SOCW 6090 Week 4 Discussion: Applying Differential Diagnosis to Neurodevelopmental Disorders
Discussion: Applying Differential Diagnosis to Neurodevelopmental Disorders
Social work clinicians keep a wide focus on several potential syndromes, analyzing patterns of symptoms, risks, and environmental factors. Narrowing down from that wider focus happens naturally as they match the individual symptoms, behaviors, and risk factors against criteria A–E and other baseline information in the DSM-5.
Over time, as you continue your social work education, this process will become more automatic and integrated. In this Discussion, you practice differential diagnosis by examining a case that falls on the neurodevelopmental spectrum.
To prepare:
Read the case provided by your instructor for this week’s Discussion and identify relevant symptoms and factors. You may want to make a simple list of the symptoms and facts of the case to help you focus on patterns.
Read the Morrison (2014) selection. Focus on Figure 1.1, “The Roadmap for Diagnosis,” to guide your decision making.
Identify four clinical diagnoses relevant to the client that you will consider as part of narrowing down your choices. Be prepared to explain in a concise statement why you ruled three of them out.
Confirm whether any codes have changed by checking this website: American Psychiatric Association. (2017, October 1). Changes to ICD-10-CM codes for DSM-5 diagnoses. Washington, DC: Author. Retrieved from https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm-5/coding-updates
By Day 3
Post a 300- to 500-word response in which you address the following:
Provide a full DSM-5 diagnosis of the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
Identify which four diagnoses you initially considered in the case of the client, using the DSM-5 diagnostic criteria to explain why you selected these four items. In one or two sentences each, explain why three of these diagnoses were excluded.
Explain any obvious eliminations that could be made from within the neurodevelopmental spectrum.
Describe in detail how the client’s symptoms match up with the specific diagnostic criteria for the primary disorder that you finally selected for him. Note two other relevant DSM-5 criteria for that illness from the sections on “diagnostic features” and “development and course” that fit this case.
By Day 6
Respond to at least two colleagues in the following ways:
Compare the diagnosis you provided and the process in which you reached the diagnosis with those of your colleague.
Explain how the Z codes (other conditions that may be a focus of clinical attention) that your colleague identified may influence the client’s upcoming treatment.
Response 1
Amber Alanis Week 4 – DB – A. AlanisCOLLAPSE
I would diagnose Aponi with the following:
F91.3 Oppositional Defiant Disorder, Moderate
Z62.898 Child Affected by Parental Relationship Distress
Explain diagnosis/Match symptoms:
Aponi meets criteria A because she often loses temper, is easily annoyed, is often angry, often argues with authority figures and adults, blames others for her mistakes/behavior, and has been spiteful/vindictive. She is angry, irritable, argumentative, and defiant. Her behavior has been assessed and is occurring in more than one setting and across multiple relationships (home, school, friends). Aponi is also justifying her behavior because of the way others treat her. The DSM-5 also points out that children who have had multiple caregivers are more likely to struggle with ODD.
Identify 3 other considered diagnoses:
Conduct Disorder: I initially thought Aponi might have conduct disorder until I read in the differential diagnosis portion in DSM-5 that conduct disorder has a higher prevalence in aggression and destruction of property.
Antisocial Personality Disorder: although she does have some antisocial behavior, due to her age, she does not meet criteria for this diagnosis.
Disruptive Mood Dysregulation Disorder: although she does meet some of the criteria for this disorder, I feel that it is missing the other components mentioned above in the explanation for ODD diagnosis.
As mentioned above, I feel that ODD is the most appropriate diagnosis due to her defiance, anger, irritability, the fact that Aponi has had multiple caregivers her entire life, she is having frequent tantrums, is having these issues in the school setting and with peers, blames others for her issues (mother and brother), always wants her way, has a difficult time with peer relationships, and struggles to effectively communicate with others.
Reference:
American Psychiatric Association (2013f). Disruptive, impulse-control, and conduct disorders. In
Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association Publishing.
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