Psychological Treatment Plan

Everleigh

caseofJuliapreviousPsychiatricDiagnosis.pdf

Home >Psychology homework help >Psychological Treatment Plan

Psychiatric Diagnosis

Wayne Natoya

Psychopathology PSY645:

Hausch-Gwaltney Stefanie Dr. Instructor:

Campus Global Arizona of University

Dec 07, 2021

Introduction

A seventeen-year-old girl named Julia has a problem that requires psychiatric diagnosis and

intervention. She is a college student who participates in sporting events. She started dieting to

lose the extra weight and acquire the ideal body weight she needed to participate optimally in

athletics. However, she was determined to lose weight, which affected her mentally, physically,

and socially. The drastic measures she took was constantly worrying about her weight and

developed unhealthy eating habits. She barely ate any food and was still worried that she was too

fat when she was too thin. These symptoms lead to a suspicion that the patient, Julia could have

anorexia nervosa. Anorexia nervosa is a condition often classified as an eating disorder. It is characterized by

individuals having misperceptions about their body weight. Usually, their body weight is too low

for their body sizes, but they manifest fear of gaining any additional mass. They put too much

emphasis on the determination to reduce their weight that it disrupts their normative, day-to-day

function (Brockmeyer et al., 2018). The condition is often prevalent in females as teenagers or

young adult women. According to statistical evidence, 75% of those who grapple with the

disease are female (Wonderlich et al., 2020). It is harmful because it precipitates nutritional

deficiencies and other grave complications in the victims, such as dry skin, low blood pressure,

and increased risk of fractures due to brittle bones. Psychological Concepts in the Patient's Presentation

The symptoms that Julia, the patient under study, presents with and her history can be

analyzed using psychological concepts. These symptoms included being overly concerned about

how much she weighs. Subsequently, Julia is always anxious about what she eats because of the

fear that it might increase her weight. Further, she isolates herself from other individuals, quickly

becomes irritated, and dissects foods into small portions. Her history indicates that she was often

ridiculed for having excessive weight when she was young. Her coach college also criticized her

significantly when she gained weight when joining the institutions and could not perform well in

athletics. Based on the patient's presentation and her history, several psychological concepts can

explain her behavior and the symptoms that she presented with. Behavioral Concept Julia's clinical manifestations and mannerisms can be explained using the behavioral theory.

According to the concept, individuals’ surroundings impact their behaviors significantly.

Therefore, the behavioral traits that the patient presented with can be attributed to the aspects

present in her surroundings (Jagielska & Kacperska, 2017). For example, when Julia joined

college, her coach criticized her eating habits and weight. Subsequently, she was out of shape

compared to her teammates. These elements contributed to her escalated loss of weight that

caused her to develop poor eating habits. Psychodynamic Concept The psychodynamic theory elucidates that individuals' choices are usually based on aspects

such as the events that preoccupy their unconscious minds and the encounters they had to

contend with when they were young. Julia's childhood experiences profoundly influenced her

developing the psychological disorder (Jagielska & Kacperska, 2017). During her childhood, she

was often bullied for being too fat. The teasing that she experienced must have affected her self-

esteem and contributed to her exaggerated desire to lose weight. Humanistic Concept The humanistic theory ties the mannerisms that human beings present with to their innate

feelings and self-perceptions. Julia always viewed herself as having excessive weight even when

she had become too thin. It shows that she had a distorted perception of herself that affected her

self-image (Resmark et al., 2017). According to the perspective, human beings must engage in

the actions that pleased them because they were solely responsible for their actions. In the case

of Julia, her happiness lied in becoming as thin as she could, so she focused all her energy on

achieving this goal. Potential Disorders that the Patient could be having and their DSM-5 Criteria

Anorexia Nervosa The DSM-5 criterion identifies three specific symptoms that must be present for a patient to

be diagnosed with anorexia nervosa. These clinical manifestations include individuals having a

bodyweight substantially lower than the standard expected weight at their age and height.

