Case study diagnosis and treatments
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
At least two of your coworkers who were assigned to a different case than you should respond. Explain how you might use what you learned from your colleagues’ case studies to your own clinical practice.
NOTE: This is a positive comment.
Main Article
The treatment of an adult client diagnosed with Attention Deficit Hyperactivity Disorder is the focus of Case Study: Volume 2, Case #21. (ADHD).Questions
Question 1: Is your loved one causing you troubles because he or she is “argumentative and temperamental”?
Rationale: The client may be experiencing additional stress as a result of failed relationships, which could be related to his illness. “Emotional dysregulation is becoming more well recognized as a hallmark of ADHD” (Stralen, 2016). Low frustration tolerance and explosive behavior are symptoms of ADHD (Stralen, 2016).
2nd question:
What is the source of your greatest anxiety?
To help the patient prepare for periods when he is likely to be in high-stress situations, it is critical to identify the anxiety triggers. When a patient is feeling overwhelmed, planning a response might help him stay in control of his emotions and monitor his conduct.
Question three:
Was it physical or verbal abuse, or both, that your father was abusing you? Do you think your worry stems from previous conflicts with your father?
It is critical for the provider to comprehend the client’s point of view on his upbringing. He is aware that it has influenced him in some way, as he had previously sought counseling. I’m curious if he has ever discussed this with his father, and if his father has ever apologized for his conduct.
Family-friendly questions
I’d like to speak with his mother about how he did in school and at home as a child, including homework, chores, and whether or not he had friends. Although social problems are not part of the diagnostic criteria for ADHD, the difficulties that kids with this condition confront in peer relationships are significant (Hoza, 2007)
Exams & Diagnostics
A comprehensive psychiatric evaluation, including the Adult Self-Report Scale (ASRS). The World Health Organization developed the ASRS to evaluate if an individual (adult) has ADHD. The scale consists of six questions, and if a client exhibits at least four of the six symptoms, a professional diagnosis of ADHD may be required (ADDA, 2018). To confirm the diagnosis and rule out other problems, such as autism, auditory processing abnormalities, or mood disorders, Seay et al. (2009) recommend that the PMHNP use IQ tests, broad-spectrum scales, assessments of particular abilities, and brain scans. A comprehensive medical work-up by a PCP is also recommended to rule out any other medical diseases that may appear in the same way as ADHD.
DX Differential
Generalized Anxiety Disorder (DSM-5) 300.02: The patient has symptoms of generalized anxiety disorder (F14.1). He’s experienced the symptoms for more than six months, and they’re serious enough that they’re interfering with his everyday activities. The patient complains of uncontrollable concern, impatience, restlessness, difficulty concentrating, and a sense of being on edge. Neither a physical disease nor substance abuse have been related to the patient’s symptoms (Reynolds & Kamphaus,2013).
Client with ADHD complains of being tense, irritated, and anxious all of the time (Stahl Online, 2019). After the overall anxiety symptoms have subsided and the client is left feeling hyperactive, inattentive, and unable to concentrate, questions arise (Stahl Online).
Post-Terrible Stress Disorder (PTSD): The client’s anxiety diagnosis could be due to underlying concerns from a traumatic event he had as a child. The client’s father was an alcoholic and verbally abusive to him. It’s possible that the client’s problems have something to do with past exposure as a child. Post-Traumatic Stress Disorder (PTSD) is a dangerous disorder that can affect people who have been through a variety of traumatic events, including abuse (PTSD, 2018).
Medications
The client had failed to attain remission on an SSRI, a 5-HT1A receptor partial agonist, an antihistamine anxiolytic, and an SGRI by year six, according to the case (Stahl Online, 2019).
I would choose either Cymbalta 60mg or Effexor XR 150mg based on the pharmacological substances. Cymbalta elicited a response, but adverse effects prohibited the dosage from being increased. The therapy that evoked remission for this client was augmenting with guanfacine, an alpha-adrenergic agonist.
Learned Lessons
To be sure of the correct diagnosis, I learned to always examine extra differential diagnoses and to assess and re-evaluate each circumstance separately.
Patients frequently have comorbid diagnoses, and treating both is critical to the patient’s recovery.
The patient’s symptoms of mental illness fluctuate over time, necessitating ongoing care. For the client to feel at ease in his or her presence, the provider must constantly be approachable and friendly.
References
Attention Deficit Disorder Association. (2018). Adult ADHD Test. Retrieved from https://add.org/adhd-test/
Generalized Anxiety Disorder. (2018). Anxiety and Depression Association of America. Retrieved fromhttps://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad
Posttraumatic Stress Disorder. (2018). Anxiety and Depression Association of America. Retrieved fromhttps://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd
Seay, B., McCarthy, L. F., and Williams, P. (2009). Your complete ADHD/ADD diagnosis guide.
Retrieved from https://www.additudemag.com/adhd-testing-diagnosis-guide/
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical
Applications (4th ed.). New York, NY: Cambridge University Press.
Stralen, J. W. (2016). Emotional dysregulation in children with attention-deficit/hyperactive disorder.
Attention Deficit Hyperactivity Disorder. 8(4). p. 175-187. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110580/
Hoza B, Mrug S, Gerdes AC, Bukowski WM, Kraemer HC, Wigal T, et al. What aspects of peer relationships are impaired in children with attention-deficit/hyperactivity disorder? Journal of Consulting and Clinical Psychology. 2005b;73:411–423.
Reynolds, C. & Kampaus, R. (2013). Generalized Anxiety Disorder. Pearson. Retrieved from:
www.images.pearsonclinical.com/images/assets/basc-3/basc3resources/DMS-5_
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