1-Respond to your peers, identifying areas where additional information might have been useful to include in the flyer. Point out information or ideas that were particularly effective. Also, include one aspect of their flyer that would be particularly helpful for the intended audience.
1.1- AD-1 Document
1.2-Report Document
2-Read the posts of other learnersCritique the strengths and weaknesses of their comments on the cultural or ethnic diagnostic controversy. What additions or deletions would make their handout more effective, and why?
2.1-Psyc 6210 U7D1 Document
2.2David Jite-Ogbuehi
TuesdayNov 21 at 2:04am
I would distinguish between the three by looking for certain behaviors from each individual. For the individual with schizophrenia, I would look for symptoms of hallucinations, delusions, disorganized thinking, and impaired cognitive function. For the individual with schizoaffective disorder, I would look for symptoms that resemble mood disturbances, such as bipolar disorder or major depressive disorder. For the individual with a brief psychotic disorder, I would look for symptoms of disorganized speech and grossly disorganized or catatonic behavior.
F20.9 Schizophrenia
F25.0 Schizoaffective Disorder Bipolar Type
F23 Brief Psychotic Disorder
Power Point Link:
Schizophrenia & Brief Psychotic Disorder.pptxDownload Schizophrenia & Brief Psychotic Disorder.pptx
A current issue related to cultural and ethnic factors in the diagnosis of schizophrenia revolves around the potential cultural bias in symptom assessment and interpretation. The main concern is whether the criteria used to diagnose schizophrenia take into account the diverse cultural variations in the expression and interpretation of mental health symptoms.
Cultural differences affect the interpretation of schizophrenia symptoms. Standardized diagnostic criteria may not capture culturally specific expressions of distress, leading to misdiagnosis and inappropriate treatment. Reviews have suggested that adverse social experiences of ethnic minority groups may contribute to their elevated risk, such as perceptions of discrimination and exclusion (Veling et al., 2010). This may also contribute to stigmatization and hinder the development of culturally sensitive mental health services.
The debate about cultural and ethnic issues in the diagnosis of schizophrenia is centered on achieving a balance between recognizing cultural diversity in symptom manifestation and upholding the accuracy and usefulness of diagnostic criteria. This balance is vital to ensure that people from different cultural backgrounds receive correct diagnoses and proper treatment without the danger of stereotyping cultural differences.
References:
1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. DSM-5-TR. Arlington, VA: American Psychiatric Association; 2022.
VELING, W., HOEK, H. W., WIERSMA, D., & MACKENBACH, J. P. (2010). Ethnic identity and the risk of schizophrenia in ethnic minorities: A case-control study. Schizophrenia Bulletin, 36(6), 1149-1156. https://doi.org/10.1093/schbul/sbp032Links to an external site.
3-Review the posts of your peers, and respond . In each case, begin by explaining the extent to which you agree, or disagree with your peer’s conclusions, providing your reasons. Then describe what you think might be determined by a further diagnostic evaluation.
3.1Najeem Atinsola
Nov 17, 2023Nov 17 at 9:54pm
Case Study: Ben
Demographics and General History
CASE SUMMARY
Demographics
Name: Ben
Age: 46
Occupation: Computer scientist at a large university
Marital Status: Married (23yrs)
Family:
Parents living in Arizona, a brother three years older
Health and Lifestyle:
Generally healthy, jogs four miles daily, moderate alcohol consumption
Recent Significant Event:
Car accident six months ago, with head injury (negative findings on initial assessment)
Referred by and for:
Wife (Cindy) for showing atypical behaviors in the past few weeks. Wife is concerned about his mental and emotional well-being.
Sources of Information:
Primary: Wife Cindy (Credible since she lives with Ben and has been for 23 years of their marriage)
Secondary: Ben (Credible source for observation)
Tertiary: Notes from Ben’s journal to verify information related to Ben’s health, including the car accident six months ago and his overall medical history.
Ben’s Brother
Clinical Impression (Diagnosis)
These new revelations have changed the diagnosis for Ben. Based on this new information, the following is the new clinical impression that I have of Ben:
Schizophrenia Spectrum and Other Psychotic Disorders (Paranoid Type)
DSM-5 Code: 295.30 (F20.0)
ICD-10 Code: F20.0 (APA, 2022).