Subsequently, another symptom is that those affected must display profound fear of gaining

excessive weight, with no improvement even when their body mass reduces significantly

(Brockmeyer et al., 2018). Additionally, they should also have misconceptions about their body

weight. For example, they claim excessive weight even when it is not true. Bulimia Nervosa The DSM-5 criteria provide three significant symptomatic expressions that are should be

present for a diagnosis of bulimia nervosa to be made. Firstly, the patients should be overly

concerned about the size of their bodies. Subsequently, they should have abnormal feeding

patterns characterized by consuming substantial, large amounts of food and engaging in

compensatory behaviors such as self-induced vomiting, misusing drugs such as laxatives and

diuretics to eliminate excess nutrients, or exercising too hard (Wonderlich et al., 2020). Another

significant symptom, according to the criteria, is that those with the condition should be overly

concerned about the appearance of their bodies.

Avoidant Restrictive Food Intake Disorders The main symptoms that individuals with avoidant restrictive disorders have according to

the DSM-5 criteria include lacking interest in food of a particular kind. They may dislike how it

looks, tastes, or smells. Subsequently, their dietary consumption is not adequate to meet the

needs of his body hence triggering immense loss of weight and mineral deficiencies

(Brockmeyer et al., 2015). Also, they are usually overly concerned about the consequences of

eating. Diagnosis of Patient Based on Presenting Symptoms and DSM-Criteria

The patient Julia's diagnosis is based on comparing the clinical presentation she presents

with, and comparison with the DSM-5 criteria is anorexia nervosa. This condition has been

identified as the possible diagnosis for the patient. Firstly, the DSM-5 manual indicates that for a

patient to be diagnosed with the condition, the patient must have a substantially low body weight

(Jagielska & Kacperska, 2017). The patient's history shows that her body weight was too low

that her family members, friends, and educators were concerned, an aspect that matches the first

criteria. Secondly, the DSM manual indicates that patients should be diagnosed with the

condition if they are afraid of gaining weight (Wonderlich et al., 2020). Analysis of the case

study of Julia shows that she was constantly worried about gaining weight, a factor that caused

her to develop erratic eating patterns and stringent exercising regimens. The third criteria indicate that the patient must have misconceptions about their body

images. This aspect was evident in Julia. She felt that she was too fat even when she was too thin

that other individuals were worried about her health and wellbeing. The aspect that rules out

bulimia nervosa is that the patient does not eat excessive food. On the other hand, the element

that rules out avoidant restrictive food intake disorders is not a possible diagnosis because the

patient is not afraid of eating certain foods, but anything that may cause her to gain weight

(Resmark et al., 2017). The analysis of the different conditions and comparing the manifestations

with the DSM-5 criteria confirms that the patient has anorexia nervosa. Justification for Using DSM-5 Diagnostic Manual in Making the Diagnosis

The DSM-5 diagnostic manual for diagnosing mental disorders provides standardized

criteria for diagnosing mental illnesses that ensure that the conditions are identified

appropriately. The evidence that supports its validity is that it draws its formula of clustering the

diseases from investigative research. Subsequently, using the DSM-5 diagnostic manual is

significant because it provides a proven structure of diagnosing psychiatric problems that ensures

that medical providers do not diagnose based on assumptions (Schneider et al., 2021). It gives a

strategy for diagnosing the condition that ensures that the actual condition is identified, and the

appropriate intervention is administered. Despite its validity in diagnosing psychiatric disorders,

the DSM-5 diagnostic manual has several limitations. One of the limitations of using the DSM

diagnostic manual is that it can cause healthcare professionals to misdiagnose psychiatric

conditions (Schneider et al., 2021). It may cause individuals to be assumed to have certain

medical conditions because they exhibit some mannerisms. Summary of the Diagnosis Theoretical Orientations

