psy 6210 unit 9 assignment 1

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Capella University *

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6210

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Psychology

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Feb 20, 2024

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PSY6210 Case Study Response Guide Use this outline to structure your case assignments. 1. Case Summary-Kim Part 2 Kimberly and her mother, Diana, offered more relevant information in their second interview, which helped the case. The second meeting includes Kimberly and her mother, Diana. Kimberly had a distinct vibe from her first meeting. She has increased anxiousness, trouble focusing, and tense movements. Diana revealed in a confidential conversation that the pharmacists called her to say Kimberly had tried to buy a lot of cold medications. Diana says she found anhydrous ammonia and batteries in Kimberly's trunk. Diana confidentially stated that neighbors had seen Kimberly with much money, which is surprising given her terrible financial management. Diana worries that Kimberly will commit suicide after the discovery. Diana urges Kimberly to be hospitalized immediately, citing her research on eating disorders and suicide. Kimberly was unresponsive when interviewed. With increased anxiousness and involuntary muscle spasms, her temperament and look changed significantly from the first session. The client appears tense, unable to concentrate, and on edge. Kim's expression does not match her indifference. Her mother said she tried to buy a cold medication and was seen around town with lots of cash. Her mother found batteries and ammonia, among other strange materials. Kimberly seems jittery and resistant to questioning. Concentration seems complicated for her. Evaluations have not yet been reported. Her mother has read about eating disorders and believes this is the problem. 2. Clinical Impression (Diagnosis) Write the clinical impression in the DSM-5 format: 313.81 (F91.3) Oppositional Defiant Disorder Mild (R/O) (APA, 2022) 305.70 (F15.10) Amphetamine-type substance (Provisional Diagnosis) 307.1 (F50.01) Anorexia Nervosa Restricting type (Provisional Diagnosis) OTHER FACTORS: V61.20 (Z62.820) Parent-Child Relational Problem V62.3 (Z55.9) Academic or Educational Problem V15.89 (Z91.89) Other Personal Risk Factors V15.59 (Z91.5) Self-Harm 3. Recommendations A regular pattern of oppositional, disobedient, and angry behavior directed at authority figures defines oppositional defiant disorder (ODD). These symptoms are often accompanied by emotional instability and angry outbursts. They argue with grownups and purposefully annoy others. They possess high degrees of impatience, sensitivity, and wrath and struggle to manage intense mood swings and low frustration tolerance. The severity and personal adaptation of ODD differ from comorbidity (Marco et al., 2013). Kimberly should be evaluated for substance use as her condition has changed since her last appointment. I also recommend that Kim obtain a complete medical exam to assess her health. Psychotherapy would help determine the source of her behavioral changes or drug use. I propose that Kim get a drug test the same day to confirm her drug use. A family therapy session would also be helpful. Stimulant use disorder 1

