following phrases listed afterward (” principle diagnosis “) H u m a n i t i e s

GUIDELINES FOR DISCUSSION POSTS

1. The discussion contribution or response clearly addresses the content issue(s) presented by the question.
2. The discussion contribution or response includes the appropriate level(s) of critical analysis.
3. The discussion contribution or response includes pertinent course and disciplinary concepts, theories, or materials, and applies them correctly.
4. The discussion contribution or response provides validation and support by including relevant examples and supporting evidence, as appropriate.
5. The discussion contribution or response stimulates fellow learners to clarify, extend, and strengthen their dialogue.
6. The discussion contribution or response is concise, clearly organized, and well structured.
7. The discussion contribution or response uses grammar, usage, and mechanics expected of graduate level composition and expression.
8. All citations and references adhere to APA 6th edition style.
9. The discussion contribution or response fosters collaboration with fellow learners and communicates in a manner that respects the dignity and integrity of fellow learners and the instructor.
10. The discussion response meaningfully supplements and extends consideration of the topic by including one of more of the following: new information, questions, constructive or corrective feedback, or alternative viewpoints.

FIRST DISCUSSION POST

1. The purpose of this discussion is to make your first attempt at diagnosis of abnormal behavior and to think through the processes involved. Read the brief Case Study of Edgar below. Then, using what you learned in your reading in this unit (u01s1 Study), identify the type of disorder that best describes Edgar’s behavior. Once you have selected a group of disorders, review the outline of that group of disorders in the DSM-5 Classification to identify the codes involved. (Make sure you have read the section on Depressive Disorders in the DSM-5.)

Case Study of Edgar

Edgar is 25 years old and was hospitalized today after a suicide attempt in which he drove his car into a lake. This is his first depressive episode. It started six months ago and is characterized by a nearly continual depression, loss of interest in all activities, an unplanned loss of twenty-five pounds, hypersomnia (excessive sleepiness), an inability to concentrate and recurrent thoughts of killing himself. His mood state is severe, but there is no evidence of psychosis.

He began drinking five to eight beers per day in the last two months, clearly exacerbating his symptoms. Prior to the onset of these symptoms he consumed one to two beers per day. He uses no other drugs. Medical records indicate no medical conditions of concern. His marriage is in trouble due to his severe behavioral symptoms. His wife is thinking of leaving him; he was recently terminated from his job because he can’t get up to make it to work; and their house is in danger of being foreclosed on by the bank because he forgot to pay the mortgage for four months.

For your initial post in this discussion, address the following four aspects

***Record Edgar’s diagnosis or diagnoses as you see the issues in this case study. Do so in the following format.

Note: This is the essential format you will use for all diagnostics in this class and beyond. In other words, whenever a discussion question or assignment asks you to provide a diagnosis, be sure to list your choices in this format. It is also important to reference the DSM-5 in the section of your work that includes this formatted list of diagnostic codes and names. Here is the standard format:

DSM-5 Code number of disorder. ( ICD-10 number code, put in parentheses).

Name of the disorder detailed in the DSM-5. It is proper to list the most relevant or “principle” diagnostic label first and have one of the following phrases listed afterward (“principle diagnosis”) or (“reason for visit”).

Other Factors: In this section, you will list problems or situations that may require clinical attention but are not otherwise considered a mental illness. In other words, they are a list of stressors that that may be involved and impacting the case. You will want to consider “Other Conditions That May Be a Focus of Clinical Attention” starting on page 715 (toward the end of Section II of the DSM-5). Most codes you will list here begin with the letter “v” such as V60.0 (Z59.0) Homelessness. You should NOT list formal mental illness diagnoses in this section.

Example (Realize that this example diagnosis may or may not be accurate; it is offered as an example of the format to use when you arrive at your own diagnostic view of the case of Edgar):

296.23 (F32.2)	Major Depressive Disorder, Single Episode, Severe.
305.00 (F10.10)	Alcohol Use Disorder.

Other Factors:

V61.10 (Z63.0)	Relationship Distress with Spouse or Intimate Partner.
V62.29 (Z56.9)	Problem related to Employment (job loss).
V60.9 (Z59.9)	Potential loss of housing due to job loss.

