Week Five Programmatic Assessment Scenario Abby is a 20-year-old female college student. For at least the last 3 months, Abby has experienced ongoing anxiety and worry without a specific cause for these feelings. She has been restless and has noticed that her muscles feel tense and that these symptoms are beginning to affect her behavior in a way that is causing her to become distressed and that is preventing her from being able to complete her normal tasks. Abby correctly believed that it was normal to feel a little anxious sometimes; however, as the semester has progressed, she has not begun to feel significantly more comfortable. On the recommendation of a friend, Abby visited the university’s counseling center and talked to Dr. Smith. Dr. Smith was warm and welcoming and, after discussing the limits of confidentiality with Abby and obtaining informed consent, encouraged Abby to describe her concerns. Dr. Smith listened attentively and asked Abby a few questions. They both agreed on an appointment date and time for the next week. Dr. Smith gave Abby a homework assignment to keep a written log of the negative thoughts or assumptions she has during the week and the circumstances under which those thoughts occurred. Abby was asked to bring the log with her to her next appointment. Short-Answer Questions Answer the following questions based on the scenario above. Answers should be short and concise. 1. Which DSM-5 disorder matches the symptoms Abby is reporting? Based on the DSM-5, the diagnostic criteria for generalized anxiety disorder (300.02) is excessive anxiety and worry occurring more days that not for at least 6 months, Abby reports feeling anxious for at least 3 months. She meets some of the criteria, such as restlessness, muscle tension, and difficulty concentrating. A provisional diagnosis could be unspecified Anxiety DO (300.00) VS an adjustment DO with anxious mood. The DSM-5 describes adjustment to disorder as emotional or behavioral symptoms in response to an identifiable stressor or 3 months. Stressors within. However, Abbey describes that there is no specific cause for those feelings; there is not enough information provided in the scenario to make a cleat diagnosis. 2. Which theoretical model does the homework assigned by Dr. Smith match? 3. If Dr. Smith recommended medications only, which theoretical model would this match? 4. If Dr. Smith recommended medications in addition to therapy, which theoretical model would this match? 5. If Dr. Smith completed a free association exercise with Abby, which theoretical model would this match? 6. If Dr. Smith used unconditional positive regard in the treatment, which theoretical model would this match? 7. If instead of the symptoms listed in the scenario, Abby reported the following: She had been in a car accident where she feared for her life. She had sleep disturbances including nightmares and became uncomfortable at the thought of driving, to the point that she avoided driving. She now believes she is a horrible driver, although her friends assure her this is not true. If these symptoms have lasted for longer than a month, which DSM-5 disorder label might match her symptoms? 8. If instead of the symptoms listed in the scenario, Abby reported the following: Every day for the past 2 weeks she felt down or sad for most of the day, had noticed an increase in her appetite, had been unable to sleep or concentrate, and felt tired. Additionally, this was interfering with her goals and tasks, and she reported that she had never felt manic or hypomanic. Which DSM-5 disorder label might match her symptoms? 9. If instead of the symptoms listed in the scenario, Abby reported the following: Every day for at least the past week she felt irritable with persistently increased energy and talkativeness, was easily distracted, did not seem to need sleep, and noticed that this behavior was interfering with her job. She reported that she has felt these symptoms before in her past and that she has also felt depressed sometimes. Which DSM-5 disorder label might match her symptoms? 10. If instead of the symptoms listed in the scenario, Abby reported the following: Throughout her life, she has always been suspicious of others. She reports that she really would like to have good relationships, but even as a child she knew that others, including family members, could not be trusted. She feels that she needs to stay on guard to protect herself. Which DSM-5 disorder label might match her symptoms? 11. If instead of the symptoms listed in the scenario, Abby reported the following: She began drinking when she was 18 and now needs to drink more or higher concentrations of alcohol to continue to function. She reports that she has lost her part-time job because of her drinking and is in danger of failing out of college. She was hospitalized last weekend due to experiencing delirium tremens during withdrawal, and the doctor explained to her that she could die from this disorder. Abby recognized that her drinking was interfering with her life, and she knew that she did not want to die. Which DSM-5 disorder label might match her symptoms? 12. If instead of the symptoms listed in the scenario, Abby’s former roommate reported the following: During a significant portion of the past month, Abby had talked to herself out loud and told her roommate that she had heard voices telling her to harm herself. Her roommate reported that Abby had told her that she occasionally stated that she was Joan of Arc and that the school mascot was stalking her. Her roommate asked to change rooms, and now that Abby was living alone, she did not appear to have bathed in more than a week. This was not typical behavior for Abby, as she had been known to be meticulous with her appearance and hygiene. The roommate expressed her concern for Abby and stated that although she had noticed some of these behaviors since she first met Abby more than 6 months ago, the behaviors seem to have increased over the past month. Which DSM-5 disorder label might match her symptoms? 13. If Abby were 5 years old and, instead of the symptoms listed in the scenario, her symptoms included nightmares, physical complaints, recurrent separation-related fear, and a refusal to leave home, what DSM-5 disorder label might match her symptoms? 14. If Abby were 67 years old, and instead of the symptoms listed in the scenario, had no major medical issues, had never been diagnosed with a neurocognitive disorder, and her symptoms included a substantial decline in the cognitive functioning areas of memory and attention that interfere with her independence, what DSM-5 disorder label might match her symptoms? 15. Dr. Smith discussed the limits of confidentiality and required Abby to sign an informed consent form before treatment. These are examples of items used to protect the patient’s ______________.
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