Diagnosis of Trauma- and Stressor-Related Disorders and Dissociative Disorders
Assignment: Diagnosis of Trauma- and Stressor-Related Disorders and Dissociative Disorders
One possible variation where trauma may factor is in dissociative disorders. Although dissociative disorders are not categorized within trauma- and stressor-related disorders, psychological trauma can trigger dissociative disorders and those suffering from trauma- and stressor-related disorders can encounter dissociative symptoms, such as flashbacks.
Thus, diagnosing in this area requires careful attention. In this Assignment, you practice diagnosing in these areas.
Note: Remember that symptoms can occur in many disorders. As a result, all disorders in the DSM-5-TR covered up until this point may factor into your diagnosis (for example, as a possible additional disorder you diagnose).
To Prepare
Review the case study for this week.
Start by familiarizing yourself with the disorders from the DSM-5-TR found in the Learning Resources this Week.
Look within the noted sections for symptoms, behaviors, or other features the client presents within the case study.
If some of the symptoms in the case study cause you to suspect an additional disorder, then research any of the previous disorders covered so far in the course.
This mirrors real social work practice where you follow the symptoms.
Review the correct format for how to write the diagnosis noted below. Be sure to use this format.
Remember: When using Z codes, stay focused on the psychosocial and environmental impact on the client within the last 12 months.
By Day 7
Submit your diagnosis for the client in the case. Follow the guidelines below.
The diagnosis should appear on one line in the following order.
Note: Do not include the plus sign in your diagnosis. Instead, write the indicated items next to each other.
Code + Name + Specifier (appears on its own first line)
Z code (appears on its own line next with its name written next to the code)
Then, in 1–2 pages, respond to the following:
Explain how you support the diagnosis by specifically identifying the criteria from the case study.
Describe in detail how the client’s symptoms match up with the specific diagnostic criteria for the disorder (or all the disorders) that you finally selected for the client. You do not need to repeat the diagnostic code in the explanation.
Identify the differential diagnosis you considered.
Explain why you excluded this diagnosis/diagnoses.
Explain the specific factors of culture that are or may be relevant to the case and the diagnosis, which may include the cultural concepts of distress.
Explain why you chose the Z codes you have for this client.
Remember: When using Z codes, stay focused on the psychosocial and environmental impact on the client within the last 12 months. The case has 1 F code and 2 Z codes.
Week 9 – Case of Ning – 1 F codes 2 Z codes
CASE of NING
INTAKE DATE: April xxxx
IDENTIFYING/DEMOGRAPHIC DATA: Ning is 22-year-old and the oldest child of two working-class parents. Ning has one younger brother, aged 9. Both parents immigrated from China. Ning lives in Boson with her parents. She is finishing up her final year at college. ?
CHIEF COMPLAINT/PRESENTING PROBLEM: “I am having trouble sleeping since I witnessed a stabbing downtown two weeks ago”
HISTORY OF PRESENT ILLNESS: Ning has been waitressing downtown since freshman year at a bar/restaurant to supplement financial aid for tuition. She has very good grades (B+ to A) in college. After leaving her shift 2 weeks ago, Ning was walking to the bus stop and witnessed a man beating up a woman and eventually stabbing the woman. Since then, her grades started slipping and she began missing classes. She reports not having interest in school any longer but wanted to graduate for her parents since she is this close. Ning reports her sleeping is really off. Not sleeping is impacting her ability to wake up in time for school, as well as ability to concentrate. She struggles to get to sleep and often wakes up startled. She also reported being so tired during the day “it interfered with everything”.
When Ning is at work, she cannot stop thinking about what happened and fears leaving at night to go home. The police have taken her statement several times, but she gets a lot of anxiety when needing to talk about the incident. She believes the police get angry with her because she cannot remember some facts about the incident.
PAST PSYCHIATRIC HISTORY: Ning attended some group therapy sessions in college. She had some challenges living an American lifestyle with parents who want her to maintain the culture of the “old country”.
SUBSTANCE USE HISTORY: Ning drinks on weekends with her college and “bar” friends. Ning reports beer bloats her, so she drinks vodka and cranberry juice mixed drinks. Ning denies a problem with alcohol. She stated the last couple of weeks she has been leaning on alcohol to get to sleep.
PAST MEDICAL HISTORY: Ning reports normal childhood illnesses. She has not had any major illnesses.
CURRENT FAMILY ISSUES AND DYNAMICS: Ning’s childhood was otherwise unremarkable. She reported that she has always worked hard at school and generally was an “A” student through high school. She ran track and was involved in many activities, socializing with boyfriends, and a large social circle. She reported no particular difficulties with her parents although they do hold onto the “old” ways. Since this incident, Ning has been very irritable. Her mood varies over the week, and she admitted to chronic anxiety and some tendency to get into “arguments” with her friends, parents, and coworkers.
MENTAL STATUS EXAM: Ning is a well-dressed young lady who looks her stated age. Her mood is depressed, and she lacks eye contact. Her affect is anxious. Motor activity is appropriate. Speech is clear. Thoughts are logical and organized although there seems some confusion at times. There is no evidence of delusions or hallucinations. On formal mental status examination, Ning is found to be oriented to three spheres.
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