The Case of Shannel. This was a voluntary intake for this 28-year-old single African American female. Shannel lives with a 24-year-old female roommate in New York City. She has a bachelor’s degree in Art History and is employed by a major New York museum. Shannel was born and raised in Virginia and moved to New York 4 years ago for employment. CHIEF COMPLAINT: “My roommate suggested I go to therapy. I do not agree. I can handle my life, but she threatened to move out and I cannot afford the apartment by myself.” HISTORY OF PRESENT ILLNESS: Shannel admitted to purging and frequent use of laxatives to try and keep her weight down. Shannel reported her weight was being monitored by a nutritionist and she had lab work done to be sure she remained healthy. Shannel reports that she was much heavier as a teenager and wants to confirm she doesn’t get like that again. Shannel reported that she has a very stressful job. She stated that approximately one month ago she started to have difficulty concentrating at work. She had several altercations with coworkers as well. Several weeks ago Shannel reported that a coworker “said something nasty and I lost it.” Shannel reported that she was angry and “hit everything I knew I could—but that did not help.” Shannel also reported being under stress due to applying for her master’s degree in art history and difficulties with her boyfriend.
Shannel complained of depression with insomnia and sleeping only a few hours per night, feeling confused, decreased concentration, irritability, anger, and frustration. She admitted to suicidal ideation. She complained of feeling paranoid over the past few weeks and believed the police were after her and that she heard them outside her door. This was another reason her roommate wanted her to seek treatment. Shannel reported she was emotionally abused as a child and suffered from post-traumatic stress disorder, but she denied a history of flashbacks or nightmares or any avoidance of the person who she says emotionally abused her. Shannel noted that at times over the past year she has very strange experiences of being overwhelmed with fear. At these times she begins sweating, has chest pains and chills, and thinks she is going crazy. It concerns her terribly that these may happen at inappropriate times. Reluctantly, Shannel admitted to bingeing several times per month since she was 17-years-old. Explain how you support the diagnosis by specifically identifying the criteria from the case study. 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. You do not need to repeat the diagnostic code in the explanation. Identify the differential diagnosis you considered. Explain why you excluded this diagnosis. 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. Explain why you chose the Z codes you have for this client. Remember: When using Z codes, stay focused on the psychosocial and environmental impact on the client within the last 12 months.
Use APA referencing style.