NR 547 Differential Diagnosis in Psychiatric-Mental Health across the Lifespan Practicum – Chamberlain University – Comprehensive Practicum Materials

NR 547 Differential Diagnosis in Psychiatric-Mental Health
across the Lifespan Practicum - Chamberlain



NR 547 Week 7 s s s




1. Rico is a 30-year-old who is referred to the clinic by his wife,Tracy. Rico and
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Tracy have been married for eight years. She states that in the past year, his
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s behaviors have become disquieting. He constantly accuses her of cheating on
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s him. He often takes her phone and scrolls through her calls, texts, and social
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s media accounts. He is suspicious about texts she receives from coworkers
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s and other acquaintances. He starts frequent arguments with her about where
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s she has been and who she was with, and often replies to her responses
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with sarcastic, "mean" comments. Tracy is concerned about Rico's paranoid
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s behavior.
Based on DSM-5-TR (APA, 2022) criteria, does Rico meet diagnostic criteria for
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s paranoid personality disorder?
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yes
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unable to determine: No s s s







Rationale: Although Rico meets diagnostic criteria of preoccupation about his wife's
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s loyalty, reads into benign events, and has suspicions of his wife's fidelity, these
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,2. Crispin is a 33-year-old who presents after experiencing auditory hallucina-
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s tions. He states he has heard voices "grumbling at him" about three or four
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s times in the past week, for about 15 minutes each time. He is employed as
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a data analyst and works from home. He does not have hobbies or activities
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s outside of work. He does not use alcohol, marijuana, or illicit drugs; he smokes
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s cigarettes. He lives with his sister, who is getting married in a month; he will
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s be moving into an apartment with a roommate whom he found on Craigslist.
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s He is stressed about the move. He states he has no friends and prefers it that
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s way, and he has felt this way since adolescence. He is not looking forward
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to his sister's wedding as he prefers to be alone. When asked if he would be
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s bringing a date to the wedding, he noted that he has never considered dating,
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s as he doesn't have use for it; he endorses a lack of interest in sex.
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: Schizoid personality disorder
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Rationale: Crispin meets DSM-5 criteria for schizoid personality disorder. He is
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s detached from social relationships, prefers solitary activities, lacks close friends,
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s and lacks interest in sexual experiences. He has experienced these traits since
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adolescence. Clients with a schizoid personality disorder may have brief periods of
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psychotic episodes when stressed. s s s




3. Heloise is a 27-year-old who presents to the clinic with symptoms of de-
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s pressed mood. She states that she has been stressed by a recent wildfire that
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s started near her community. She believes that she caused the fire to spread
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s because she was thinking about it too much. She also says that she hears the
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s animals crying out to her as they are2succumbing
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/ 11
to the fire. She states she s s s s s s s s s s s s s




s has never had friends, other than her sister because she gets very anxious
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s around other people. She was teased throughout high school and labeled a
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, Rationale: Heloise meets diagnostic criteria for schizotypal personality disorder.She
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s exhibits ideas of reference, magical thinking, unusual perceptual experiences, has
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s an odd appearance and speech patterns, social anxiety, and lacks close friends.The
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s traits have been present since she was in high school.
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4. Personality disorders involve:: -"an enduring pattern of inner experience and
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behavior that deviates markedly from the expectations of the individual's culture" per
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s the Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5)
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-pervasive unhealthy patterns of thinking, functioning, and behaving
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-usually begins by late adolescence or early adulthood and causes distress or
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s problems in functioning s s




-affect at least two of these areas:
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• Way of thinking about oneself and others
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• Way of responding emotionally
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• Way of relating to other people
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• Way of controlling one's behavior
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-Diagnosis is only applicable to individuals 18 or olders s s s s s s s




• People under 18, personalities are still developing
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-3 clusters s




• A, B, C s s




-occur in 10-20% of the general population and about 50% of psychiatric clients
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5. personality disorders should not be diagnosed unless:: the symptoms are
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s long-standing and impact functioning. s s s






6. Cluster A: Cluster A personality disorders are characterized by odd or eccentric
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s thinking or behavior. s s