DSM5 Knowledge Demonstration Assignment

DSM5 Knowledge Demonstration Assignment

DSM-5 Assessment

Directions: This quiz allows you to demonstrate your knowledge regarding mental health

disorders associated with the DSM-V. Below are 10 vignettes. Using the DSM-5 as a guide, read

each vignette and answer the questions, completely and to the best of your ability. When you

have completed this quiz email me your responses.

Case Study 1

Jessica is a 28-year-old married female. She has a very demanding, high-stress job as a second

year medical resident in a large hospital. Jessica has always been a high achiever. She graduated

with top honors in both college and medical school. She has very high standards for herself and

can be very self-critical when she fails to meet them. Lately, she has struggled with significant

feelings of worthlessness and shame due to her inability to perform as well as she always has in

the past.

For the past few weeks, Jessica has felt unusually fatigued and found it increasingly difficult to

concentrate at work. Her coworkers have noticed that she is often irritable and withdrawn, which

is quite different from her typically upbeat and friendly disposition. She has called in sick on

several occasions, which is completely unlike her. On those days she stays in bed all day,

watching TV or sleeping.

At home, Jessica’s husband has noticed changes as well. She’s shown little interest in sex and

has had difficulties falling asleep at night. Her insomnia has been keeping him awake as she

tosses and turns for an hour or two after they go to bed. He’s overheard her having frequent

tearful phone conversations with her closest friend, which have him worried. When he tries to

get her to open up about what’s bothering her, she pushes him away with an abrupt “everything’s

fine.”

Although she hasn’t ever considered suicide, Jessica has found herself increasingly dissatisfied

with her life. She’s been having frequent thoughts of wishing she was dead. She gets frustrated

with herself because she feels like she has every reason to be happy, yet can’t seem to shake the

sense of doom and gloom that has been clouding each day as of late.

1. What preliminary diagnosis, subtype, and/or specifier (if applicable) would you give this

client? Why (justify your answer)?

2. What, if any, PIE or cultural factors, do you see or should you consider for either patient?

Why?

Case Study 2

Kate is a 38-year-old divorced mother of two teenagers. She has had a successful, well-paying

career for the past several years in upper-level management. Even though she has worked for the

same, thriving company for over 6 years, she’s found herself worrying constantly about losing

her job and being unable to provide for her children. This worry has been troubling her for the

past 8 months. Despite her best efforts, she hasn’t been able to shake the negative thoughts.

Ever since the worry started, Kate has found herself feeling restless, tired, and tense. She often

paces in her office when she’s there alone. She’s had several embarrassing moments in meetings

where she has lost track of what she was trying to say. When she goes to bed at night, it’s as if

her brain won’t shut off. She finds herself mentally rehearsing all the worse-case scenarios

regarding losing her job, including ending up homeless.

1. What preliminary diagnosis would you give each of your patients and why?

Case Study 3

Jacob is a 27-year-old male who recently moved back in with his parents after his fiancée was

killed by a drunk driver 3 months ago. His fiancée, a beautiful young woman he’d been dating

for the past 4 years, was walking across a busy intersection to meet him for lunch one day. He

still vividly remembers the horrific scene as the drunk driver ran the red light, plowing down his

fiancée right before his eyes. He raced to her side, embracing her crumpled, bloody body as she

died in his arms in the middle of the crosswalk. No matter how hard he tries to forget, he

frequently finds himself reliving the entire incident as if it was happening all over.

Since the accident, Jacob has been plagued with nightmares about the accident almost every

night. He had to quit his job because his office was located in the building right next to the little

café where he was meeting his fiancée for lunch the day she died. The few times he attempted to

return to work were unbearable for him. He has since avoided that entire area of town.

Normally an outgoing, fun-loving guy, Jacob has become increasingly withdrawn, “jumpy,” and

irritable since his fiancé’s death. He’s stopped working out, playing his guitar, or playing

basketball with his friends – all activities he once really enjoyed. His parents worry about how

detached and emotionally flat he’s become.

1. What preliminary diagnosis, subtype and/or specifier (if applicable) would you give this

client? Why (justify your answer)?

Case Study 4

Kenneth is a 21-year-old business major at a large university. Over the past 6 weeks his family

and friends have noticed increasingly bizarre behaviors. On many occasions they’ve overheard

him whispering in an agitated voice, even though there is no one nearby. Lately, he has refused

to answer or make calls on his cell phone, claiming that if he does it will activate a deadly chip

that was implanted in his brain by evil aliens. His speech has also been disorganized.

His parents have tried to get him to go with them to a psychiatrist for an evaluation, but he

refuses. He has accused them on several occasions of conspiring with the aliens to have him

killed so they can remove his brain and put it inside one of their own. He has stopped attended

classes altogether. He is now so far behind in his coursework that he will fail if something

doesn’t change very soon.

