Diagnosis of “Andrea C.: Experiencing Violence in the Workplace” Being able to form a diagnosis properly for a client is a process that is wide-ranging and broad. The Diagnostic and Statistical Manual of Mental Disorders (DSM) (American Psychiatric Association [APA], 2013) supports recommendations and standards for identifying a diagnosis for a client. The procedure of diagnosing is more than skimming for symptoms in the DSM; one must assess, interview and identify issues, as well as refer to the DSM for a diagnosis.
Case Study: Andrea C
Andrea C. a company manager, is forty-nine and divorced. The location of the building where she was employed was an isolated part of the town. Her job duties included opening and preparing the office each day. The location of the office and being alone in the morning give Andrea a sense of fear and uneasiness. Andrea shared her concerns about her safety with her superiors at work. Disappointingly, before the issue was addressed Andrea was brutally assaulted while opening the office one morning. Andrea was beaten unconscious, nose broken, cuts to the face and neck, stabbed multiple times, sexually assault was attempted (Butcher et al., 2013).
As a result of the attack, Andrea endured “a fractured skull, fractured nose, multiple stab wounds on her body, facial injuries, dizziness, impaired balance, wrist pain, residual cognitive symptoms from being unconscious, poor memory, intense anxiety, and symptoms of posttraumatic stress” (Butcher et al., 2013, p. 117). Based on the case study, her diagnosis is as follows: 309.81 Posttraumatic Stress Disorder, With Dissociative Symptoms (F43.10) 300.82
Somatic Symptom Disorder
V62.89 Victim of Crime (Z65.4)
Hansell and Damour (2008) explain stress disorder trauma as an emotionally overcoming experience where either real or apparent likelihood of loss of life or grave injury to self or a significant other. The DSM (APA, 2013) explains that a client who experiences PTSD must face one or more of the following symptoms: direct experience with a traumatic event, witness an event, learn of a traumatic event related to a close friend or family, and extreme or repeated exposure to traumatic events. Andreas experience was directly related to her own personal involvement with a traumatic event. Andrea experiences intrusion symptoms; these symptoms arrive suddenly and occur when memories of the previous traumatic event plague your life (APA, 2013). Andrea expresses that she has a solid fear of returning to work (Butcher et al. 2013). Andrea’s opposition to return to work can be considered a “persistent avoidance of stimuli” (APA, 2013, p. 271).
Andrea is feeling hopeless, guilty and withdrawn (Butcher et al. 2013) showing that Andrea is having “negative alterations in cognitions” (APA, 2013, p. 271). Andrea is also exhibiting hypersensitivity towards undertakings and activities stating that they are debilitating. Andrea also speaks of memory problems. Somatoform are physical symptoms triggered through psychological factors (Hansell & Damour, 2008). Consider “somatic presentations can be viewed as expressions of personal suffering inserted in a cultural and social context” (APA, 2013, p. 310). Andrea expresses somatic symptom disorder through multiple symptoms. Andrea’s physical grievances are excessive, suggesting her need for attention. She states that she is in a tremendous amount of pain and easily agitated and hostile if others do not take her seriously (Butcher et al., 2013).
It seems that Andreas lasting psychological problems are being revealed as physical symptoms. Andrea is experiencing two of the symptoms, excessive feelings and thoughts (APA, 2013) that are related to somatic disorder. Other factors and data relevant to the assessment, treatment, and diagnosis of Andrea is the fact that she was a victim of a crime. Andrea may have image issues related to the scars associated with the attack she received, causing her shame, embarrassment or uneasiness. Andrea’s incapability to return to work and her related symptoms are negatively affecting her life. These issues are results of being the victim of a crime.
Providing Andrea with a diagnosis is no simple task. Andrea exhibits several different symptoms, hence, providing comorbidity. The diagnosis I offer is accurate from the data supported in Andrea’s case and from the assessment. With data gathered from the DSM, the MMPI, Andrea’s case study, I conclude that the diagnosis of PTSD, Somatic Symptom Disorder and Victim of a crime are applicable to Andrea.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).Arlington, VA: Author. Butcher, J. N., Hooley, J. M., & Mineka, S. (2013). Abnormal psychology (16th ed.). Boston, MA: Pearson. Hansell, J. & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: Wiley.