SOCW 6090: Psychopathology and Diagnosis for Social Work Practice<\/p>\n
Week 4 (your nursing study bay) Applying Differential Diagnosis<\/p>\n
Post a 300- to 500-word response in which you address the following:<\/p>\n
\u00b7 Provide a full DSM-5 diagnosis of the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.<\/p>\n
\u00b7 Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.<\/p>\n
\u00b7 Identify which four diagnoses you initially considered in the case of the client, using the DSM-5 diagnostic criteria to explain why you selected these four items. In one or two sentences each, explain why three of these diagnoses were excluded.<\/p>\n
\u00b7 Explain any obvious eliminations that could be made from within the neurodevelopmental spectrum.<\/p>\n
\u00b7 Describe in detail how the client\u2019s symptoms match up with the specific diagnostic criteria for the primary disorder that you finally selected for him. Note two other relevant DSM-5 criteria for that illness from the sections on \u201cdiagnostic features\u201d and \u201cdevelopment and course\u201d that fit this case.<\/p>\n
Respond to at least two colleagues in the following ways:<\/p>\n
\u00b7 Compare the diagnosis you provided and the process in which you reached the diagnosis with those of your colleague.<\/p>\n
\u00b7 Explain how the Z codes (other conditions that may be a focus of clinical attention) that your colleague identified may influence the client\u2019s upcoming treatment.<\/p>\n
CASE of ALIM<\/p>\n
Intake Date: August 2020<\/p>\n
IDENTIFYING\/DEMOGRAPHIC DATA: Alim is a\u202f12-year-old male\u202fin 7th grade who lives with his mother, father and brought in for services by his\u202fadoptive\u202fmother. The adoptive parents are upper middle class and have three biological children (ages 9, 7, and 5).<\/p>\n
CHIEF COMPLAINT\/PRESENTING PROBLEM: The mother reported that Alim\u202foften hides\u202ffood in his room\u202fand\u202fgorges himself when he eats. She said she does not understand this behavior because he always has enough food, and she never restricts his eating. In fact, because of his small size and weight, she often encourages him to eat more. Alim sometimes reacts when his lunch is packed differently\u202fwithin his lunch box for school.\u202fHe also seems to pay less attention to teachers and often interrupts class with his own comments.<\/p>\n
HISTORY OF PRESENT ILLNESS: Alim acts younger\u202fthan his 12 years,\u202fcarrying around toy cars in his pockets, which he proudly displays and talks about in detail. Aim\u2019s mom reports that Alim\u202fhates any type of transition and will get upset and have temper tantrums if she does not prepare him for any changes in plans.\u202fHe is reported to kick and hit both parents, and they have had to restrain him at times to stop him from hurting himself and others.<\/p>\n
The parents have never sought help before, as Alim managed to largely keep up with his schoolwork. His mother said that he has\u202falways taken things literally,\u202fbut up until 6th grade, he had attended school without major problems. They had not been concerned about his grades or lack of friends. His mother said that he has always been \u201cvery shy\u201d and\u202fnever had a \u201cbest friend.\u201d He has always shown\u202finterest in cars, trains, and trucks.\u202fRecently, behaviors at school changed and worsened.\u202fHis school has complained of his inability to focus and the increase in his disruptive behaviors.<\/p>\n
Collateral contact with his teachers confirmed that\u202fhe struggles with school, has no friends, and often has \u201cmeltdowns\u201d when he does not get his way.\u202fOne teacher noted that in small group classroom activities, Alim has trouble with restlessness and will stumble over his words, pause excessively, and restart talking fairly rapidly and loudly. In 6th grade his teachers were concerned about occasional facial \u201ctics\u201d that occurred at times. His teachers commented that\u202fAlim talks more about World War II topic (sample nursing essay examples by the best nursing assignment writing service)s than any other topic (sample nursing essay examples by the best nursing assignment writing service).<\/p>\n
PAST PSYCHIATRIC HISTORY: Alim had never had any testing for special education, nor had he ever received any counseling services.<\/p>\n
SUBSTANCE USE HISTORY: No substance use is reported.<\/p>\n
PAST MEDICAL HISTORY: Alim is very small in stature, appearing to be only 8 years old. His parents report that Alim was given all the vaccines required to attend school.<\/p>\n
FAMILY HISTORY INCLUDING MEDICAL AND PSYCHIATRIC: Alim was\u202fadopted at age 3\u00bd\u202ffrom an orphanage in Haiti. The orphanage knows little about his early developmental milestones, but Haitian staff noted that\u202fAlim\u2019s language was far less developed\u202fthan that of his peers at the time of his adoption. The mother stated that Alim came to the United States not knowing any English. She knows very little about his family of origin other than that he lived with his\u202fbiological parents until age 2 and then lived in the orphanage\u202funtil he was adopted. She reported that the\u202fplane ride\u202ffrom Haiti was horrible and that Alim\u202fcried the entire flight and refused to sleep for the first 2 days\u202fthey had him. They tried holding him, but he would not quiet down.<\/p>\n
CURRENT FAMILY ISSUES AND DYNAMICS: Alim is reported to often\u202fget upset with his siblings and hit or kick them.\u202fHis mother stated that Alim has always had issues with jealousy, and when her other children were younger, she had to closely monitor him when he was around them. She reported several occasions when she found\u202fAlim attempting to suffocate each of his younger siblings\u202fwhen they were babies. Alim\u2019s mother explained this as part of his \u201calways being immature\u201d and not good at explaining himself. Besides this, his mother reported that he is not a \u201cmean\u201d child but tends to\u202ffunction according to his own rules.\u202fHe often needed reminders to use his \u201cindoor voice\u201d and to \u201cwait his turn to speak.\u201d<\/p>\n
Initially Alim\u2019s parents were unsure what to do about their son\u2019s behaviors. His mother is the primary caretaker and his father thought she should handle any therapy or problems related to school. His mother reported that she was now \u201cat the end of her rope\u201d and was ready to give her son up to foster care. Both parents are exhausted. Alim\u2019s mother shared her frustration with Alim\u2019s father, who \u201cjust does not understand how hard it is to care for him.\u201d<\/p>\n
MENTAL STATUS EXAM: During this intake, the school social worker met briefly with Alim alone. During this time, he was\u202fclearly restless, appeared anxious, and avoided her in the room. He was very slow to engage with her and\u202fwas distracted by his pocket toys, which he fingered. He had\u202fpressured speech and some facial tics\u202fand was unable to keep his legs still during the interview.\u202fWhen he did engage, he chose to play a board game during his time in the session and he talked\u202fin detail about World War II\u202fand each of the boats in the game. His hand was in his pocket fingering toys at some moments. When asked how he knew so much about all the warships, he stated that he often\u202fwatched television documentaries on the subject. Once on this topic (sample nursing essay examples by the best nursing assignment writing service) he took less time to respond and spoke at length. Alim appeared oriented to time and place. His voice in this interview was somewhat monotonic and repetitive of his interests. He was generally cooperative, and\u202fthe interview passed without incident although it was obvious that he was eager to be \u201cdismissed\u201d from the meeting.<\/p>\n
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\u2013153. https:\/\/doi.org\/10.1080\/10911359.2015.1052913<\/p>\n","protected":false},"excerpt":{"rendered":"
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