Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD ·        For this Assignment, you practice assessing and diagnosing patients with anxiety disorders

Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

·        For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5-TR criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5-TR criteria.

• Consider what history would be necessary to collect from this patient.
• Consider what interview questions you would need to ask this patient.
• Identify at least three possible differential diagnoses for the patient. 

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.

Incorporate the following into your responses in the template:

• Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? 
• Objective: What observations did you make during the psychiatric assessment?  
• Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

Training Title 85 Name: Mrs. Isla Flanagan Gender: female Age: 47 years old T- 98.0 P- 82 R 18 136/62 Ht 5’0 Wt 123lbs Background: Born and raised in Northern Ireland, parents brought her and her one sister to U.S. when she was 15 to go to U.S. university where she met her husband. They live in Charleston, SC. She obtained her master’s degree in education; no history of mental health or substance use treatment, no family history. Her husband reported a recent school shooting nearby 3 weeks ago “flipped a switch” in her. She is watching the news 24/7, barely sleeping, and even when she does, it is only a few hours, Appetite is decreased. Hx of hysterectomy, NKDA, no legal hx.

Transcript of the video

BEGIN TRANSCRIPT: 

00:00:00[sil.] 

00:00:15CAROL Sorry, I, I can't find it. 

00:00:20OFF CAMERA It's okay. 

00:00:20CAROL No, it's not. Where is it? I never, I never leave without it. Oh Jesus. 

00:00:30OFF CAMERA What is it you're looking for? 

00:00:30CAROL My cell. I never check the b. . . um, the trunk. I have to go. 

00:00:45OFF CAMERA You seem very upset not to have your phone with you. 

00:00:50CAROL Of course, who wouldn't be? We'll have to talk some other time. 

00:00:55OFF CAMERA Your husband must have his phone, he called that you were running late. 

00:01:00CAROL Yeah, he has his phone, but . . . 

00:01:00OFF CAMERA But what? 

00:01:05CAROL The children do not call their father when they want something. 

00:01:10OFF CAMERA They never call your husband? 

00:01:10CAROL No, they only call me. 

00:01:10OFF CAMERA Uh-huh, are you expecting your children to call? 

00:01:15CAROL My children are at home with the babysitter, my neighbor. She's a widow. I just, I don't feel comfortable, in case they need me. And I always call, they'll be worried if I don't. 

00:01:35OFF CAMERA How often do you call your children when you're away from home? 

00:01:40CAROL I don't know, a few times. Just normal checking. 

00:01:45OFF CAMERA Do you work? 

00:01:45CAROL I'm a mother, so yes, I work. 

00:01:50OFF CAMERA I'm sorry, I didn't mean to suggest parenting isn't work. It very much is work. Do you also have a job outside of the home? 

00:02:00CAROL I used to work from home. I quit my job after my last child, Colin, he's five now. But, this really isn't the time for this right now. Nor ever, really. I'm just here as a courtesy, no offense. 

00:02:20OFF CAMERA I understand you do not want to be here. But it would be helpful if we could talk for a few minutes. Perhaps your husband can call your children. Do you want me to go get him for you? 

00:02:35CAROL I'll be fine. We can talk for five more minutes. 

00:02:40OFF CAMERA Thank you. You seem to have strong feelings that you want to call your children. But you do not have strong feelings that you want to ask your husband to call them. 

00:02:50CAROL He refuse. We don't see eye-to-eye. But I'm not here for marriage counseling. 

00:03:00OFF CAMERA What is your understanding about why you're here? 

00:03:00CAROL Ask my husband, Greg. 

00:03:05OFF CAMERA What current concerns do you have when you leave your children? 

00:03:10CAROL There's a laundry list on that one. Start with serial rapists and end with Newtown, and you've only scratched the surface. 

00:03:20OFF CAMERA How often do you worry about those types on incidents? 

00:03:20CAROL I'm mother of three. I have to keep in mind the world as it is. Part of my job description. Every day, people die from gun deaths. 18,000 people are raped. Over 50,000 children go missing every year. 

00:03:40OFF CAMERA Those are unsettling statistics. 

00:03:45CAROL Dr. Phil did a profile on a serial rapist, that was horrifying. I called my friends to watch it. I TiVo'ed it for them. 

