Question

Over the past decade, cases of substance related disorders have appeared more prevalent in society. From the mental health perspective, research has shown an increase in cases of substance related disorders, particularly with adolescents. This increase has prompted further investigation into adolescent risk and resilience factors, as well as accuracy in diagnosis and appropriate treatment plans. Yet, in cases of adolescent substance use, further investigation is still needed concerning notification rights of parents, legal authorities, and/or case workers.  

For this Application, review the client case study in the Learning Resources. Consider the characteristics of the client. Which specific characteristics might you consider important in developing a diagnosis? Consider your rationale for assigning particular diagnoses on the basis of the DSM. Also, think about what other information or people you may need to include in the assessment in order to make an accurate diagnosis.

The Assignment (3–4 pages)

A DSM diagnosis of the client in the case study

An explanation of your rationale for assigning the diagnosis on the basis of the DSM

An explanation of what other information you might need about the client to make an accurate diagnosis

A brief description of additional individuals you might include in your assessment and explain why

Substance Related and Addictive Disorders Program Transcript

FEMALE SPEAKER: He's-- he's always doing things on the computer. He talks on the telephone, texting. He never stops, not even to eat. He never eats much anymore.

MALE SPEAKER: Eat your veggies. Drink your milk. Eat your veggies. Drink your milk. Who needs to eat? Seen any good movies lately? I like horror movies, myself. Zombies, especially. The fast ones.

FEMALE SPEAKER: There's no alcohol or drugs in our house, none. We've never done that. We don't leave drink wine. That's why I wanted our minister to talk to him.

MALE SPEAKER: Talk about zombies.

FEMALE SPEAKER: He's the one who suggested that we come here and talk to because he was thinking that maybe something's going on.

MALE SPEAKER: Yuck! I hate booze. I don't do drugs, either. I say no every day.

FEMALE SPEAKER: Personally, I think it's the music he's listening to.

MALE SPEAKER: Oh, brother.

FEMALE SPEAKER: I mean, the screaming. It's so aggressive and angry.

MALE SPEAKER: Feels good.

FEMALE SPEAKER: Maybe you agree with your mom that you've been depressed and angry in the past, do you remember, maybe, why you felt that way?

MALE SPEAKER: Because I'm stupid.

FEMALE SPEAKER: You're not stupid, honey. See, he had to repeat the fifth grade, so he's a year behind all his friends at school.

MALE SPEAKER: They're not my friends. You hate my friends.

FEMALE SPEAKER: I don't hate them. It's just I don't think you should be hanging around boys who are that much older than you.

Answer 1

In the above mentioned case ,depending on the conversation between the female speaker and the male speaker few things can be inferred but number of factors are not clear to make particular diagnosis.

The provisional Diagnosis one can make is on the basis of following points

- female speaker tells about overindulgence in technology and giving up daily chores like eating or sleeping , suggest male is having salience due to dependence to particular substance or addiction.Details of substance used is not stated, duration from when he was using substance in what pattern is not known.

When female is talking ,in between he is associating the thought and talking something irrelevant, suggestive of disturbances in thought process,can be probably due to substance induced psychotic symptoms. She also mentions of screaming or getting aggressive suggestive of either hallucinatory behavior, there is equal probability that he has substance induced mood disorder. Detailed mental status examination is important in that case along with detailed history.

Better history can be taken from better informant who can be any of his close friends who knows about use of his drug pattern.

Also psychological evaluation is important, assessment by applying rating scales along with objective tests like Rorschac can be applied to make sure about the psychosis ,also to know more about the type of personality or other personality disorder if any, also to know of any intelligence issues as female tells about his failure in fifth grade. Also to know about other comorbid psychiatric conditions like conduct disorder or mood disorder.

Also urine drug screen by involving a person from path lab is also important to make sure what all substances client was using,to get better communication relation of symptoms.

All these information and lot more is essential for making accurate diagnosis.