*****Briefly describe the decision-making steps or process you used to arrive at your diagnosis or diagnoses of Edgar ******What did you find easy or difficult about this task at your current level of training in diagnostics? *****What more you would like to know to ensure that you have coded Edgar’s diagnostic issues accurately?

SECOND DISCUSSION POST

The purpose of this discussion is to think through some of the ambiguities that can make the diagnostic process more complex than it might at first appear.

Begin by carefully reading the Case Study of John. Pay particular attention to how the psychologist’s diagnosis changes as the case unfolds and more information is available about John. Imagine how much more difficult accurate diagnosis would have been if you had followed a particular diagnosis prematurely.

1. What were your thought processes and reactions as you noted the changing picture presented in John’s case?
2. Using the diathesis-stress model to assess John’s case, what salient vulnerabilities and stressors come to mind?
3. Attempt a diagnosis for John, based on your current knowledge, providing the DSM-5 and ICD-10 codes, according to the format provided in Unit 1.

Some suggestions to help you prepare your initial post: Since you have not yet learned diagnostic specifics, just describe your evolving impressions in whatever terms seem the most accurately descriptive, and the reasons for those impressions. Turn to the DSM Decision Trees and DSM-5 diagnostic categories for assistance. A combination of narrative comment and a highlighted encoding DSM-5 diagnosis would work well.

Refer to the Case Study Response Guide to assist you with this discussion.

PLEASE REFER TO THE ATTACHED DOCUMENT NAMED DISCUSSION POST 2 For the case study.

THIRD DISCUSSION POST

For this discussion, refer to the psychological diagnosis you chose to read for a single diagnostic code in DSM-5 text in the study in this unit (u02s1).

Each of us has a different background of experience. Keeping your experience level in mind, along with what you personally need to glean from such a diagnostic manual, please provide your analysis of how effectively the manual covered the following aspects of the diagnosis you read about.

1. Diagnostic features.
2. Subtypes and specifiers.
3. Associated features and disorders, including:
   1. Laboratory findings.
   2. Physical examination and general medical condition findings.
4. Culture, age, and gender features.
5. Prevalence.
6. Course of the disorder.
7. Familial pattern.
8. Differential diagnoses.
9. Diagnostic criteria.

Be sure to address what was effective and helpful in the DSM’s presentation, what you feel is missing or could be improved, any cultural or diversity issues that might be of concern, and what you personally need to know more about.

FOURTH DISCUSSION POST

Read the Case Study of Marvin.

In addition to anxiety being a symptom of mental health diagnoses, it can also be a symptom of certain medical illnesses.

1. Find a medical condition that can mimic or cause anxiety and obsessive-compulsive symptoms, and find two articles about that medical disorder.
2. Post your summary of the two research articles you reviewed. Be sure that you integrate both into one coherent summary, providing support for your claims about which medical conditions should be kept in mind when seeing anxiety and obsessive-compulsive symptoms.
3. What, if any, ethnic or cultural controversies are factors to consider when teasing out the etiology of anxiety and obsessive-compulsions related to this medical concern?

Note: You may want to pay particular attention to the sections of your DSM-5 text (pages 226–233 and 257–263) that review substance or medication-induced anxiety or obsessive-compulsive disorders, as well as possible medical reasons for the disorders.

Any of the listed medical conditions might contribute to Marvin’s anxiety and obsessive-compulsive behaviors.

1. Provide a critical evaluation of the research you studied.
2. Is it methodologically robust?
3. Are the findings sufficiently robust to persuade you?

Be sure to support your conclusions well. Think about these issues carefully before you begin to write this post. It will be particularly important for you to answer these questions:

• How do you know the research is methodologically robust?
• What is needed to make it robust?
• If you are unsure about this, how can you get your questions answered?

FIFTH DISCUSSION POST

Review the Case Study of Marvin. Using the medical illness you choose to write about in this unit’s first discussion, respond to the following:

• How would this specific medical condition or illness be likely to impact or interact with Marvin’s described anxiety symptoms and obsessive-compulsive symptoms?
• How would you sort out (understand) the differential impacts of the two conditions (obsessive-compulsive disorder, as opposed to the medical condition you chose)?
• Would you still make a diagnosis of obsessive-compulsive disorder if you found that Marvin also suffered from this disorder?
• How do you differentiate Marvin’s obsessive-compulsive symptoms between the related diagnoses of:
  • Obsessive-compulsive disorder.
  • Obsessive-compulsive personality disorder.

