TrainingTitle21week4.docx

Training Title 21

Name: Sergeant Patrick Flanrey Gender: male Age:27 years old T- 97.4 P- 84 R 18 B/P134/88 Ht 5’8 Wt 167lbs Background: He entered the military just after high school and did three long tours of duty in warzones. He separated from active duty in the Marines (MOS 0800 Field Artillery) less than a year ago after eight years of service. He is engaged to be married (no date set) and is currently working as a furniture salesman. He said he grew up poor and would not do much else if he didn’t go into the military. He denies ever using any drugs and avoids alcohol because his father was “sloppy drunk.” Father is still alive, unwell (DM, liver disease, HTN), still drinking. Paternal grandfather was also a veteran and suffered depression at times though he never told anyone except the patient because of their combat connection. Mother is alive and well, still “caring for dad.” He has one younger and one older sister. He lives in a different state, approximately five hours from his parents and siblings. After the military, he and his fiancé moved because she got a much better opportunity. They want kids someday and hope to marry in a year or two. Has service-connected asthma, seasonal allergies; no hx of psychiatric or substance use treatment

Symptom Media. (Producer). (2016). Training title 21 [Video]. https://videoalexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-21

Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

“Fear,” according to the DSM-5, “is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2013). All anxiety disorders contain some degree of fear or anxiety symptoms (often in combination with avoidant behaviors), although their causes and severity differ. Trauma-related disorders may also, but not necessarily, contain fear and anxiety symptoms, but their primary distinguishing criterion is exposure to a traumatic event. Trauma can occur at any point in life. It might not surprise you to discover that traumatic events are likely to have a greater effect on children than on adults. Early-life traumatic experiences, such as childhood sexual abuse, may influence the physiology of the developing brain. Later in life, there is a chronic hyperarousal of the stress response, making the individual vulnerable to further stress and stress-related disease. 

Photo Credit: Hill Street Studios / Blend Images / Getty Images

For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5 criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5 criteria. 

To Prepare:

· Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing anxiety, obsessive-compulsive, and trauma- and stressor-related disorders.

· Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document. 

· By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.

· Consider what history would be necessary to collect from this patient.

· Consider what interview questions you would need to ask this patient.

· Identify at least three possible differential diagnoses for the patient.

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.

Incorporate the following into your responses in the template:

· Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? 

· Objective: What observations did you make during the psychiatric assessment?  

· Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.

· Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

Training Title 21

Name: Sergeant Patrick Flanrey Gender: male Age:27 years old T

-

97.4 P

-

84 R 18 B/P134/88 Ht 5’8 Wt

167lbs

Background: He entered the military just after high school and did three long tours of duty in

warzones. He separated from active duty in the Marines (MOS 0800 Field Artillery) less than a year ago

after eight years of service. He is engaged to be married

(no date set) and is currently working as a

furniture salesman. He said he grew up poor and would not do much else if he didn’t go into the

military. He denies ever using any drugs and avoids alcohol because his father was “sloppy drunk.”

Father is still a

live, unwell (DM, liver disease, HTN), still drinking. Paternal grandfather was also a

veteran and suffered depression at times though he never told anyone except the patient because of

their combat connection. Mother is alive and well, still “caring for d

ad.” He has one younger and one

older sister. He lives in a different state, approximately five hours from his parents and siblings. After the

military, he and his fiancé moved because she got a much better opportunity. They want kids someday

and hope to m

arry in a year or two. Has service

-

connected asthma, seasonal allergies; no hx of

psychiatric or substance use treatment

Symptom Media. (

Producer). (2016). Training title 21 [Video].

https://video

alexanderstreet�com.ezp.waldenulibrary.org/watch/training

-

title

-

21

Training Title 21

-

Alexander Street, a ProQuest Company (openathens.net)

Assignment: Assessing and Diagnosing

Patients With Anxiety Disorders, PTSD, and

OCD

“Fear,” according to the

DSM

-

5

, “is the emotional response to

real or perceived

imminent threat, whereas

anxiety

is anticipation of future threat” (APA, 2013). All

anxiety disorders contain some degree of fear or anxiety symptoms (often in

combination with avoidant behaviors), although their causes and severity diff

er.

Trauma

-

related disorders may also, but not necessarily,

contain fear and

anxiety

symptoms, but their primary distinguishing criterion is exposure to a traumatic

event. Trauma can occur at any point in life. It might not surprise you to discover

that tr

aumatic events are likely to have a greater effect on children than on adults.

Early

-

life traumatic experiences, such as childhood sexual abuse, may influence the

physiology of the developing brain. Later in life, there is a chronic hyperarousal of

the str

ess response, making the individual vulnerable to further stress and stress

-

related disease.

Training Title 21

Name: Sergeant Patrick Flanrey Gender: male Age:27 years old T- 97.4 P- 84 R 18 B/P134/88 Ht 5’8 Wt

167lbs Background: He entered the military just after high school and did three long tours of duty in

warzones. He separated from active duty in the Marines (MOS 0800 Field Artillery) less than a year ago

after eight years of service. He is engaged to be married (no date set) and is currently working as a

furniture salesman. He said he grew up poor and would not do much else if he didn’t go into the

military. He denies ever using any drugs and avoids alcohol because his father was “sloppy drunk.”

Father is still alive, unwell (DM, liver disease, HTN), still drinking. Paternal grandfather was also a

veteran and suffered depression at times though he never told anyone except the patient because of

their combat connection. Mother is alive and well, still “caring for dad.” He has one younger and one

older sister. He lives in a different state, approximately five hours from his parents and siblings. After the

military, he and his fiancé moved because she got a much better opportunity. They want kids someday

and hope to marry in a year or two. Has service-connected asthma, seasonal allergies; no hx of

psychiatric or substance use treatment

Symptom Media. (Producer). (2016). Training title 21 [Video].

https://videoalexanderstreet�com.ezp.waldenulibrary.org/watch/training-title-21

Training Title 21 - Alexander Street, a ProQuest Company (openathens.net)

Assignment: Assessing and Diagnosing

Patients With Anxiety Disorders, PTSD, and

OCD

“Fear,” according to the DSM-5, “is the emotional response to real or perceived

imminent threat, whereas anxiety is anticipation of future threat” (APA, 2013). All

anxiety disorders contain some degree of fear or anxiety symptoms (often in

combination with avoidant behaviors), although their causes and severity differ.

Trauma-related disorders may also, but not necessarily, contain fear and anxiety

symptoms, but their primary distinguishing criterion is exposure to a traumatic

event. Trauma can occur at any point in life. It might not surprise you to discover

that traumatic events are likely to have a greater effect on children than on adults.

Early-life traumatic experiences, such as childhood sexual abuse, may influence the

physiology of the developing brain. Later in life, there is a chronic hyperarousal of

the stress response, making the individual vulnerable to further stress and stress-

related disease.

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