Psychology: Diagnostic Workup, Essay Example

Many other conditions should be evaluated when an anxiety diagnosis is made, relate to those within the DMS -5 category. They pertain to all other mental disorders within that category and include evaluations for all other forms of anxiety that gimmick the unspecified type for which the patient has been diagnosed. For example, Substance/Medication-Induced Anxiety Disorder and Anxiety Disorder Due to Another Medical Condition are very important considerations when making an anxiety diagnosis. In this case is ruling out those two distinct categories.

Rationale

Patient’s symptoms that meet criteria for any diagnosis assigned.

Tina endured an early marriage, which ended in divorce three years ago. She is raising her school-aged daughter while working as a bank teller.  Signs and symptoms:-

• Feeling dizzy
• disoriented
• Cannot maintain control over her body or consciousness.
•  Extremities tremble in a spasmodically

There are also severe medical like symptoms including

• Difficulty to drawing a full breath while these episodes last.
• Feel terrified
• Episodes begin with lightheadedness
• dizziness in less than a minute
• Trouble breathing emerges after, followed by the trembling, heart pounding, and finally disorientation.

Alternative diagnoses that were considered, and how the differential was made.

Substance/Medication-Induced Anxiety Disorder and Anxiety Disorder Due to other Medical Conditions are the two alternative diagnoses which ought to be considered. He has a medical condition and must have been taking medications for them. The client cannot identify any situations in which these episodes are, especially, likely to occur, stating that it is their unpredictability that is so very frightening.

Tina suffered encountered seven of these episodes during the last five weeks, and has become increasingly concerned. While they do appear to be psychological, these signs and symptoms could amalgamate some underlying serious medical condition. Further, at times the symptoms gimmick a TIA attack, which could be life threatening

Other Conditions That May Be a Focus of Clinical Attention

Many other conditions should be evaluated when an anxiety diagnosis is made, relate to those within the DMS -5 categories. They pertain to all other mental disorders within that category and include evaluations for all other forms of anxiety that gimmick the unspecified type for which the patient has been diagnosed. For example, Substance/Medication-Induced Anxiety Disorder and Anxiety Disorder Due to Another Medical Condition are very important considerations when making an anxiety diagnosis. In this case is ruling out those two distinct categories.

Rationale

Patient’s symptoms that meet criteria for any diagnosis assigned.

• sweating,
• trembles with every climb upon the sight of a snake
• difficulty controlling her bladder when a snake is in sight
• fear of snakes since she was six or seven years old, but adds that it has become more intense recently
• As a child and early teen, she would make every effort to avoid contact with reptiles
• Definite fear reaction when confronted by any type of snakes, fleeing the situation if at all possible.

Recently these signs and symptoms have become worse.

• She almost stepped on a rattlesnake during a vacation in New Mexico.
• Now she is experiencing anticipatory anxiety that is making it almost impossible for her to go out into the field.
• This is having an adverse impact on her studies, as some of her geology classes involve field trips.
• It is also bothering her fiancée, who does not want to have to give up their dream of an independent lifestyle.

Discuss any alternative diagnoses that were considered, and how the differential was made.

Specific phobia could be an alternative diagnosis to unspecified anxiety disorder. While it appears that the snakes are the source of the fear unspecified anxiety disorder other symptoms such as bladder irritability suggest panic attacks. This nineteen year old may incur anxiety due to the very presence of her fiancée which may be unrelated to the snakes.

Other Conditions That May Be a Focus of Clinical Attention

Service in the military and young very active woman taking on a huge responsibility after leaving school

Rationale

Patient’s symptoms that meet criteria for any diagnosis assigned.

• In ability to remain focused on task oriented behavior
• Unable to normally relate to supervisors or peers, she burst out in rage, screaming at them and storming out of the room.
• She no longer felt herself to be part of the unit
• It was as if she went through her daily tasks in a daze.
• Nor could she open her heart to people at home
• The only contacts were via e-mail and occasional satellite telephone conversations.

None of her family members could not understood what went wrong.

• She was engaged to be married back home, but losing contact with her fiancée
• Her wartime romance begins to dwindle.
• No longer  is she looking forward to seeing him again,
• No longer planning their future together..

 Alternative diagnoses that were considered, and how the differential was made.

While all anxiety present with basic features of unrelated to reality fears, apprehension and dread of the unknown, which is unimportant to others post traumatic stress disorder has been peculiar too persons serving in the military. This disorder encompasses fear and could manifest as unspecified anxiety disorder as well since a multiplicity of symptoms may surface all at once.

