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Initial Assessment and Diagnosis of Donald

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Donald is 33 years old. Although Donald is of relatively high intelligence, he has never been employed for more than a few days at a time, and he currently lives in a sheltered community setting. Donald has brief periods when he needs to be hospitalized. His hospitalizations are triggered by episodes of great agitation during which Donald hears voices. These voices taunt him with insulting and abusive comments. In most social situations, Donald is socially inappropriate, awkward, and painfully unsure of himself.

In his mid-teenage years, Donald began to withdraw socially and from his friends and family. At 17, he suddenly, without any obvious trigger, began to hear voices. At that time he was stubbornly insistent that the voices were coming - with malicious intent - from within a neighbor's house, transmitted electronically to the speakers of the family television. More recently he has considered the possibility that he somehow produces the voices within himself. During periods of deterioration, Donald can be heard arguing vehemently with the voices. The rest of the time he appears to be reasonably able to ignore them, although the voices are never entirely absent for sustained periods.

Prior to his breakdown, Donald had lived relatively normal middle-class life. Reasonably popular among his peers, he showed considerable athletic prowess and earned passing grades in school, although he often seemed inattentive and preoccupied. There was no evidence of ever having abused drugs.

Identify what information would be important to collect during the initial assessment process to make a diagnosis and why.

Explain what methods you would use to collect the data or make ongoing assessment.

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Assessment of Donald

(1) Identify what information would be important to collect during the initial assessment process to make a diagnosis and why.

Diagnostic considerations based on DSM-IV-TR criteria would be to suggest Schizophrenia in the assessment of this client. It appears that Donald's behavior is being caused by troubling voices and hallucinations that suggest a form of schizophrenia based on features of the (DSM-IV-TR [APA}, 2000) guidelines. However, such a generalization on the basis of MMPI results alone would be insufficient to make this diagnosis. Prior to testing Donald for schizophrenia, a therapist/counselor would have to collect more data on his background. A more accurate and descriptive analysis may reveal that Donald is experiencing a pattern of mental illness that does not meet DSM-IV-TR criteria for schizophrenia.

Thus, an ...

Solution Summary

This solution descibes the initial assessment of a specific case study.