Post-Traumatic Stress Disorder (PTSD)
DSM-5 Code: 309.81 (F43.10)
ICD-10 Code: F43.10 (APA, 2022).
Recommendations for interventions, treatment, and/or disposition
Given the new diagnosis that suggests the possibility of schizophrenia spectrum and psychotic disorders alongside PTSD, I recommend an intensive psychiatric treatment program and psychoeducation for Ben’s family. My rationale is that there is a possible genetic predisposition to Ben’s mental health issues from the fact that his uncle (Uncle Mo) suffered mental health issues for over 14 years into his adulthood. Ben has displayed severe symptoms that include self-harm and the potential to harm others. There is, therefore, a need for a comprehensive diagnostic evaluation, considering psychiatric hospitalization or enrollment in an intensive treatment program. Regarding family psychoeducation, I propose that his family should be provided with psychoeducation about schizophrenia spectrum disorders, including the nature of symptoms, potential exacerbating factors, and treatment options. The educator should address misconceptions and enhance understanding to facilitate active family support.
How the New Information Alters the Picture Presented in the Original Study
My previous assumptions were that Ben might have suffered brain injuries that were not revealed by the X-ray analysis and required an MRI or CT scan. However, the additional historical information, particularly the college episode and the fight with the department head, provides a clearer picture of Ben’s long-standing psychiatric symptoms, odd beliefs, and reluctance to discuss psychiatric treatment, further supporting the consideration of schizophrenia spectrum disorders. Lastly, the journals Cindy discovered may provide valuable insights into Ben’s thought processes, contributing to a more comprehensive understanding of his mental health.
My Diagnosis Hypothesis and Justification
My rationale is based on Ben’s history, including the college episode where he assaulted his roommate due to paranoid delusions about the KGB. This incident aligns with a diagnosis on the schizophrenia spectrum. Similarly, the recent escalation of symptoms, erratic behavior, paranoid thoughts (e.g., believing the department head plagiarized his work), and reluctance to discuss previous medication use point toward a psychotic disorder. Regarding PTSD, I still believe that the delayed and obstructed medical follow-up after the car accident, coupled with reported traumatic experiences such as the assault episode in college and the plagiarism incident, supports the consideration of PTSD as a comorbid condition.
References
APA. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR(TM). American Psychiatric Publications Inc.https://www.migna.ir/images/docs/files/000058/nf00058253-2.pdf
3.2Raswinder Nagra
MondayNov 20 at 4:57pm
1. Case Summary
The following case summary has been provided by the case notes provided by Jung (2023).
Ben is a middle-aged Caucasian male who presents for evaluation at the hospital accompanied by his wife, Cindy. Ben presents to the initial appointment hostile and indicates he was brought to the hospital against his will and does not want to be interviewed. Ben also becomes disorientated and anxious during the interview when questioned about his family history. Cindy reports moody, irritability, and inappropriate behavior from Ben over the last five days. Cindy reports that last week, Ben asked an attractive neighbor at a party if she was having a good time and then proceeded to touch her breast and was surprised by her angry response. This resulted in him striking her husband after he was pushed away. Cindy reports she called her doctor yesterday after Ben ate his cereal with his fingers, had difficulty organizing his belongings, and started the car, yet forgot and took the bus to work.
Ben reports that work stress is the cause of his behavior change and proceeds to use profanity to describe his work and his boss. It is difficult to engage Ben to report further due to his irritability and distracted nature. Cindy also reports financial mismanagement as he previously has only made conservative investments and recently invested in a high-risk investment with little reason. The erratic behavior was reported in the past five days, approximately 6.5 months post-car accident. Cindy was troubled to recently discover Ben’s journals that contain “nonsensical” information.
Cindy reports that her husband is generally kind, respectful, and shy. She reports that Ben is careful, organized, and follows through with plans. Cindy recalls a period earlier in their marriage when Ben fought with a department head who he was certain was plagiarizing his work. Ben changed jobs, and he shared with his wife he had evidence of plagiarism due to both articles being published by the same letter of the alphabet.
