Specific Case Vignette Examination Assignment - Essay Prowess

Specific Case Vignette Examination Assignment

Specific Case Vignette Examination Assignment

Paper instructions:

Purpose

The purpose of this assignment is to have you examine a case vignette, identify symptoms associated with a wide variety of mental health disorders, defend the presence/non-presence of relevant disorders (to the vignette), and come to an informed decision regarding the diagnosis best suited given the information provided in the vignette. This is an empirically validated approach to diagnostic decision and one that most clinicians use in everyday practice. The overall benefit of having you complete this assignment is to generate some exposure to the complexities psychologist encounter in their applied practice. You will learn more about diagnostic decision making in graduate school, but for now it is important that you begin to process the importance of defending a diagnosis given a list of symptoms disseminated through an intake summary. Remember, diagnostic decision making processes are not about finding the “right” mental health condition, but about identifying the most defensible mental health conditions. 

Procedure

Below I will provide you with a case vignette to evaluate in terms of diagnostic impressions. I want you to deconstruct the vignette from a scientifically valid approach. No snap shot diagnosing (hasty and off the cuff). Instead, I am going to ask you to follow an in-depth approach to the diagnostic process. To some extent, I have been asking you to complete similar assignments in your discussion board activities. However, now I will ask you to complete a more detail and elaborate defense of a diagnostic process. In this exercise, I want you to read the vignette and complete the following tasks: 

Identify a list of symptoms that may be helpful in determining a diagnosis.
Discuss how the the symptoms identified meet the five criteria for abnormality ( the 5 D’s). Make sure you provide enough evidence to clearly defend how symptoms are dysfunctional, distressful, deviant, dangerous, and durable. 
Categorize your symptoms by categories that will help you evaluate potential diagnoses. You may create the labels that you place symptoms under. 
Engage in multiple hypothesis testing. Here you are to choose three diagnoses that you want to consider in the diagnostic process. You must evaluate at least three disorders. For each disorder you evaluate, you must consider converging evidence (evidence that confirms the presence of a specific disorder) and diverging evidence (evidence that disconfirms the presence of a specific disorder). You will need to reference the notes and the textbook to determine the specific criteria for the diagnoses you are considering. You want to match the symptoms to the criteria — a checking off process. If you have enough symptoms to meet a specific criterion for a disorder — you want to note that criterion A (for example) is met because of the presence of two more psychotic symptoms (for example). Clearly defend how each criteria for a diagnosis is met or not met. 
Construct a confidence assessment based on your defense process. Here I want you to rate (from 1 to 10 with 10 being a score reflective of great confidence) how confident you are in terms of the diagnosis being present within the case vignette. Do this for each disorder you consider. 
Finally, I want you to chose one (or more) diagnosis that you feel best characterizes that symptoms present in the vignette. You may need to consider some specifiers if we reviewed them in the notes. After making your selection, I want you to write up a small summary that defends your conclusions. This summary only needs to be four to five sentences. (Note ** — this section is not a part of the template/example I am going to provide you — please do not forget to complete this section). 
There are no right or wrong answers. However, you will be graded on how you defend your logic in responding to the designated components of the defense process — as seen directly above. Please see the grading rubric below for specific grading criteria. 

Particulars

The paper must be written in Times New Roman with a font size of 12. The margins must be set at one inch. You must include a title page. The title page should include your name, the course name, and the title of your paper. Violation of any of these regulations will automatically reduce your grade by 5-20 points depending upon the magnitude and frequency of the violations. 

Case Vignette

Casey Weston is a 36 year old, European American man who was self-referred to therapy for difficulties with anxiety and social isolation. Upon entering therapy, Casey indicated that he is riddled by fear, which prevents him from creating and maintaining relationships with others. Casey further noted that his inability to create relationships has engendered “heavy feelings of loneliness.” He noted that his loneliness is marked by persistent concerns that he will always be alone, frequent bouts of crying, perceptions of low self-worth, and difficulties falling asleep. When asked about his inability to create and maintain relationships, he cited his fear as the major deterrent.

Casey indicated that as far as he can remember (at least 20 years), he has always been fearful of being “trapped or suffocated by people.” When queried further, Casey indicated that he is fearful about being stuck in a place where he will not be able to escape or find help. In the past, Casey stated that he had difficulties going to crowded concerts and movies because of the overwhelming amount of people who “seem like they are on top of him.” In addition, Casey cited difficulties carpooling with co-workers. Specifically, he noted that carpooling makes him feel so restricted because there are often at least four people in a car and (unless you are the driver) few people are in control of the door locking system.

When asked about when these fears first appeared, Casey noted that he “had no idea.” However, he did indicate that as a child he often had a number of medical difficulties (e.g., asthma, impetigo) that were severe in presentation. When fits of asthma or impetigo would occur, Casey noted that he would often feel a strong need to find aid quickly. Casey distinctly remembers one instance where he came down with a bad bout of asthma (“I thought I was going to die.”) and he was fearful that he would not be able to find help because it occurred at recess where few teachers would monitor the students. He recalled that his friends tried to help him, but everyone time that they got closer, he felt like his symptoms became worse. Casey indicated from that point on, he would try to avoid large groups of people for fear of having an asthma attack with no means of seeking immediate aid.

Casey indicated that his asthma and impetigo difficulties were successfully treated and have remained under control for a long period of time. However, he noted that he still fears being trapped. Casey noted that when he finds himself in a situation where there is no obvious point of escape, he experiences a number of debilitative symptoms of anxiety. Specifically, he reported consistent difficulties with extreme restlessness/irritability, muscle tension, heart palpitations, trembling and shaking, chest pain, dizziness, and nausea when placed in situations where he has felt trapped. Moreover, Casey indicates that his fear has gotten worse over the last ten years. Specifically, Casey indicates that he experiences his anxiety symptoms more severely. Because of this escalation in symptoms severity, Casey admitted that he vigilantly avoids “most social interactions.” Specifically, he now has difficulty going to the grocery store, riding in a car (even by himself), going to a work meeting, etc. In fact, Casey admitted that his symptoms were so severe that he had to quit his job and find a new job that allows him to work from home. For a long time, Casey believed that the only true safe place was his home. Whenever he was forced to leave his home, he would experience an overwhelming feeling of dread that is accompanied by different physiological symptoms associated with anxiety, based on self-report.

Finally, Casey noted that his symptoms peaked to such an extent that he does not even feel safe in his home all of the time. Based on Casey’s recent memory, he cited difficulties going to the dentist for his annual cleaning approximately 2 months ago. Upon arriving at the dentist’s office, he indicated that he became incapacitated by fear to such an extent that he could not enter the dentist’s office. After experiencing a substantial amount of anxiety related turmoil, Casey reported feeling an intense surge of fear that was marked by difficulties breathing and accelerated heart rate. Casey admitted that during the intense anxiety episode he felt like he was going to die. Despite feelings of dying, Casey did note that the most severe symptoms dissipated within a few seconds. Once Casey was able to function, he walked slowly to his car and returned home. From that point, Casey reported that he has been concerned about experiencing those specific types of symptoms again. To ward against the onset of similar symptoms, Casey noted that he has stopped working out, venturing from home (he now has his groceries delivered to his house), and watching scary movies (movies that he once found enjoyable).

Specific Case Vignette Examination

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