sufferers may steal, prostitute, or sell drugs to get money or narcotics (APA, 2022). The source of Kim's significant funds is unknown. However, this cash may have been obtained by drug trafficking, prostitution, or other commodification for profit. Kim's funding would be my question. I would ask Kim about the stuff her mother found and why she keeps them. I would ask her mother about Kim's sleep and absences. I would ask her mother about drug misuse or self- destruction in her family. Kim's trauma history is also worth asking. Answer assignment guidelines' specific questions. Explain how fresh knowledge affects the initial case study drawing. Discuss diathesis-stress paradigm use. Now that we know Kim allegedly produced methamphetamine, our comprehension of the issue has changed. Her weight loss may be due to an eating disorder. The markings her mother mentioned may be burn injuries from drug manufacture or use. Due to insufficient data, my diagnosis theory is preliminary. Her mother or father can confirm that she meets other diagnostic criteria. Dialectical Behavior Therapy (DBT) treats ODD symptoms such as emotional instability, low frustration tolerance, interpersonal issues, and impulsivity. In teenagers with ODD, DBT may be a promising treatment. Initial research suggests that DBT is helpful (Marco et al., 2013). 4. Questions Address the specific questions that were asked in the instructions for this assignment. Here is a sample assignment question and an appropriate brief response: Question: Describe further information you would need to diagnose this case accurately. Response: Individuals afflicted with stimulant use disorder may engage in theft, prostitution, or drug trafficking as a means to obtain drugs or funds for drugs (APA, 2022). Currently, the source of Kim's substantial funds remains unknown. However, it is worth mentioning that these funds may have been acquired by illicit means, such as involvement in drug trafficking, engaging in prostitution, or other forms of exchange for monetary gain. I would inquire about the source of Kim's financial resources. I would ask Kim directly about the exact nature of the goods her mother has discovered and the rationale behind her possessing them. I would inquire with her mother regarding Kim's sleep patterns and the duration of her absences from home. I would inquire with her mother about the presence of any familial background of drug abuse or suicidal tendencies. I would inquire about Kim's history of trauma as well. Respond to the precise inquiries outlined in the assignment's guidelines. Explain the impact of the additional knowledge on the portrayal depicted in the original case study. Ensure to discuss the potential application of the diathesis-stress paradigm. This newly acquired information significantly changes the situation as we now possess knowledge of Kim's involvement in the suspected production of methamphetamine, which might perhaps explain her weight reduction as a result of an eating disorder. The marks that her mother earlier described could potentially be attributed to burns resulting from drug production or bodily manifestations stemming from drug consumption. The provisional diagnosis requires additional information to support my new hypothesis on her diagnosis. By obtaining information from either her mother or father, it can then be ascertained that she fulfills further requirements for the diagnosis. 2

PSY6210 Case Study Response Guide Use this outline to structure your case assignments. 1. Case Summary-Kim Part 3 Kim's mother seemed to have changed her mind about her actions this session. It is revealed that she drove the family automobile across the garden due to unfamiliarity with the type of car. Kim's mother also said the housekeeper's narrative was one-sided. She keeps her grandmother's jars nearby because they are unique. She becomes tearful talking about her friend Celia, whom she has not seen. She does not think her mother would understand their intimate friendship. Kim explains her arm marks due to wire cuts during three weekly bridge visits, "trying it on for size." Kim also said she lost her appetite, which may have contributed to her weight loss. Part three of Kimberly's case provides valuable information. Kimberly attends this meeting with her mother. Diana examined old jars with vegetable canning residue before the session. After meeting Diana alone, she modifies her stories. Diana has altered her earlier story of Kimberly chipping instead of shattering the furniture. Diana admits she missed Kimberly's relationship with the housekeeper. More details of the Rose Garden automobile accident reveal that Kimberly accidentally put the car in reverse instead of driving, landing her in the rose bushes. Diana also fears an eating disorder like her older daughter and wants to prevent it in Kimberly. This time, Kimberly agreed to be questioned alone. After being asked about the old canning materials, Kimberly opened up. She was close to her recently deceased grandmother. Kimberly says her grandmother always accepted her and that her passing hurts. Kimberly describes her friendship with Celia. Since she has depression, she spends much time with Celia in the cabin and feels connected to her. Kimberly is deeply affected by Celia's recent withdrawal. Kimberly sheds emotions over missing Celia for nearly a week. When asked about her diet, she says she is not hungry. When asked about her arm marks, she says they were unintentional and created by scaling a fence and that she would never hurt herself. 2. Clinical Impression (Diagnosis) Write the clinical impression in the DSM-5 format: 296.32 (F33.1) Major Depressive Disorder Moderate w/ melancholic features (Provisional) 313.81 (F91.3) Oppositional Defiant Disorder Mild (R/O) (APA, 2022) OTHER FACTORS: V62.82 (Z63.4) Uncomplicated Bereavement V15.59 (Z91.5) Personal History of Self-Harm V61.20 (Z62.820) Parent-Child Relational Problem 3