Based on the behavioral perspective, Julia's condition was precipitated by the factors present

in the environment, such as her negative childhood experiences (Brockmeyer et al.,

2018). During her childhood, she was bullied because of her body weight, making her desire to

have a leaner body structure, which caused her to develop anorexia nervosa. Subsequently, the

pressure that the coach put on her to perform exceptionally well in her athletics also caused the

condition. She felt she had the lowest weight possible to be successful in the sporting events,

which made her develop poor eating habits that resulted in her developing bulimia nervosa. On the other hand, based on the humanistic perspective, the patient's condition was caused

by changes in her behaviors, resulting from her self-perceptions and her feelings about the things

that were happening to her. Julia felt that the food she ate would cause her to gain weight; hence,

she refrained from eating and developed anorexia nervosa. Also, the criticism she encountered

during her childhood and from her college coach made her consider excessive weight even when

she had become too thin. The psychodynamic concept is also vital in determining the cause of the patient's condition.

According to the theory, individuals' childhood experiences significantly impact their behaviors

as they grow older (Brockmeyer et al., 2018). Based on this theory, Julia’s childhood experiences

were the primary cause of her developing bulimia nervosa. She was bullied because of having

excess weight, hence triggering an intense desire to lose her body mass. Evaluation of Symptoms within the Context of Appropriate Theoretical Orientations The symptomatic expressions that Julia manifested can be explained using different

theoretical orientations. The first symptom that the patient presented with is a very low body

weight which can be explained using the humanistic perspective (Jagielska & Kacperska, 2017).

Julia perceived her body mass as being too voluminous; hence, she constantly reduced it until

she became too thin. The second symptom she presented with is being overly anxious about her

weight. These behaviors can be explained in the context of the psychodynamic theory that relates

mannerisms of individuals to their childhood experiences. Therefore, the bullying that the patient

endured during her childhood was a significant trigger that caused her to be constantly worried

about her weight. Another notable symptom inherent in the patient is isolating herself from other

individuals. This trait can be explained using the behavioral concept. According to the theory,

the mannerisms of individuals are influenced by the factors in their environment (Resmark et al.,

2017). Julia knew that her friends and family members would question her feeding habits if they

were aware of how frugal it was. Therefore, she isolated herself from other individuals to hide

her detrimental feeding habits. Evaluation of the Validity of the Diagnosis Using Peer-Reviewed Articles

The article Outcome, comorbidity, and prognosis in anorexia nervosa. Psychiatr Pol, 51(2),

205-18 (2017) studies the issue and anorexia to determine its causes, prevalence, and impacts on

the affected populations. It indicates that the condition is rampant in individuals aged between

fifteen and twenty. The studies carried out by Jagielska and Kacperska (2017) imply that the

total population affected by anorexia nervosa is 1.2%, with the women having the highest

rampancy rates, a total of 0.9%. According to the write–up, the population most vulnerable to the

condition is females aged between the ages of fifteen and twenty, the category population in

which Julia, the girl in the case study, belongs.

On the other hand, the article Severe and enduring anorexia nervosa: Update and

observations about the current clinical reality. International Journal of Eating Disorders, 53(8),

1303-1312 (2020) also contains significant information about anorexia nervosa. According to the

article, anorexia nervosa is characterized by different symptomatic expressions, including

exceptionally low body weight, distorted perceptions about their body weight, and abysmal

eating habits. The symptoms outlined in the article are like those that Julia, the girl in the case

study, manifested, proving the diagnosis's accuracy. The scientific merits of the selected articles that prove the validity of the content that has

been extracted from them include the fact that they are scholarly articles that have been peer-

reviewed and proven to be containing accurate information. Subsequently, the articles base their

conclusions about the ailment on the information they have compiled by carrying out scientific

studies. They document the steps used while undertaking the studies, such as the participants

encapsulated in the research and the findings that emerged (Resmark et al., 2017). Therefore, the