Defend your answer.

Record the diagnosis you would give Marvin if he clearly displays this medical condition in addition to his anxiety and obsessive-compulsive symptoms. Review the Case Study Response Guide to assist you with this discussion.

Response Guidelines

Review the other posts of other learners, and respond to at least two of them. What did you learn from their research and writing? Do you agree with their diagnosis? Why or why not? Explain your position.

SIXTH DISCUSSION POST

In your Diagnostic and Statistical Manual of Mental Disorders (5th Edition) text, critique the strengths and weaknesses of the Bipolar Disorders section, including such factors as its structure and organization, ease of use, and the primary research and methodological considerations that were used to establish the criteria for these disorders.

In particular, assess how you differentiate between Bipolar I Disorder, Bipolar II Disorder, and a Cyclothymic Disorder, and how these came to be viewed as different diagnoses in the development of the DSM. This will entail some research outside of required course materials.

SEVENTH DISCUSSION POST

Based on the material presented in the Case Study of Bill:

1. Provide the DSM-5 differential diagnoses for Bill, including a listing of “Other Factors,” and support your decision process with a brief narrative.
2. Refer to the two ICD-10-CM appendices in your DSM-5 text, pages 839–862 and 877–896 and detail any differences in the diagnosis that you might find if you were to use the ICD-10 to arrive at the diagnosis or diagnoses. (As this is your first look at the comparison between the ICD-10 and the DSM classification systems, you may want to take a little time to understand how these systems relate to each other.)
3. Explain the etiological factors that you think are relevant in this case along with their reasons, keeping the diathesis-stress model in mind. You will need to do some research to clearly explain and support your reasons for suspecting these etiological factors.
4. List the three primary issues that need to be addressed in a treatment plan for Bill.

Review the Case Study Response Guide to assist you with this discussion.

EIGTH DISCUSSION POST

We now revisit the case of Bill from the previous unit. Imagine you have conducted a second interview with him. After pondering the case presented in this unit’s readings:

1. Reformulate your diagnostic work-up of Bill, given the new information in Part 2 of his case study.
2. Describe your decision-making process in arriving at this reformulation.
3. Evaluate the difficulties in accurately diagnosing personality disorders.
4. Discuss the difficulties in obtaining accurate information about clients’ histories.

Review the Case Study Response Guide to assist you with this discussion.

NINTH DISCUSSION POST

Find and report on psychological literature that addresses these three issues:

1. Discuss the role that individual differences (gender, ethnicity, socioeconomic status, sexual orientation, religious commitment, age, geography, and so on) may play in behaviors or attitudes that might be considered signs of a personality disorder.
2. Give examples to support your points.
3. Examine in writing at least three of these individual differences, but give particular attention to one of your choice.

Be sure to cite references for each of these sections.

TENTH DISCUSSION POST

Respond to the following in your initial post:

• Distinguish between substance use, abuse, and dependence. Be sure to use current DSM-5 terminology and conceptualizations as you respond to this task.
• Compare the presentation differences you could expect to see in an individual diagnosed with a generalized anxiety disorder who is dependent on one of these:
  • Marijuana.
  • Alcohol.
  • Methamphetamines.
  • Cocaine.
• Briefly assess the factors involved in at least one ethnic and cultural issue related to substance abuse that is at the heart of a current controversy, being sure to include a perspective on diathesis-stress issues.

ELEVENTH DISCUSSION POST

Review the Case Study of Ben, Part 1. Use the Case Study Response Guide to guide your analysis of how you might apply the DSM-5 to diagnose Ben’s condition.

For your initial post in this discussion, though, rather than providing a diagnosis, submit your responses to these questions:

1. What diagnostic possibilities does Ben’s case present?
2. What have you read in the case history so far that presents these possibilities for you?
3. What kind of questions you might ask to evaluate each diagnostic possibility? You must consider at least two, but no more than three, diagnostic possibilities, and develop a series of questions to interview for each possibility.
4. What possible answers would lead you toward or away from each of your possibilities?
5. What further information and referrals would you want to clarify Ben’s diagnosis?

