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Your client is a 40 year old divorced female who was scheduled to see a mental health provider after being hospitalized for suicide ideation. She recently fight with her boyfriend. She has been pregnant 1 time which she miscarried during her previous marriage. She has had multiple hospitalizations for suicide ideation. She has a twin sister who has depression and anxiety. She drinks 3 mixed drinks daily since age 25. She currently lives alone and has a full-time job as auditor for a local hotel. This is her 4th job in the past 3 years. She has been arrested for assault in the past. She has a 4-year college degree and is in school part-time for her MBA. She has no significant medical history. She had an appendectomy at age 14.
This week you will be learning about personality disorder. Please review the video assigned and complete a comprehensive assessment
training title 27 https;//video.alexanderstreet.com/watch/training-title-27
Assignment: Assessing and Diagnosing Patients With Personality and Paraphilic Disorders
This week’s introduction explained that not all personality patterns represent disorders; it is pervasive patterns that lead to life impairment that meet the criteria for a disorder. Similarly, paraphilic, or sexual, behaviors fall on a spectrum and may or may not meet the criteria for a disorder. Sexual behaviors that could be a symptom of a disorder (e.g., enacting specific fantasies or integrating a fetish object into sexual activity) would only meet the criteria if they were present for more than six months and significantly impacted social or occupational functioning.
For this Assignment, you practice assessing and diagnosing personality and paraphilic disorders by analyzing a case study and completing assessment documentation on the patient.
Photo Credit: [shironosov]/[iStock / Getty Images Plus]/Getty Images
Review this week’s Learning Resources and consider the insights they provide.
Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
By Day 1 of this week, you will be assigned to a specific video case study for this Assignment. View your assigned video case, keeping the requirements of the documentation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.
By Day 7 of Week 9
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Training Title 27. Anonymous Symptom Media, 2016. https://video.alexanderstreet.com/watch/training-title-27 Training Title 27. Anonymous Symptom Media, 2016. https://video.alexanderstreet.com/watch/training-title-27
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template
CC (chief complaint):
Past Psychiatric History:
Caregivers (if applicable):
Psychotherapy or Previous Psychiatric Diagnosis:
Substance Current Use and History:
Family Psychiatric/Substance Use History:
Physical exam: if applicable
Mental Status Examination: