Problem
• IDENTIFYING/DEMOGRAPHIC DATA: Laura is a 12-year-old Caucasian female who resides in California with her parents and 2 siblings. Laura comes from a middle-class family. She attends a private catholic.
• CHIEF COMPLAINT/PRESENTING PROBLEM: Laura was brought in by her mom because of her outbursts. Mom things it started when Laura first got her menstrual period at 9 years old but the incidents are fairly often and disruptive.
• HISTORY OF PRESENT ILLNESS: Mom noticed Laura started with the outbursts that are over and above any particular thing that happens. At first the outbursts were a couple of times per month but now they are several times per week. Mom cannot remember a week that they are not happening. Teachers have noted over the past couple of years that Laura would have these outbursts in the classroom or on the playground. Laura's parents have had teacher parent meetings several times over these behaviors.
• PAST PSYCHIATRIC HISTORY: Laura reports that she is never really happy and is not sure why she has these outbursts. When she is not having an outburst she feels irritable and angry all the time.
• SUBSTANCE USE HISTORY: Laura denies any alcohol or drug use.
• PAST MEDICAL HISTORY: Laura has had normal childhood illness. There are no prominent illnesses reported.
• CURRENT FAMILY ISSUES AND DYNAMICS: Laura believes her sisters intentionally target her and initiate her outbursts.
• MENTAL STATUS EXAM: Laura looks her stated age of 12. She is dressed appropriately for her age. Laura describes her mood as down. Her eating habits and weight is unchanged from earlier years. Laura denies homicidal and suicidal ideation.
1. Explain how you support the diagnosis by specifically identifying the criteria from the case study.
2. Describe in detail how the client's symptoms match up with the specific diagnostic criteria for the disorder (or all the disorders) that you finally selected for the client.
3. Identify the differential diagnosis you considered.
4. Explain why you excluded this diagnosis/diagnoses.
5. Explain the specific factors of culture that are or may be relevant to the case and the diagnosis, which may include the cultural concepts of distress.
6. Explain why you chose the Z codes you have for this client.