Effects of Drug Abuse

*Use headers for each question*

300- to 500-word response in which you address the following:

Provide the full DSM-5 diagnosis for the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention).  Keep in mind a diagnosis covers the most recent 12 months.

Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.

Discuss other disorders you considered for this diagnosis and eliminated (the differential diagnoses).

Describe an evidence-based assessment scale that would assist in ongoing validation of your diagnosis.

Recommend a specific intervention and explain why this intervention may be effective in treating the client.

Support your recommendation with scholarly references and resources.

CASE PRESENTATION –NAHIA
INTAKE DATE: May 2019
IDENTIFYING/DEMOGRAPHIC DATA: Nahia is a 43-year-old, married,
heterosexual, African American female. Nahia lives with her husband, Dion, of 24
years. She describes being happily married. Nahia is a Certified Public
Accountant, who loves her job. She is the manager over 12 employees. Dion is a
manager of a gym franchise. They have three children, 19 years old, 17 years old
and 12 years old.

CHIEF COMPLAINT/PRESENTING PROBLEM: “My job is flexible and I can
work from home often but I get nervous if I am not in the office and lately my
focus has been in other areas and I just have trouble focusing on work”
HISTORY OF PRESENT ILLNESS: Nahia worries about many things, which is
not new to her. She describes herself as always worrying about things which has
been successful for her in her career. She loves to clean her house as therapy to
take her mind off the worry. There are times when she looks at her surroundings at
home and it triggers her and within minutes she has intense discomfort feeling
dizzy, sweating, feels nauseous, and trouble breathing. It concerns her that there
may be germs around and she must keep the house clean to keep her children
healthy. She is concerned since they are growing up and will be leaving the
household soon. She also worries that she may get a visitor and the house is not in
order. She sometimes becomes irritated with Dion and at the end of their
disagreements cannot figure out what she was annoyed about.
Nahia is concerned about her job since she is having trouble sleeping and wakes
up fatigued. On several occasions, she woke up in the middle of the night
worrying about getting to work on time which increased her anxiety.
PAST PSYCHIATRIC HISTORY: Nahia has never been for therapy before and
decided to attend now because her life seems to be spinning out of control. She
has always been organized but has spent most of her adult life concerned about her
children, her husband, her employees, the clients she works with. Her anxiety goes
“through the roof” often and has progressively increased over the last 10 years.
She remembers getting so anxious as a teenager visiting friends, she would get
dizzy and nauseous at their homes.
SUBSTANCE USE HISTORY: Nahia reports drinking socially. She tried
marijuana in college several times but did not like it. She denies any other drug
use.

PAST MEDICAL HISTORY: Nahia had the usual childhood illnesses but has not
had any severe illnesses in adulthood.
FAMILY MEDICAL AND PSYCHIATRIC HISTORY: Nahia shared that when
she was 2-years-old her mother died from cancer. She denies any psychiatric
history in the family although she does not know her mothers’ family very well.
CURRENT FAMILY ISSUES AND DYNAMICS: Nahia shared that she was
raised in the military; her father is an army officer. Nahia’s father remarried and
she gets along well with her stepmother. She has two half brothers from that
union. She has travelled all over the world living on military bases mostly. She
has a very close relationship with her father. She knows they were raised in the
“military” fashion but believes it has benefitted her over the years.

MENTAL STATUS EXAM: Nahia is oriented to time, place, and person. She is
professionally dressed, and looks her stated age. She presents with some anxiety in
the interview. Motor activity is appropriate. Speech is clear. There is no evidence
of delusions or hallucinations. Nahia intelligence appears above average.