study can be replicated to deduce whether it is factual, an aspect that increases the validity of the

information present therein. Risk Factors Associated with the Diagnosis

The risk factors that make individuals susceptible to developing anorexia nervosa include biological

factors such as genetic composition. People with specific genes are at a higher risk of developing the

disorder. Therefore, because genetic materials are hereditary, the chances of individuals whose relatives

have the disease developing it are significantly high (Wonderlich et al., 2020). Another significant risk

associated with the condition is psychological factors such as engaging in dieting plans and starving

oneself. Venturing into stringent routines to lose weight may precipitate dangerous habits that are

difficult to overcome. Additionally, a history of personal anxiety, depression, perfectionism, and

body dysmorphia issues. Environmental factors such as the process of transitioning to a new place,

such as a new school, also increase the possibilities of individuals developing the condition (Resmark et

al., 2017). Pressures from family members for their daughters to fit a certain ideal body type that

they see fit. For female athletes, pressure from coaches in certain sports that requires perfection

and favors a certain body type with restrictive diets and training regiments are also

environmental risk factors. Further, social factors such as the ideations of certain body types also make

young people prone to want those desired body types. These ideations of certain socially defined

“ideal body” types are often portrayed on social media content consumed by adolescent

teenagers and women. Peer pressure and bullying are also social factors.

Evidence-Based and Non-evidence Based Treatment for the Condition

The evidence-based treatments for young people like Julia who have anorexia nervosa will

be cognitive behavior therapy (CBT), support groups psychotherapy, individual and family

therapy. Family therapy will be one of the best options for Julia because it entails creating

counseling sessions for patients and their families to determine the genesis of the condition and

the interventions that can be used to overcome it and to address the social, psychological,

environmental issues that contribute to causing anorexia nervosa (Resmark et al., 2017).

Psychopharmacology options such as antidepressants and anti-anxiety medications can help

control the symptoms of depression and anxiety that may aggravate and contribute to the cause

of anorexia nervosa. On the other hand, the non-evidence-based treatment for anorexia is taking

supplements such as vitamins to replace the nutrient deficiencies resulting from the patient's

limited dietary intake. Additionally, other non-evidence-based options will be body awareness

therapy such as yoga, relaxation therapy and acupuncture which although some studies show that

they can be effective, there are still more evidential research to be done for their effectiveness for

condition such as anorexia nervosa. Well-Established Treatments for the Condition and their Outcomes

The well-established treatment protocol for managing anorexia nervosa includes using psychological therapies that will help change the patients' perceptions towards food and their

body sizes, including therapeutic models including CBT, support groups, and individual and

family therapy. These therapies work by changing patients' thought patterns to embrace positive

thoughts and eliminate negative ones like distorted self-perceptions (Resmark et al., 2017).

These methods have a high likelihood of successfully treating the condition because it helps in

changing the way the patients think hence fast-tracking the healing process. Another treatment

process is administering medication such as antidepressants and antipsychotic agents that help

reduce the negative thought patterns and improve the condition of the patients (Wonderlich et al.

2020). However, the treatment process does not often elicit positive outcomes in managing

patients with the disease because many do not view the illness as an ailment requiring medical

intervention. Conclusion

Julia's case is a classic case of anorexia nervosa. The symptoms she presents with align with

those inherent in the DSM-5 criteria for the condition. Therefore, it is significant to analyze the

theoretical basis of the condition under different theoretical orientations to determine its genesis.

This will aid in deducing the treatment process that can control it effectively and elicit positive

outcomes in the patient and other patients with the same condition.

