Vignette 3

This assignment focuses on vignette analysis and direct application of course concepts to the persons and situations presented in the vignette for each question. All discussions must take into account the legal and ethical considerations, as well as issues of culture and human diversity that may pertain to the situation presented below. Legal, ethical and cultural information are the course text. Cultural information is also in the DSM 5. You may use alternative resources for culture, law and ethics to enhance your work. You are required to use current, evidence based research taken from professional journals, to support the text material

Use the reading assignments thoroughly in an integrative discussion. You are also required to use evidence-based research to support and enhance the text information. A minimum of three (3) current research articles must be included. Remember to reference all work cited or quoted, in APA format.

Please keep your responses focused on what is presented in the vignette. Do not add information but use your creativity to support what you see in the vignette as written. Avoid elaborations and assumptions. This assignment MUST be typed, double-spaced, in APA style, and must be written at graduate-level English.

To complete the Vignette Analysis, please use the DSM 5 criteria

Assignment should be 5 pages total plus a title and reference page
Do not include the vignette in your response

Please review the Sample Vignette located under Resources

Please use grading rubric!

Vignette Three

Arthur is a 35-year old Middle-Eastern male who lives with his partner Gerald. Arthur works as a bus driver. Last year, he was admitted to the psychiatric unit at the local general hospital by his primary care doctor. At that time, he reported hearing voices of three acquaintances discussing turning him into a “zombie” or statue, and then using him “for their evil deeds because I am gay.” After 3-days of evaluation and observation, his symptoms subsided. He was discharged as stable with no medication.

Arthur remained asymptomatic for four months post hospitalization until he experienced an incident in which his life was threatened by taxi drivers which Arthur believes was a hate crime. He reported hearing voices and was once again admitted by his primary care doctor to the psychiatric emergency unit for three days. As with his first hospitalization, the symptoms settled down after 36 hours, and he was discharged as stable, again, on no medication.

Now, two months later, Arthur comes to see you, accompanied by Gerald who would like another evaluation. Gerald reports that Arthur is up pacing the house at night muttering to himself. Arthur tells you, that he is “bewitched by three acquaintances, as they are jealous of me. They control my thoughts and actions, which causes me to become extremely fearful. I fear they may blind me while I am driving the bus, and all my passengers may be killed.”
Arthur hears voices of three people planning to kill him. The voices have a “congress meeting” in which they discuss him; at other times they speak directly to him and give him instructions. The week prior to this episode of auditory hallucinations, he reports feeling very fearful and apprehensive, as if he had done something wrong. He was unable to work and despite wanting to sit quietly he felt restless. The duration of the auditory hallucinations had been approximately ten days. Arthur admits to “a bit of an amphetamine problem” in the past, but denies any use in recent years. He reports excessive drinking in the past, but that his last use of alcohol was two months ago. He does admit to being treated with antidepressant medication in past years, for what he describes as “awful depressive episodes which forced me to take a leave of absence from work. I couldn’t get out of bed in the morning.” While Arthur admits to current depressive mood swings, he denies they are as severe as they were in the past.

1. Given what you see in the vignette, with consideration of a differential diagnosis formulation, what comorbid disorders may exist? What additional information would you need to confirm your diagnostic impressions. Choose one provisional diagnosis for Arthur. Support your provisional diagnosis by comparing the DSM-5 diagnostic criteria to vignette content. (See Sample Vignette Analysis located under Resources for guidance)
2. Choose 1 theoretical model to explain how you conceptualize Arthur’s clinical presentation. From the perspective of this theoretical model, discuss how you would provide clinical treatment for Arthur. Integrate vignette content thoroughly in your treatment plan.
   (Remember to consider culture, law and ethics when diagnosing and treating)

Additional resources:

https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/assessment-measures#Level1

American Psychiatric Association (2013). DSM-5 Diagnostic and Statistical Manual of Mental Disorders. (5th ed). Arlington, VA ISBN 978-0-89042-555-8

Book
Sue, D., Sue, D. S., Sue, D., & Sue, S. (2016). Understanding Abnormal Behavior. (11 ed). Stamford, CT Cengage. 9781305088061