Problem:
Vignette: Aaliyah, a 27-year-old transgender woman, reports a two-year history of preoccupation with her facial features, with symptoms worsening significantly in the past eight months. She spends hours each morning examining her face in the mirror, convinced that others notice flaws in her jawline and forehead. She avoids bright lighting, video calls, and social gatherings, fearing that people are scrutinizing her appearance. Her grooming routine has become so time-consuming that she is frequently late to work, and she often cancels social plans at the last minute.
Aaliyah has endured transphobic harassment in public spaces and online, including a physical assault several years ago. These experiences have left her wary of strangers and hyperaware of how she is perceived. She has found some grounding in a local Buddhist meditation group that affirms LGBTQ+ identities, and while mindfulness helps her feel calmer, it does not quiet the intrusive thoughts about her appearance. She longs for connection but feels trapped by fear and self-scrutiny.
Presenting Problem Summary (3-5 sentences)Summarize the key symptoms and functional impairments. Symptom Cluster Identification List the primary symptom clusters relevant to DSM-5-TR categories. Primary Diagnostic Hypothesis Identify one likely diagnosis. Cite DSM-5-TR criteria that align with the vignette (bullet points).Explain why this diagnosis is the best fit. Differential Diagnoses (Rule-Outs)Identify two differential diagnoses. For each: List criteria that do not fit the vignette. Identify additional information needed to rule in/out. Cultural, Contextual, and ADEI Considerations Discuss at least three factors (e.g., age, race, class, gender, stigma, access to care, family context).Person-in-Environment & Functional Impact Describe how symptoms affect functioning at home, school/work, and in relationships. Remaining Questions List 5-7 questions you would ask to clarify the diagnosis. Need Assignment Help?