To complete each assignment, you will need to read the case study. Assume that t

Question

To complete each assignment, you will need to read the case study. Assume that the client described in each case study meets criteria for a DSM-5 disorder. You will then consult the DSM-5 criteria and write 1-2 detailed paragraphs in which you assign a primary diagnosis for the client and justify that diagnosis. In this section you should reference EACH of the DSM-5 criteria for the diagnosis you are assigning and provide evidence from the case study for or against the presence of that criterion. If you have no information for a particular criterion you should specify this. For example, if the DSM-5 criteria specify that the symptoms cannot be accounted for by a medical condition and you have no evidence that the client has a medical condition that would explain their symptoms, you should state this. Next, write a paragraph in which you provide an example of at least one related diagnosis that you are ruling out based on the information you have. This is a process called “differential diagnosis.” As you know, the categories provided in the DSM-5 do not represent “true” categories in nature, and often clients will often have symptoms in multiple categories. As a clinician, you need to rule out other categories or explanations for the symptoms. For example, if someone is experiencing panic attacks in the wake of a traumatic event, you might consider the diagnoses of Posttraumatic Stress Disorder, Acute Stress Disorder, or Panic Disorder. The DSM-5 criteria will help you figure out which is the most appropriate diagnosis, and you should specify why you are ruling out another disorder, providing specific justification for ruling it out. The best disorders to rule out are those that share features or symptoms described in the case but are not the best diagnosis for the client. Finally, you will write one paragraph in which you may specify the use of a psychosocial treatment, a psychoactive medication, or both. You must briefly describe how this treatment works and you must justify your choice of treatment based on the research evidence for the efficacy of the treatment.

Case Study #3

John is a 67-year old, widowed, Asian American, retired U.S. Air Force Lieutenant Colonel. He was referred by his primary care physician due to John’s intense concern about his own health. John is terrified of developing cancer. He has had several relatives (including both his father and wife) die of cancer over the past ten years, and for the past 3-4 years he has become “obsessed” with his own health. He states that since he retired 4 years ago, he has spent most of his time on behaviors related to maintaining his health. He exercises daily because he is aware that there is a link between sedentary behavior and cancer risk. His daughter reports that he becomes so anxious if he does not get his daily exercise that he has declined to participate in family events, vacations, and other recreational activities if they interfere with his rigid exercise schedule. He has also adopted a vegan diet due to concerns about cancer and consumption of meat and dairy, and he spends a significant amount of time procuring and preparing his food; he will not eat any food that he has not prepared himself for fear that it may contain any ingredients that may lead to “inflammation.” He keeps a daily diary of his weight and level of fatigue, and if he has more than a day or two of feeling “run down” he becomes convinced that his symptoms are related to cancer. John reads a great deal of health related material on the internet, and is unconvinced by his doctor’s assurances that he has a clean bill of health. His daughter reports that John seems to be unaware that his concern is excessive or the extent to which his concerns are interfering with his relationships and quality of life.

Explanation / Answer

Considering the case above, the client, John is suffering from a form of Anxiety Disorder under Somatic symptom disorder called Hypochondriasis. This is a conditon when a person feels excessively worried about having a serious illness. This condition results from an inaccurate perception of ones body condition despite the absence of an actual medical diagnosis.

In the case given, John displays many symptoms of a Hypochondriac. Some of those are:

1) He is intensely concerned about his own health, so much so, that it has been described as an obsession.

2) He spends most of his time in health maintenance.

3) He declines family events, vacations and other recreations if that comes on the way of his health routine.

4) He has adopted a vegan diet.

5) Symptoms of "run down" makes him believe that he is suffering from cancer.

6) He spends his day cooking his own food and reading about health related articles.

7) Inspite of doctor's clean bill on his health, he is excessively bothered about him getting cancer and is unconvinced with his medical reports.

According to DSM-IV, when concerns about health impairs one's social, occupational and other important areas of functioning, and the duration is atleast 6 months, it could be taken for a disorder. In John's case both these criteria are agreed upon.

To treat Hypochondriacs:

Cognitive Behavioural Therapy: This is a psycho-social intervention which focuses on development of personal coping strategies that targets solving current problems and changing unhelpful patterns in cognition.

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