At the onset it may never be easy to make a diagnosis of post traumatic stress disorder unless the military aspect of the person’s life is considered. Therefore in my opinion unspecified anxiety is the alternative diagnosis, which is applicable in this case to post traumatic stress disorder.

Other Conditions That May Be a Focus of Clinical Attention

This is a very gifted student with above average academic attainment or intelligence.

Patient’s symptoms that meet criteria for any diagnosis assigned.

Specific signs and symptoms for this case these include:-

• Graduate student in molecular biology at a large state university
• Although he puts in long hours at his advisor’s laboratory, he is finding it impossible to complete the projects he has been assigned.
• He has a history of being was a very good student as an undergraduate majoring in chemistry at the same university,
• A falling just a little short of the grades he needed to gain admission to medical school.
• Enrollment in doctoral program in which he is now enrolled.

Recent developments include:

• The demand for independent research mounted, so did his anxiety.
• He copes with stress through meticulous attention to detail, reasoning that if he performs impeccably he will be safe from criticism.
• This strategy has begun to backfire.
• He no longer checks over his work only once, or even twice; despite certainty (on one level) that he has entered the correct figures in his lab notebook.
• He cannot help feeling as if he has made a terrible mistake.
• He has developed a routine in which he goes over his day’s work in its entirety seven times.
• If he arrives at a different answer on even a single occasion, he rechecks that portion of his work seven more times.
• If another case of discrepancy occurs, he redoes the entire experiment.

 Alternative diagnoses that were considered, and how the differential was made.

This includes obsessive–compulsive personality disorder, which manifests similar signs and symptoms Obsessive-Compulsive Disorder. In this case the individual is pre-occupied with orderliness and becomes very distracted to the point of being unable to function if their surroundings are not in their perception of orderliness.

In this case the differential diagnosis focuses on order, which may not be accompanied by high academic achievement or unique intelligence. This case study demonstrates more repetitiveness than orderliness in trying to accomplish tasks and the student fear a failure and loss of reputation if the research is not completed at a usually high standard.

Other Conditions That May Be a Focus of Clinical Attention

Simone is married, has three children, but no established career.

Rationale

Patient’s symptoms that meet criteria for any diagnosis assigned.

These pertain to her being:

• A worrier perosnality
• feeling of emotional tension that “just won’t go away” that she says is produced by her endless worrying
• difficulty getting to sleep at night
• Muscular tension that sometimes leads to annoying cramps.

The manifestations have developed into

• Nervous and edgy about something or other.
•  Worries about her children’s health and adjustment, she worries about her students’ learning
• Worries about her husband’s love for her
• Worries about what the future may holds in store for a woman who worries too much
• She cannot relax

Alternative diagnoses that were considered, and how the differential was made.

Unspecified Anxiety Disorder can be considered an alternative diagnosis for Simone who worries excessively about almost everything. Initially, the anxiety is unspecified because there is no known   medical condition or it is not known if she takes any substances that would trigger worrying episodes.

The signs and symptoms pertaining to unspecified anxiety disorder are similar to generalized anxiety disorder. A marked difference, however, is the compulsive worrying demonstrated by Simone. While there is worry in unspecified anxiety it is less intense , but accompanied by immense fears

Other Conditions That May Be a Focus of Clinical Attention

A young single man with a career and might be anxious about his life. Jim is a tall young man who seems to be putting on weight. Also, he is a former athlete, playing baseball for his college team. Jim has become very busy with work and neglected exercise for the last eight months.

Rationale

Patient’s symptoms that meet criteria for any diagnosis assigned.

Signs and symptoms include

• Recurrent episodes of intense anxiety, during which he feels his heart racing, his chest muscles hurt.
• Feeling of being smothered
• Palms break out in heavy sweating.
• He was afraid that he might be having a heart attack at first and sought medical advice, but was given a clean bill of health.
• He  still feels that something is very wrong medically
• He has suffered through at least a dozen more attacks over the last two months

More signs and symphony along with concerns appear as

• At the end of the day he sometimes meets with co-workers or old college friends for a few drinks at a nearby tavern.
• He acknowledges that sometimes these “tension-tamers” turn into extended bouts, especially when he has had a rough day and meets with former teammates.
• He is accustomed drinking alcohol regularly
• He hates going to work the next day after drinking
• Most times he has a hangover, which triggers the anxiety

 Alternative diagnoses that were considered, and how the differential was made.

Panic attack is an alternative diagnosis to panic disorder. While the symptoms and signs are similar a panic attack is a disorder, but not classified as such because the symptoms may appear only once and subsides when the person’s emotional equilibrium is restored. Also it may be associated with some phobia.