Medical history: Cindy reported that six months ago, Ben was a passenger in a car accident where they rear-ended the car in front of him. X-rays reveal no findings, and no signs of observable brain injury were noted up to 48 hours after the injury. Recent medical tests reveal no medical effects from the accident supported by brain scans.
Ben reports that he normally has a glass of wine with dinner and approximately 2 to 3 glasses on a weekend. There is no report of substance or alcohol abuse. Previous medical history reveals no illness, injuries, accidents, or medications. The patient maintains physical health by jogging 4 miles per day. Previous surgeries include tonsillectomy and removal of impacted wisdom teeth. His wife and his sibling corroborate this information.
Family History: There are no reported instances of a family history of mental illness or medical illnesses. Ben has one sibling, a brother who is three years older. Ben’s parents are still living and in fair health.
Psychiatric History:. Cindy reports Ben’s siblings report in college, Ben had assaulted a roommate as he believed he worked for the KGB. Over an eight-month period, Ben’s symptoms went from erratic and peculiar to cumulating into an assault. Ben was seen by a college psychiatrist who placed Ben on a prescription. There are no further details as Ben did not share details, and the family did not inquire further. A family history of mental illness was not descriptive, yet noted Uncle Mo, whom they report “has a case of the nerves,” yet Cindy noted he died in a mental hospital where he was institutionalized for 14 years.
Academic / Vocational: Ben works for a software company as a computer scientist at a large university. He works 50 hours a week and has received excellent reviews and promotions. It is reported that Ben was an excellent student in both high school and college, placing on the Dean’s list nine times.
Social History: Ben has been married for 23 years to his wife, Cindy, and has had a healthy and faithful relationship with mild conflict. In the interview, Ben becomes lecherous in discussing an interest in a female colleague from the past. Cindy reports Ben is normally a social person with good family relations and a good childhood and is close friends with many coworkers and people from high school and college. His wife reports that he initiates many telephone calls with neighbors and finds ease in maintaining relationships. There is no reference to the patient’s culture, ethnicity, or socioeconomic status.
Clinical Impression (Diagnosis)
(F23) Brief Psychotic Disorder with a marked stressor (R/O, provisional)
To meet Criterion A, Ben presents with disorganized speech due to his derailment in the interview and his incoherent journals. Grossly disorganized behavior, as noted by Cindy as his inability to prepare and present to work, and his unpredictable agitation with the interaction with the neighbors. The duration of these symptoms has been present over the past 5 days but less than one month, meeting Criterion B. The disturbance cannot be better described by major depressive disorder or bipolar disorder as it doesn’t meet the criteria for these disorders at this stage. There is a marked stressor, as noted by Ben, caused by increased work stress.
OTHER FACTORS:
(Z56.3) Stressful work schedule
(Z63.0) Relationship distress with spouse
Recommendations
I would recommend the Mini-mental State Examination. Requesting previous medical records, especially the college psychiatric assessment, would be required. I would also recommend further psychological assessments to determine if Ben meets the criteria for any other mental illness, such as bipolar disorder, schizophrenia, or other mental illnesses. The World Health Organization Disability Assessment Schedule, Version 2.0 (American Psychiatric Association, 2022), would be helpful to assess Ben in his communication skills, self-care, relating to others, participation in life and society, and the ability to get around. The DSM-5 Level 1 Cross-Cutting Symptom Measure can also be utilized as both a self or informant-rated measure to assess the psychiatric diagnoses, such that the medical team can assess the changes in Ben’s symptoms and their progression (American Psychiatric Association, 2022). The 13 psychiatric domains will be assessed over the preceding two-week period, which would be important as Ben’s behavioral changes are acute and may change as time progresses. These tests are important as the assessment of depression, mania, and cognition will allow diagnosis of the different psychotic disorders, especially if the symptoms last for more than one month. If this is a recurrent disorder, which will require assessment of college psychiatric diagnoses, then a recurring psychotic episode may be due to schizophrenia, b or bipolar disorder may be responsible for the manifestation of symptoms with Ben. Further recommendations include medical assessment and laboratory work to ensure a medical condition, or use of a substance may be leading to psychotic symptoms.
References;
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787Links to an external site.
Jung, N. (2023). Psy6210: Case Study Benl. Department of Capella University. https://campus.capella.edu/homee | Capella University
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