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3. Recommendations Major depressive disorder (MDD) is a prevalent and chronic condition characterized by recurrent recurrences. It has the fourth position in the ranking of medical and psychiatric problems in terms of its impact on persons and is widely recognized as the primary source of disability (Berking et al., 2013). I suggest the establishment of a suicide prevention initiative that is specifically customized for Kim, in addition to providing the contact information for the suicide prevention hotline. I suggest undergoing a medical assessment to investigate her weight loss further. I suggest engaging in family therapy with Kim's parents to enhance their understanding of her relationship with Celia, particularly from her mother's standpoint. Family therapy will deepen the family's comprehension of the underlying causes behind her depression and the driving forces behind her hoarding behavior with the jars. A prescription for a drug screening remains necessary. Considering the evident change in her conduct, it would be advisable to suggest grief therapy as a response to the passing of her grandmother. Cognitive Behavioral Therapy (CBT) combined with systematic Emotional Regulation Training (ERT) has the potential to enhance the effectiveness of existing therapies for Major Depressive Disorder (MDD). This statement should catalyze further investigation into the prospective advantages of augmenting adaptive emotional regulation skills in those afflicted with depression. To be more precise, it is recommended that future research initially concentrates on identifying specific emotional regulation (ER) skills that are particularly effective in preventing and managing depression. Subsequently, interventions should be developed and evaluated to enhance these skills most effectively. Finally, it is essential to determine how these interventions can be integrated into empirically validated treatments for depression (Berking et al., 2013). 4. Questions Address the specific questions that were asked in the instructions for this assignment. Here is a sample assignment question and an appropriate brief response: Question: Describe further information you would need to diagnose this case accurately. Response: Including Kim's behavior data significantly modifies the overall perception. According to our sources, during the previous session, it is possible that Kim's mother provided exaggerated descriptions of her actions. The diagnosis is tentatively changed to major depressive disorder due to Kim fulfilling most of the criteria. However, further information is required. Kim experiences a pervasive and persistent low mood throughout the day, almost every day. This is evident either by self-reported feelings of sadness, emptiness, and hopelessness or through observations by others, such as seeming emotional (APA, 2022). Kim experiences substantial involuntary weight loss (e.g., a drop exceeding 5% of body weight within a month) and exhibits daily hunger fluctuations (APA, 2022). Based on her repeated visits to the bridge during the week, it is plausible to infer that she has a deliberate intention to commit suicide. Kim's grieving can elicit several responses, such as profound sadness, persistent thoughts about the loss, difficulty sleeping, reduced appetite, and noticeable weight loss, all of which can reflect symptoms of a depressive episode as described in Criterion A. While it is acceptable for individuals to have some symptoms or reactions in response to a loss, it is essential to carefully assess the presence of a major depressive episode with the expected response to a significant loss. The process of making this decision unavoidably necessitates the application of clinical discernment, considering the person's background and the societal standards for how suffering is typically manifested in the context of grief (APA, 2022). We must 4

ascertain whether there exists any familial background of depression or mental disease. Additionally, we can utilize the diathesis-stress model to analyze her social life and educational background. References American Psychiatric Association (2022). Diagnostic and statistical manual of mental disorders (5th edition, text rev). American Psychiatric Association. Berking, M., Ebert, D., Cuijpers, P., & Hofmann, S. G. (2013). Emotion Regulation Skills Training Enhances the Efficacy of Inpatient Cognitive Behavioral Therapy for Major Depressive Disorder: A Randomized Controlled Trial. Psychotherapy and Psychosomatics, 82(4), 234-45. https://doi.org/10.1159/000348448 Marco, J. H., García-Palacios, A., & Botella, C. (2013). DIALECTICAL BEHAVIOURAL THERAPY FOR OPPOSITIONAL DEFIANT DISORDER IN ADOLESCENTS: A CASE SERIES. [Aplicación de la terapia dialéctica comportamental al trastorno negativista desafiante en adolescentes: una serie de casos.] Psicothema, 25(2), 158-163. https://doi.org/10.7334/psicothema2012.119 5

psy 6210 unit 9 assignment 1

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