Annotated Bibliography Brockmeyer, T., Friederich, H. C., & Schmidt, U. (2018). Advances in the treatment of anorexia

nervosa: a review of established and emerging interventions. Psychological

Medicine, 48(8), 1228-1256. https://doi.org/10.1017/S0033291717002604 This article examines different treatment approaches used in the management of anorexia

nervosa. It analyzes various interventions and their efficacies in managing the conditions

in diverse populations based on compiling different scholarly articles with the

information. The content is reliable because Brockmeyer et al. (2017) are experts in

psychology who have the expertise needed to investigate the issue comprehensively and

gather valid results. Jagielska, G., & Kacperska, I. (2017). Outcome, comorbidity, and prognosis in anorexia

nervosa. Psychiatr Pol, 51(2), 205-18. https://doi.org/10.12740/PP/64580 In this write-up, the authors elucidate what anorexia entails and the population in which it

is prevalent. It provides valid evidence on the rampancy of the condition in different

people by compiling content from scholarly articles that contain the information. As

experts in child psychiatry, the authors are knowledgeable in psychology; thus, their input

on the subject is reliable. Resmark, G., Herpertz, S., Herpertz-Dahlmann, B., & Zeeck, A. (2019). Treatment of anorexia

nervosa—new evidence-based guidelines. Journal of clinical medicine, 8(2), 153. https://doi.org/10.3390/jcm8020153

This essay discusses the new stipulated guidelines for treating anorexia nervosa. It

analyzes different forms of therapies that are effective in treating the condition, including

evidence-based and non-evidence-based practices. The authors, who are well-established

https://doi.org/10.1017/S0033291717002604

https://doi.org/10.12740/PP/64580

https://doi.org/10.3390/jcm8020153

professionals in the psychology field, provide an in-depth explanation of the different

interventions compiled from undertaking adequate scientific research on the topic. Schneider, L. H., Pawluk, E. J., Milosevic, I., Shnaider, P., Rowa, K., Antony, M. M., ... &

McCabe, R. E. (2021). The diagnostic assessment research tool in action: A preliminary

evaluation of a semi structured diagnostic interview for DSM-5 disorders. Psychological

Assessment. https://psycnet.apa.org/doi/10.1037/pas0001059 This article analyzes the significance of using the DSM-5 diagnostic manual in

identifying psychiatric conditions. It explores the benefits and demerits of using the

manual, including providing a factual basis for deducing patients' mental disorders and

suitable interventions. The content present in the write-up is dependable because it has

been documented by professionals in the psychiatric field who have adequate knowledge

on the topic. Wonderlich, S. A., Bulik, C. M., Schmidt, U., Steiger, H., & Hoek, H. W. (2020). Severe and

enduring anorexia nervosa: Update and observations about the current clinical

reality. International Journal of Eating Disorders, 53(8), 1303-1312. https://doi.org/10.1002/eat.23283

This article has a compilation of important information on anorexia nervosa. It is a peer

reviewed write-up that discusses the symptoms patients with the condition present with.

It also scrutinizes the treatment process that can effectively treat the condition.

https://psycnet.apa.org/doi/10.1037/pas0001059

https://doi.org/10.1002/eat.23283

References

Brockmeyer, T., Friederich, H. C., & Schmidt, U. (2018). Advances in the treatment of anorexia

nervosa: a review of established and emerging interventions. Psychological

Medicine, 48(8), 1228-1256. https://doi.org/10.1017/S0033291717002604

Gorenstein, E., & Comer, J. (2015). Case studies in abnormal psychology (2nd ed.). New York,

NY: Worth Publishers. ISBN: 9780716772736.https://redshelf.com.Case 18: You

Decide: The Case of Julia.

Jagielska, G., & Kacperska, I. (2017). Outcome, comorbidity, and prognosis in anorexia

nervosa. Psychiatr Pol, 51(2), 205-18. https://doi.org/10.12740/PP/64580

Morrison, J. (2014). DSM-5 made easy: The clinician’s guide to diagnosis. New York, NY: The

Guilford Press. Retrieved from https://redshelf.com

Resmark, G., Herpertz, S., Herpertz-Dahlmann, B., & Zeeck, A. (2019). Treatment of anorexia