Vignette Analysis II:

keep your responses focused on what is presented in the  vignettes. Do not add information but use your creativity to support  what you see in the vignettes as written.  Avoid elaborations and  assumptions. This assignment MUST be typed, double-spaced, in APA style,  and must be written at graduate-level English.
Use the reading assignments thoroughly in an integrative discussion.  Remember to reference all work cited or quoted by the text author. You  should be doing this often in your responses. If you use outside resources, they should support the text information, but not replace the text.
You are encouraged to use the DSM-5 Level 2 Assessment Measure(s) to formulate your diagnosis:
http://www.psychiatry.org/practice/dsm/dsm5/online-assessment-measures#Level2
All discussions must take into account the legal and ethical  considerations, as well as issues of culture and human diversity that  may pertain to the vignettes below.  Legal and Ethical information  is in Chapter 16 of the course text. Cultural information is covered  throughout the course text and DSM 5. You may use alternative cultural  resources to enhance your work.
Your assignment should be 3-4 pages plus a title and reference page.
Sara is a 38 year old woman who was referred by her  employer for mandatory counseling. She presents as markedly underweight,  in baggy clothing.  She tested positive for amphetamine on a recent  random test at work and is on suspension. It is obvious that Sara does  not want to be there, but knows she must cooperate to get her job back.   Sara is currently taking anti-psychotic medication and mood  stabilizers.  When you ask her why, she tells you that “my shrink thinks  I’m nuts. OK, I admit that sometimes I think the devil is telling me to  kill myself, but I never do it. I just cut myself  instead. Nothing  serious, just a scratch here and there”. She admits that,  “a couple of  drinks or a line, calms the beast and the voices stop”.  She also admits  to loving excitement and risk taking.  “I love it when my mind races  and I just hop in the car and go.  Messes with my job sometimes, but who  cares”.
During your psychosocial assessment, you learn that Sara  was born in Japan.  Her father was a Native-American spirit-seeker.  He  came to Japan to study Eastern Religions where he met her mother, who  she describes as, “a meek and quiet little Japanese woman”. When Sara  was 8 years old, they left Japan and moved to the United States, living  with her father’s family. She appears nervous talking about this time of  her life, but does admit it was a dark and fearful time, except for her  grandmother, who she loved deeply, but died when Sara was age 14.
At age 15, she began seeing spirits of her deceased  grandmother. She wondered if this was a spiritual sign. It saddened her  so much, that she began self-abuse, strict dieting and substance use at  about that age. She believes that the devil tells that her grandmother’s  death, “was all my fault. I deserve to suffer”.  Her guilt and  self-loathing have prevented her from committing to a relationship. She  has been dating the same man for 15 years who she describes as, “too  good for me. I don’t know why he hangs around”.
1. Formulate a Differential Diagnosis for Sara.  What comorbid  disorders might you see?  Support your ideas by discussing what you see  in the vignette utilizing your course readings thoroughly in your diagnostic formulation.  What information would you look for to confirm your diagnostic impression and why?
2. Choose two (2) theoretical models to explain to explain Sara’s  clinical presentation and suggested treatment modalities.  Support your  ideas by discussing the models directly and specifically to Sara.
(Remember to consider culture, law and ethics when diagnosing and treating)
Assignment Outcomes:

Analyze the physical, cognitive, social and personality aspects of abnormal psychology and implications across the life span

Examine the major diagnostic domains and specific criteria associated with DSM-5 disorders.

Evaluate legal and ethical issues in mental health treatment

Develop an awareness of diversity and cross-cultural perspectives in abnormal psychology.

Explore available treatment and interdisciplinary services for community members experiencing mental health disorders.

Identify the barriers associated with seeking and receiving therapeutic services.

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