12th DISCUSSION POST

Respond to the following in your initial post:

• If you were working in the emergency room of a hospital, how would you distinguish between three individuals, one of whom presents with schizophrenia, another with a schizoaffective disorder, and the third with a brief psychotic disorder?
• What is the basic ICD-10 code (the number) for each of these diagnoses?
• Create a brief PowerPoint presentation you could provide to families that explains the prognosis for two of these disorders and any treatment issues of which the family needs to be aware. Remember that, when using PowerPoint, the slide should present headlines, rather than paragraphs. The idea is that you would walk through the slides with the family, filling in the details as you speak. The Notes section should be used to store your details. Upload your PowerPoint presentation as an attachment to this discussion.
• Identify, analyze, and discuss both sides of one current controversy related to cultural and ethnic issues in the diagnosis of schizophrenia.

13th DISCUSSION POST

Review the Case Study of Ben, Part 3. Imagine now that you had not seen Part 2 but instead, after Ben Part 1, you read Part 3. For your initial post in this discussion, submit your response to these questions:

• Describe how the new information alters the picture presented in the original case study. Before posting, you might want to review Ben Part 1, the case you discussed last week (u06d2).
• Describe your new diagnostic hypotheses, and justify your conclusions.
• What further diagnostic evaluation do you believe is warranted?

14th DISCUSSION POST

Respond to the following in your initial post:

• Choose one disorder covered in the readings for this unit, and apply the diathesis-stress model to understanding it.
• Choose two possible categories of substance abuse from the DSM and compare and contrast the interactive impact these substance abuse disorders would likely have on the disorder you are writing about.
• Choose two different ethnic or cultural groups in the United States. Compare and contrast the impact of this diagnosis on members of these two groups.
• Be sure to put the name of the disorder in the subject line of your post.

15th DISCUSSION POST

Choose one of the disorders covered in the chapters of the DSM-5 that you read for this unit.

• Discover and review sources of information on the disorder from outside of the course materials, and present a description of some current issue or controversy in the diagnosis (not treatment) of this disorder.
• Be careful to analyze cultural influences in this controversy and to compare DSM-5 and ICD-10 terms.
• Put the name of the disorder in the subject line of the post.

16th DISCUSSION POST

Choose any of the childhood or adolescent disorders covered in the assigned readings in this unit except bipolar disorder. Discover and review sources of information on the disorder. Then respond to these topics:

• Debate the pros and cons of a current issue or controversy related to the diagnosis (not treatment) of this disorder. Be sure to consider the cultural and ethnic aspects and impact of the diagnosis.
• Present your arguments for the components of a state-of-the-art assessment that are needed to properly diagnose this disorder in children and adolescents. Be sure to consider:
  • Diagnostic ethical issues.
  • Sensitivity to diversity.
  • Etiological issues.

17th DISCUSSION POST

In recent years, there have been heated controversies about attention-deficit hyperactivity disorder (ADHD). Perhaps the most heated current controversy involves the diagnosis of bipolar disorder in children and adolescents.

• Identify and summarize two articles on this controversy, and outline the primary points of disagreement.
• Take a position on the controversy and justify it.
• Is this a condition that has been improperly under-diagnosed in minors, or are proponents over-diagnosing bipolar disorder in difficult minors?
• Support your arguments with appropriate citations.

18th DISCUSSION POST

Based upon your reading of all sources, respond to the following:

• Is there value in keeping some diagnostic system? Why or why not?
• If you believe that there is value in keeping some diagnostic system, what would it consist of?
  • Would it look like the DSM-5 or something different?
  • If different, what would the features be?

The journal articles assigned for this unit can serve as one set of ideas, but feel free to use other sources.

19th DISCUSSION POST

Based upon your reading of all sources, respond to the following:

• Is there value in keeping some diagnostic system? Why or why not?
• If you believe that there is value in keeping some diagnostic system, what would it consist of?
  • Would it look like the DSM-5 or something different?
  • If different, what would the features be?

The journal articles assigned for this unit can serve as one set of ideas, but feel free to use other sources.