Anna O’Reilly is a 32 year old medical secretary and is referred to you for treatment of depression. She confides that the reason she is depressed is that for the last five months she has been afraid that she will urinate in public. She has never actually done this, and in the safety of her own home she considered the idea that she will actually do this to be nonsensical.
When Anna is away from home, fear dominates her thinking, and she takes precautions to prevent it from happening. She always wears sanitary napkins, never travels far from home, limits her intake of fluids, has stopped drinking alcohol, and has had her desk at work relocated near a bathroom. For the 2 weeks before she sees you, she was unable to go to work because the fear had become so intense.
She vaguely recalls that her deceased father had a fear of urinating in public. Before leaving for work each day, he would urinate several times and avoided drinking any fluids. Her younger sister had been successfully treated for a cleaning ritual in which she had to wash first her left hand and then her right hand exactly 10 times without touching the sides of the sink (probably Obsessive-Compulsive Disorder).
Anna had psychiatric treatment 10 years earlier, when she began to fear that she had contracted syphilis, even though there was no clinical or laboratory evidence of infection. Prior to 5 months ago, she never feared that she would urinate in public. In addition to this specific feal, she has always been anxious and insecure- and considered by her family to be overly cautious and perfectionistic. For the past year, she has been upset about her boyfriend’s impending return to Pakistan (he is currently completing his medical studies). She was divorced five years ago and is now living with her 7 year old son and her mother. Her mother disapproves of her boyfriend and Anna has felt increasing pressure to end the relationship. She believes that the onset of her current difficulties coincide with the stress of her relationship with her mother and the threat of her boyfriend’s departure from the country.
When interviewed, Anna is visibly anxious. She remarks that she has been feeling despondent about her problems. She has trouble sleeping and has no energy during the day. Although her appetite is poor, she has not lost any weight
Assignment Instructions & Information
Students will complete a case conceptualization for a given vignette.
- APA formatting is required, sample APA paper is attached in this module
- Must be at a minimum of 5 pages in content length, not including title page and reference page
- Title page is required
- Reference page is required
- Abstract is NOT required
For full credit, paper must include:
- A comprehensive diagnosis for the client (using DSM-5 TR)
- Must include ICD diagnostic codes
- Appropriate and thorough description of the diagnosis you have chosen for your vignette
- Include specifiers, if applicable
- Appropriate differential diagnosis
- Show an understanding of biological and neurological impacts on presenting symptoms
- Include a discussion of what medications the client might expect their psychiatrist to provide (if appropriate)
Suggested Sections for Paper
- Case Conceptualization
- Rationale for diagnosis(clearly describe each symptom and how you arrived at your diagnosis). Make sure in this section that you show that you’ve used your DSM-5 to make the diagnosis. Example: If the DSM-5 says you need 2 or more symptoms for a diagnosis- state this and then state your 2 symptoms
- Differential Diagnosis
- Treatment & Potential Medication (if you need more content to make it to 5 pages, use research/text to put applicable treatments for the disorder that have been shown to help) (i.e. CBT for a trauma disorder etc.)
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