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psych assignment

PSYCH ASSESSMENT
MID-TERM FALL 2008

1. WHAT ARE THE THREE MODELS FOR ASSESSING PSYCHOLOGICAL DEVELOPMENT IN AN INDIVIDUAL? WHAT ARE THE STRENGTHS OF EACH?

2. FOLLOWING ARE CLINICAL VIGNETTES. ANSWER THE QUESTIONS BASED ON THE INFORMATION PRESENTED.

HISTORY: A 33 YEAR OLD WOMAN WITH COMPLAINTS OF ABDOMINAL PAIN COMES TO SEE YOU. SHE IS BRIGHT, ARTICULATE, AND TALKS ALOT, ASKING YOU NUMEROUS QUESTIONS AND QUESTIONING IF YOU THINK YOU CAN HELP HER. SHE MENTIONS THAT SHE HAS BEEN TO THREE OTHER DOCTORS FOR THIS SAME COMPLAINT AND NONE OF THEM HAVE HELPED HER.

MEDS: FREQUENTLY TAKES IBUPROFEN FOR HEADACHES, MENSTRUAL CRAMPS AND VARIOUS ACHES AND PAINS

SOC: LIVES ALONE, WORKS AS A NURSE AT SAME HOSPITAL FOR 5 YEARS,
CIGS-1/2-1 PPD, CAFFEINE-1-3 DRINKS DAILY, ETOH-OCCASIONALLY

PHYSICAL: THIN, WELL DRESSED/GROOMED, VITAL SIGNS NORMAL
TEETH SLIGHTLY DISCOLORED AND NOT IN GOOD CONDITION,
GUMS FRIABLE
ABDOMINAL EXAM UNREMARKABLE, HOWEVER PATIENT KEEPS TRYING TO POINT OUT PLACES THAT DON'T FEEL QUITE RIGHT AND ENCOURAGING YOU TO PALPATE THESE AREAS
EXAM OTHERWISE UNREMARKABLE

YOU CALL THE PATIENT INTO YOUR OFFICE AND GIVE HER YOUR PROVISIONAL DIAGNOSIS. AS YOU'RE EXPLAINING, SHE BEGINS TO CRY AND GETS A VERY PITIFUL/PLEADING LOOK IN HER EYES AND TELLS YOU HOW STRESSED SHE IS ABOUT HER JOB AND HOW SHE CONSTANTLY WORRIES SHE'S NOT DOING A GOOD ENOUGH JOB AND SHE'S AFRAID THEY WILL FIRE HER.


A. WHAT ARE YOUR PROVISIONAL DSM DIAGNOSES? GIVE THE TOP ONE OR TWO FOR EACH AXIS FOR WHICH YOU HAVE A DIAGNOSIS.

B. WHAT CAN YOU SURMISE ABOUT THIS PATIENT'S DEVELOPMENTAL HISTORY (EG PARENTING, BELIEFS ABOUT THE WORLD, ADAPTIVE RESPONSES, ETC.) FROM THE PERSPECTIVE OF TWO OF THE THREE MODELS OF PSYCHOLOGICAL DEVELOPMENT?








3. A 51 YEAR OLD MAN COMES TO SEE YOU COMPLAINING OF PAIN IN HIS BACK AND RIGHT HIP THAT HAS BEEN ON AND OFF FOR MORE THAN A YEAR, AND CONSTANTLY PRESENT FOR MORE THAN SIX MONTHS. HE RUNS MORE THAN 15 MILES/WEEK BUT SAYS THAT HE FEELS FINE WHEN HE RUNS. HE TELLS YOU THAT HE THINKS HE'S FINE, BUT A COLLEAGUE ENCOURAGED HIM TO GET CHECKED. ON FURTHER QUESTIONING HE SAYS THAT HIS ENERGY LEVEL HAS BEEN LOW LATELY. HE TRIES NOT TO THINK ABOUT IT MUCH, BUT LATELY HE IS AWARE THAT HIS SEX DRIVE IS DIMINISHED AND HE HAS BEEN HAVING TROUBLE SLEEPING AND HAVING TROUBLE GETTING UP AND GETTING GOING IN THE MORNING.

NO MEDS OR SIGNIFICANT PAST MEDICAL HISTORY

SOC. WORKS AS AN ACCOUNTANT. DIVORCED 1 YEAR AGO FROM WIFE OF 26 YEARS FOLLOWING AN AFFAIR. HAS 2 CHILDREN AGE 19 AND 22 BUT HAS LITTLE CONTACT WITH THEM. DRINKS 2-3 BEERS/DAY NO CIGS, 2 CUPS OF COFFEE/DAY

PHYSICAL: THIN, ATHLETIC AND METICULOUSLY DRESSED AND GROOMED. VITAL SIGNS NORMAL, WEIGHT 145 (THIS IS DOWN 10 LBS FROM HIS USUAL 155). HIS VOICE IS SOMEWHAT FLAT THROUGHOUT THE INTERVIEW AND EXAM.
BACK: NON-TENDER BUT MUSCLES FEEL TIGHT AND ROPY AND HIS RANGE OF MOTION IS SOMEWHAT DECREASED (EG: FORWARD BEND CAN TOUCH HIS SHINS)
HIP AND LEG EXAM NOTABLE ONLY FOR DECREASED RANGE OF MOTION
EXAM OTHERWISE UNREMARKABLE

A. WHAT ARE YOUR PROVISIONAL DSM DIAGNOSES? GIVE THE TOP ONE OR TWO FOR EACH AXIS FOR WHICH YOU HAVE A DIAGNOSIS.

B. WHAT CAN YOU SURMISE ABOUT THIS PATIENT'S DEVELOPMENTAL HISTORY FROM THE PERSPECTIVE OF TWO OF THE THREE MODELS OF DEVELOPMENT?

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Comments

( 1 comment — Leave a comment )
neptunia67
Nov. 4th, 2008 11:35 pm (UTC)
Fascinating!
( 1 comment — Leave a comment )

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