Christina is a 25-year-old Mexican American woman who has been working as an elementary school teacher since she graduated from college three years ago. Although she does well at her job, she has been "feeling low" ever since she left college. When she took this teaching position, she had to relocate to a city over four hours away from her family and the house she grew up in. Even though she has made some new friends, Christina still feels disconnected and lonely. She is also concerned about her mother, who has been diagnosed with a serious health condition.
For the past month, Christina has felt much worse. She reports feeling very sad and tired most of the time and is having difficulty concentrating at work. She says that she does not have enough energy to accomplish the things she would like to do, and she is upset that she has been overeating and sleeping too much. She also has very low self-esteem, despite being well-liked at her school and receiving good performance evaluations.
Christina describes her life as "heading nowhere" and says that lately she has felt extremely hopeless. She wonders if she will ever feel as happy as she did when she was in college. She does not have a history of ever feeling worse than this, does not drink or take any substances, and is in good health.
-What's christina's Axis I diagnosis? What is the process used for making this decision?
-What other information would you gather, or what other assessment instruments might you use, to help you make an accurate diagnosis for Christina?
-What would you include on Axis IV for Christina? How does the information on Axis IV help you in understanding Christina's presenting symptoms and thinking about your treatment approach?
-What social and cultural factors would be important for you to consider when assessing and diagnosing Christina?
(1) What's Christina's Axis I diagnosis? What is the process used for making this decision?
Christina' Axis I diagnosis is as follows:
Axis I 296.90 Mood Disorder Not otherwise specified
With Atypical Features
The process to derive at this decision was based on Christina's reported symptoms. For example, she reports feeling low, disconnected and lonely. In addition, she reports feeling very sad and tired most of the time and has difficulty concentrating at work. Thus, Christina meets all the criteria for Mood disorder, Not Otherwise Specified since she does not meet the criteria for other mood disordesr, which requires five symptoms for diagnosis. In addition, it does not appear that she has had a depressive episode before. She does present with symptoms required for Mood Disorder Not Otherwise Specified (e.g., increase in appetite and excessive sleeping, and her work and impaired interpersonal relations.
(2) What other information would you gather, or what other assessment instruments might you use, to help you make an accurate diagnosis for Christina?
In addition to DSM-IV-TR criteria, you would make behavioral observations, and obtain relevant historical data that could be gathered ...
This solution discusses an Axis I diagnosis for a case study of depression.