Although Kenneth occasionally has a few beers with his friends, he’s never been known to abuse

alcohol or use drugs. He does, however, have an estranged aunt who has been in and out of

psychiatric hospitals over the years due to erratic and bizarre behavior.

1. What preliminary diagnosis would give each of your patients and why?

2. What, if any, biological factors should you consider for either patient? Why?

Case Study 5

The first patient is a 26-year-old heroin addict. He has all the symptoms of withdrawal. He has a

runny nose, stomach cramps, dilated pupils, muscle spasms, chills despite the warm weather,

elevated heart rate and blood pressure and is running a slight temperature. Aside from

withdrawal symptoms, this man is in fairly good physical shape. He has no other adverse

medical problem and no psychological problems. At first, he is polite and even charming to you

and the staff. He’s hoping you can just give him some “meds” to tide him over until he can see

his regular doctor. However, he becomes angry and threatening to you and the staff when you

tell him you may not be able to comply with his wishes. He complains about the poor service

he’s been given because he’s an addict. He wants a bed and “meds” and if you don’t provide one

for him you are forcing him to go out and steal and possibly hurt someone, or he will probably

just kill himself “because he can’t go on any more in his present misery.” He also tells you that

he is truly ready to give up his addiction and turn his life around if he’s just given a chance, some

medication, and a bed for tonight.

1. What preliminary diagnosis, subtype and/or specifier (if applicable) would you give this

client? Why (justify your answer)?

2. What, if any, medical danger(s), do you see or should you consider for either patient? Why?

Case Study 6

J.T. was verbal with limited language skills. He could sing in complete sentences (echolalia) but

communicated using one- or two-word phrases. He communicated mostly by pointing. When he

did speak, his enunciation was poor except when he was angry at which time the word would be

clear. He displayed self-stimulatory behavior in the form of rocking, hand-turning, and hand

flapping. He showed no interest in other children and his eye contact was poor. J.T. also

struggles with seizures. His seizures had begun at age two. He was taking medications for

seizures and experienced one every ten to fourteen days.

1. What preliminary diagnosis, subtype and/or specifier (if applicable) would you give this

client? Why (justify your answer)?

2. What, if any, medical danger(s), do you see or should you consider for either patient? Why?

Case Study 7

Brandon is a 30-year-old male from a wealthy background. He has a very close relationship with

his mother, who struggles with depression. His father has no mental illness and denies that his

son does. However, Brandon describes severe episodes of mania, where he becomes involved in

impulsive and excessive behaviors such as spending large sums of money or travelling too other

countries. He also describes a manic thought pattern, characterized by an influx of ideas that he

feels he must act upon. In contrast, Brandon finds that once these episodes disperse, he is left

with feelings of depression, low self-esteem, and lack of energy.

1. What preliminary diagnosis, subtype and/or specifier (if applicable) would you give this

client? Why (justify your answer)?

Case Study 8

Jamal, an energetic 9-year-old boy, arrives at the clinic with his mother. Jamal’s mother states

that his teachers report he is easily distracted by extraneous stimuli, he has difficulty sustaining

attention in tasks or play activities, he leaves his seat when remaining seated is expected and he

has difficulty waiting his turn. Jamal’s mother expresses concern about his behavior at home and

school, and feels professional assistance is warranted at this time.

1. What preliminary diagnosis, subtype and/or specifier (if applicable) would you give this

client? Why (justify your answer)?

Case Study 9

Rosita is a 20-year-old, Latina, first year engineering student. Even though Rosita is doing well

academically for the past 3 months she has experienced feelings of fear and often cries at night

as she is sad about leaving home. She expressed the engineering college and dorm are100 miles

away from her home in Delaware.

She reported that she hasn’t connected with her dorm mates or peers. She has shared with teacher

that she was homesick but was afraid of telling this to her parents as she feared that they may

worry and ask her to give up her college and come back home.

1. What preliminary diagnosis, subtype and/or specifier (if applicable) would you give this

client? Why (justify your answer)?

Case Study 10

Kay Ann is a 6-year-old 1st grade student at Baltimore Elementary. She receives special

education services in the general classroom for the entirety of her school day.

When Kay Ann was three, she fell out of a tree, hitting her head on the ground. Due to some

educational challenges Kay Ann recently engaged to formal testing to see if an IEP is warranted.

The psycho-educational evaluation, conducted by the school psychologist revealed the

following: full-scale IQ of 65.

1. What preliminary diagnosis, subtype and/or specifier (if applicable) would you give this

client? Why (justify your answer)?

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