Problem:
Mr. Narcissist stated that he began using illicit substances when he was 18. At this age he began using marijuana and cocaine. According to statements given during the clinical interview, Mr. Narcissist indicated he was arrested for sale of marijuana at 17. In any event, he stated he last 6 used the substance about eight years ago. He said he used cocaine only a few times. He stated he realized how addictive it was and stopped using it. He made a point of explaining to the examiner that there was a difference between using and abusing substance. Mr. Narcissist stated he began using tobacco when he was 17 and said he currently smokes about a half pack a day. He added that he would like to stop smoking cigarettes. Mr. Narcissist appears to be downplaying his use of alcohol. He said he first consumed alcohol when he was 17 or 18. His last alcoholic drink was Halloween 2005. As indicated above, collateral information indicates that Mr. Narcissist has two DWI charges. Mr. Narcissist mentioned one; this was on his 21st birthday. He stated he spent 24 hours in jail and paid a fine. Mr. Narcissist did not mention that he has had four arrests for domestic violence in which alcohol appears to be a factor, according to collateral information. Collateral information also indicates his wife has asked him to leave the house when he is consuming alcohol. He did not mention that he has been in treatment for substance abuse. Mrs. Narcissist indicated she met Mr. Narcissist in a halfway house where they were both undergoing substance abuse treatment. Mr. Narcissist indicated that the sexual dimension of their relationship was against halfway house rules, and they were evicted from a halfway house.
Mr. Narcissist is a 30-year-old Hispanic male with a history of substance abuse and domestic violence charges. After reports of neglect, CPS removed Mr. and Mrs. Narcissist's four children from the home. CPS has ordered an evaluation requesting information regarding a DSM diagnosis and any implications it may have for placement and treatment recommendations. Mr. Narcissist's cognitive abilities are low-average. He appears to display very simple and concrete thinking. He appears to be somewhat self-absorbed and appears to get overwhelmed when situations become complex. Mr. Narcissist likely misinterprets the actions of others, particularly when they do not do what he expects of them. Mr. Narcissist does better when he knows concretely what is expected of him. Mr. Narcissist has difficulty responding to new stimuli and learning new tasks. When everything stays the way he wants it, Mr. Narcissist functions optimally, but when things are not going the way he wants them to, he becomes overwhelmed, does not respond to others appropriately, and avoids dealing with the situation. Mr. Narcissist also appears to have a long history of alcohol dependence. He stated that he first used alcohol at age 17 or 18, and that his last drink was on Halloween 2004. During these 12 years of alcohol use, Mr. Narcissist has accumulated two DWI charges, and four arrests for domestic violence which also appear to be related to his alcohol dependence. Collateral information also indicates that Mr. Narcissist's wife asks him to leave the house when he drinks alcohol. Additionally, Mr. Narcissist displayed a lack of social maturity. It appears that he may not know 9 how to appropriately express his emotions, or know how to express love in an enduring fashion. It appears that progress in therapy would prove difficult because he does not accept challenges to his point of view.
Questions:
After reading the report, please provide a DSM5 diagnosis for this patient. Make sure you explain the criteria and apply it to the case. Do you disagree with any of your peers about the diagnosis? Please show that this person meets all the diagnostic criteria for your diagnosis. Need Assignment Help?
Also please look over the treatment recommendations to get an idea of what I will be asking you do produce for your final in week 8. What other treatment recommendations would you make?
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