Question
Answered step-by-step
AdmiralProton10767
Michael is a 20-year-old who was adopted at the age of 4. …
Michael is a 20-year-old who was adopted at the age of 4. Michael’s father was a Black male, and his mother was of Latin American descent. Michael was removed from the home at the age of 4 due to neglect and physical abuse and placed in a foster home. His foster parents were White, and he was later adopted by his foster parents. Michael’s adoptive parents were living in an area of high socioeconomic status. Michael attended a private school throughout elementary-high school which consisted of primarily white students (over 85%) and the teachers were also white. Michael always felt like he was “different” and later realized the teachers pointed out he attended the school and was “one of us.” Michael remembered the students looked at him in a different way and he remembers one student touching his hair and felt it “looked cool.” Michael remembers chuckles from the other students. He went home and cried in his bedroom as he felt like his parents would not understand since he also started to feel “different” in their home.
Michael began feeling like he “wasn’t good enough” and felt trapped in an environment where he thought others excluded him. Michael stood at 5’8″ in high school and remembers a student asking him if he was planning to try out for basketball. Michael realized in that moment that it wasn’t because of his height. Michael began to isolate from his peers and his parents began to express concern. His grades declined and he would spend many days in bed. Michael also lost a significant amount of weight (8lbs.) in a two-week period and his parents found a journal where Michael expressed wanting to “end it all.” Michael wrote about his feelings in his journal and described feeling hopeless, no pleasure in activities, and irritability. Michael’s irritability increased and he had he was sent to the office three times within a two-week period for “defiant behavior.” Michael often shuts down in class due to fear of embarrassment and the teachers spoke with Michael’s parents about being “defiant” in class.
Michael’s parents made an appointment with a local therapist when he was a senior in high school (age 17). The therapist was a male in his late 20’s and was White. Michael immediately felt guarded as he entered the therapist’s office since he was in an environment again where he was “different.” Michael met with the therapist a few times and developed courage to ask for a Black therapist. The therapist expressed he was competent to deal with Michael’s “issues” and brushed off the request by stating there were no Black therapists in the area. Michael again left feeling like he was “trapped” in a world of feeling “different” from everyone around him. Using the Parent/Guardian-Rated Level 1 Cross-Cutting Symptom Measure for children between the ages of 6-17 produced the highest scores in the anxiety domain indicating moderate levels of symptom severity. The therapist diagnosed Michael with Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder. and referred him to a psychiatrist who placed him on Methylphenidate (Ritalin). After a few months of taking the medication, there was no difference in his symptoms and he continued to isolate, express irritability through defiant behavior and now felt labeled and even more “different.” Michael began attempting to find members of his biological family thinking this would help to find his roots. He discovered information about a cousin who was killed by gun violence in a nearby community. The discovery exacerbated Michael’s negative feelings and he reached his lowest point.
As time went on and Michael graduated high school, he attended a local community college. Michael was driving to class during the first month of school and was pulled over for going 35 MPH in a 32 MPH zone. Michael remembers the fear he experienced as the officer approached his vehicle. He went into a panic as he thought about everything he has seen on the news and seeing the police officer’s gun triggered the news clips about his cousin.
Two months after being pulled over, Michael began having flashbacks about his cousin and seeing news clips (almost nightly when watching the evening news). Michael’s grades started to decline (B average to a C). He is avoiding the area he was pulled over which has impacted his route to school. He is now driving over 10 miles out of the way to avoid the area. Michael has intrusive memories daily, at least 4 nightmares of childhood per week (memories of abuse from his biological parents and the news clips about his cousin). Michael is also experiencing nocturnal panic attacks three times per week. Michael is also becoming increasingly irritable and exhibiting episodes of anger (punching walls and verbally aggression toward peers).
Michael had been seeing the same therapist since high school and recognized the lack of progress and feeling “different” each time he entered the therapist’s office. Michael also realized he has been experiencing nightmares, flashbacks, fear of his future, and being startled when surprised to the point he panicked. He realized in that moment that he needed to connect with resources and support. Sine Michael turned 18 and is now in college, he felt empowered to see a new therapist (you) who provided insight into his experiences. You conducted a PTSD checklist (PCL) was conducted which indicated a score of 46 and conducted the Adult DSM-5 Cross-Cutting Symptom Measures which produced the highest scores in anxiety and indicated moderate scores in the anxiety and dissociation domains.
Part 1 :
There can be differences in how disorders are experienced, the course of the disorder, and how symptomology will look based on specific factors such as gender, age, ethnicity, race, or even context. In this section answer:
What is the course of the principal (primary) disorder? (Look in the development and course section of the DSM-5-TR and any related research that would pertain to the unique demographics in this case.) This includes how it starts, how it progresses through any stages and throughout a client’s lifetime.
How might symptomology look different from others with the same diagnosis based on factors such as gender, age, ethnicity, race or even context.? What does the research say about possible specific variations in clinical presentation of the disorder(s) based on client specific factors in this case? How would these factors apply to the client in this case?
Citation(s)**:
Part 2.. Think about biology related to this diagnosis. What are biological explanations of the principal (primary) diagnosis? What are possible biological causes or sets of causes connected with this diagnosis? In general what is the connection of this diagnosis with biology?
Citation(s)**:
Part 3:
Now think about the diagnosis from the psychological perspective. What is known about the psychological etiology (causes or set of causes, contributing factors) of the principal (primary) diagnosis? What other diagnoses often are comorbid with this diagnosis?
Citation(s):
What is the prognosis of the disorder?
Citation(s):
Part 4: Think about trauma and stress related to this case. Demonstrate an understanding of the relationship of stress to the diagnosis(es) in general and to this case in particular. Be sure to think about stress from a variety of sources (ex. societal, community, etc.). What are potential contributing factors sociologically? Think about stress as related not only to the development of the disorder, but also through the course of the disorder.