00:03:50OFF CAMERA Do you follow a lot of news programs? 

00:03:55CAROL Yeah. 

00:03:55OFF CAMERA What do you tend to watch? 

00:03:55CAROL Most of the shows. I have CNN on background for when I'm doing laundry or cooking, or prepping lessons. 

00:04:05OFF CAMERA Lessons, what lessons do you prepare? 

00:04:10CAROL For the children. 

00:04:10OFF CAMERA Oh, do you school your children at home? 

00:04:15CAROL Yes, I homeschool my children. I don't appreciate your connotations. The stereotype that homeschooling is for religious nuts is outdated. The reality is our school systems are broken. Our public schools can't even afford protection for our children. 

00:04:35OFF CAMERA Was that one of the reasons you decided to homeschool your children was because of school violence? 

00:04:45CAROL You mean... ? 

00:04:45OFF CAMERA Pardon? 

00:04:45CAROL Ridge View? 

00:04:50OFF CAMERA Yes, Ridge View, uh-huh. 

00:04:50CAROL 12 students murdered, three teachers gunned down trying to protect students. They couldn't protect themselves. Campus police didn't have time to stop it. That kid's mother and father lay dead in their house for over a week before that school massacre. Today Show profiled the ex-girlfriend. She said there was plenty of warning signs. Did the administrators listen? No. No one was capable of seeing what was coming. Yet, their signs were obvious. That child murderer drew horrifying pictures in his art classes, and you know what the teachers said? 

00:05:25OFF CAMERA No. 

00:05:25CAROL The teachers defended him. Said his evil artwork was a school assignment. Yes, to answer your question. Yes, I think school violence is a reason for homeschooling children. 

00:05:45OFF CAMERA Do these violent events seem to stay with you, hang with you? 

00:05:55CAROL I see those children's faces. They could have been my children. Greg is heartless. Instead of helping me protect our children, he sent me to a shrink. 

00:06:15OFF CAMERA Do you think that there are times where you over-worry? 

00:06:25CAROL I won't lose my children. 

00:06:25OFF CAMERA Do you fear that similar violent events may happen here at these schools? 

00:06:35CAROL Ridge View is only 100 miles from here, 100. That may as well be one mile. 

00:06:45OFF CAMERA How long have you been homeschooling your children? 

00:06:50CAROL Two months. 

00:06:50OFF CAMERA So you began homeschooling them, so that was about a month after the Ridge View incident shootings? 

00:07:00CAROL Yeah. When I pulled the children from school, Greg and I had a big fight, but it's for the best. The children are learning more now than they ever learned at school. They still socialize, they still have friends. Now, my girlfriends are considering doing the same with their children. They see how well mine are doing. My girlfriends are every bit as frightened as I was. This isn't some sort of frantic phobia on my part. I'm an educated woman about these matters. Greg, doesn't understand what it's like to lose family. 

00:07:50OFF CAMERA Do you have stronger feelings about losing people than your husband does? 

00:07:55CAROL Yes, I do. 

00:08:00OFF CAMERA Have you lost people who were close to you? 

00:08:05CAROL My parents, car accident, drunk driver, I was 19. 

00:08:10OFF CAMERA Oh, I'm sorry to hear that. 

00:08:15CAROL It happens, like that. They're gone. I won't lose a child. I won't lose more people I love. 

00:08:25OFF CAMERA Have these fears been increasing more recently for you? Preoccupying you, more of your time? 

00:08:35CAROL Yes. I think about what happened to me, to my parents, what could happen to my children. 

00:08:50OFF CAMERA What is it like to realize you cannot protect them all of the time? 

00:09:00CAROL That's what Greg says. 

00:09:05OFF CAMERA Do you disagree with him? 

00:09:10CAROL You protect them from what you can. You stop what you can. I couldn't prevent that driver from sideswiping my parents, pinning them to the freeway median. I can prevent another Adam Lanza from pointing a gun at my babies. I won't send them back to school. I won't turn off the television, and I won't stop informing myself. I will do what I can as a mother to protect my children. I'm sorry, I have to end this now, and call my children. I'll call them now. 

00:09:45END TRANSCRIPT 

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