em: http://search.ebscohost.com.
Differential Diagnosis by the Trees
https://doi-org.library.capella.edu/10.1176/appi.books.9781585629992.mf02

Meta-Analysis of the English Version of the Beck Depression Inventory–Second Edition
Bradley T. Erford, Erin Johnson, Gerta Bardoshi

Assessment & Diagnosis
Psychometric Meta-Analysis of the English Version of the Beck Anxiety Inventory
Gerta Bardhoshi, Kelly Duncan, and Bradley T. Erford 2016

Beck, A. T., Epstein, N., Brown, G., & Steer, R. (1988). Beck Anxiety Inventory. Psyctests, doi:10.1037/t02025-000

Bardhoshi, G., Duncan, K., & Erford, B. T. (2016). Psychometric meta‐analysis of the English version of the Beck Anxiety Inventory. Journal of Counseling & Development, 94(3), 356–373.

Review this source to review how to interpret the Beck Anxiety Inventory.
Derogatis, L. R. (1977). Symptom checklist-90–revised. Psyctests, doi:10.1037/t01210-000

Grande, T. L., Newmeyer, M. D., Underwood, L. A., & Williams, C. R. (2014). Path analysis of the SCL-90-R: Exploring use in outpatient assessment. Measurement and Evaluation in Counseling and Development, 47(4), 271–290.
Review this source to review how to interpret the SCL-90-R.
Prevatt, F., Dehili, V., Taylor, N., & Marshall, D. (2015). Anxiety Symptom Checklist. Psyctests, doi:10.1037/t39906-000

Beck Depression Inventory–II
Erford, B. T., Johnson, E., & Bardoshi, G. (2016). Meta-analysis of the English version of the Beck Depression Inventory–Second edition. Measurement and Evaluation in Counseling and Development, 49(1), 3–33.

Meta-Analysis of the English Version of the Beck Depression Inventory–Second Edition
Bradley T. Erford, Erin Johnson, Gerta Bardoshi

Assessment & Diagnosis
Psychometric Meta-Analysis of the English Version of the Beck Anxiety Inventory
Gerta Bardhoshi, Kelly Duncan, and Bradley T. Erford 2016

Beck Anxiety InventoryBeck, A. T., Epstein, N., Brown, G., & Steer, R. (1988). Beck Anxiety Inventory. Psyctests, doi:10.1037/t02025-000
Bardhoshi, G., Duncan, K., & Erford, B. T. (2016). Psychometric meta‐analysis of the English version of the Beck Anxiety Inventory. Journal of Counseling & Development, 94(3), 356–373.
Review this source to review how to interpret the Beck Anxiety Inventory.
Derogatis, L. R. (1977). Symptom checklist-90–revised. Psyctests, doi:10.1037/t01210-000
Grande, T. L., Newmeyer, M. D., Underwood, L. A., & Williams, C. R. (2014). Path analysis of the SCL-90-R: Exploring use in outpatient assessment. Measurement and Evaluation in Counseling and Development, 47(4), 271–290.
Review this source to review how to interpret the SCL-90-R.
Prevatt, F., Dehili, V., Taylor, N., & Marshall, D. (2015). Anxiety Symptom Checklist. Psyctests, doi:10.1037/t39906-000
Beck Depression Inventory–II
Erford, B. T., Johnson, E., & Bardoshi, G. (2016). Meta-analysis of the English version of the Beck Depression Inventory–Second edition. Measurement and Evaluation in Counseling and Development, 49(1), 3–33.

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