Psychiatric Diagnosis

Running head: OUTLINE FOR PSYCHIATRIC DIAGNOSIS 2

OUTLINE FOR PSYCHIATRIC DIAGNOSIS 2

Outline for Psychiatric Diagnosis

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I. Introduction

This is a condition that is characterized by abnormal or disturbed eating habits. The categories of the eating disorder are anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder. Eating disorders are considered to be severe mental and physical illnesses that involve a complicated and damaging relationship with food, eating, physical exercise, and body image (Gibson et al., 2019).

II. The psychological concepts in the patient's presentation

Various psychological concepts are common among patients with an eating disorder. There is an increased level of gaining weight and the behavior actions that might exposed them to gain weight. The patient also become obsessed with the rules and concerns related to body shape, diet, and weight. There is also anxiety and irritability that surround meal time, depression, and anxiety. For the patient in the case scenario, she began dieting and this continued everywhere (Gibson et al., 2019). She reported having clothes that were snug and that reported positive comments from her parents on how she looked. She set the weight goal of 115 pounds after attaining 130 pounds and was obsessed with visiting the gym. She remained hungry at lunchtime and did not increase her lunch size.

III. Symptoms or behavior exhibited by the patient

One of the symptoms presented by the patient is that she never gets adequate sleep and could not sleep for more than an hour or two at night. She mostly consumed vegetables at school and this was just a tiny portion which she could not even finish. The hair and skin were dull and dry. There was a loss of interest in socializing with others and was always alone, no more parties or handing out meals (Gibson et al., 2019). She had odd eating habits and exercise a lot, was extremely underweight, was always afraid of gaining weight.

IV. Diagnosis in the DSM-diagnostic manual, how the patient met the criteria, and the criteria in DSM-5 diagnostic manual

Based on DSM-5 criteria, the diagnosis is based on the symptoms such as restriction of food that result in reduction in the body weight or failure in gaining weight, fear associated with the risk of weight gain, and having distorted perceptions about themselves. Based on the symptoms presented by the patient, the potential diagnosis is anorexia nervosa. The condition is characterized by not eating enough, being underweight, having self-esteem that is based on the body looks, obsession with or terrified of gaining weight, hard to sleep through the night, and hair falling out among others.

V. The validity of the DSM-5 diagnostic manual

Some studies have supported the validity of the DSM-5 severity specifiers for EDs. Nevertheless, the study by Smith et al. (2018) does not support the validity of these specifiers. The author reveals that such lack of support can be associated with the small size of some severity groupings as well as the differences in the study measures. There is also limited data that are present about the predictive validity of severity specifiers.

The other study by Dakanalis et al (2018) focused on examining the validity and utility of the DMS-5 severity rates of the disease within the clinical sample. The study reveals that there are classifications of anorexia nervosa based on mild, moderate, severe, and extreme. Nevertheless, they were statistically indisIntroduction

This is a condition that is characterized by abnormal or disturbed eating habits. The categories of the eating disorder are anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder. Eating disorders are considered to be severe mental and physical illnesses that involve a complicated and damaging relationship with food, eating, physical exercise, and body image (Gibson et al., 2019).

The psychological concepts in the patient's presentation

Various psychological concepts are common among patients with an eating disorder. There is an intense fear of gaining weight and the ongoing behavior that does not lead to weight gain. There is also obsessive concern and rules about dieting, body shape, and weight. There is also anxiety and irritability that surround meal time, depression, and anxiety. For the patient in the case scenario, she began dieting and this continued everywhere (Gibson et al., 2019). She reported having clothes that were snug and that reported positive comments from her parents on how she looked. She set the weight goal of 115 pounds after attaining 130 pounds and was obsessed with visiting the gym. She remained hungry at lunchtime and did not increase her lunch size.

Symptoms or behavior exhibited by the patient

One of the symptoms presented by the patient is that she never gets adequate sleep and could not sleep for more than an hour or two at night. She mostly consumed vegetables at school and this was just a tiny portion which she could not even finish. The hair and skin were dull and dry. There was a loss of interest in socializing with others and was always alone, no more parties or handing out meals (Gibson et al., 2019). She had odd eating habits and exercise a lot, was extremely underweight, was always afraid of gaining weight.

Diagnosis in the DSM-diagnostic manual, how the patient met the criteria, and the criteria in DSM-5 diagnostic manual

According to the DSM-5 criteria, the diagnosis is based on the symptoms such as restriction of food that result in weight loss or failure in gaining weight, fear of becoming fat or gaining weight, and having a distorted view about themselves. Based on the symptoms presented by the patient, the potential diagnosis is anorexia nervosa. The condition is characterized by not eating enough, being underweight, having self-esteem that is based on the body looks, obsession with or terrified of gaining weight, hard to sleep through the night, and hair falling out among others.

The validity of the DSM-5 diagnostic manual

Some studies have supported the validity of the DSM-5 severity specifiers for EDs. Nevertheless, the study by Smith et al. (2018) does not support the validity of these specifiers. The author reveals that such lack of support can be associated with the small size of some severity groupings as well as the differences in the study measures. There is also limited data that are present about the predictive validity of severity specifiers.

The other study by Dakanalis et al (2018) focused on examining the validity and utility of the DMS-5 severity ratings of anorexia nervosa in the clinical sample. The study reveals that there are classifications of anorexia nervosa based on mild, moderate, severe, and extreme. Nevertheless, they were statistically indistinguishable in psychiatric disease comorbidity and distress, demographics, and the age of the anorexia onset.

Limitations of DSM-5 Manual

The limitation of this tool is linked to the increase in mentally ill persons and pathology of normal behavior as a result of the expanded diagnostic criteria. This leads to thousands of new patients being exposed to medications.

The general view of the diagnosis from the theoretical orientations

According to the biological theory, eating behavior is a complex process under the control of the neuroendocrine system whereby the hypothalamus-pituitary-adrenal-axis (HPA) forms a major component. The dysregulation of the HPA axis leads to eating disorders for example irregularities in amount and elevated levels in anorexia and bulimia. In terms of genetic theory, a person in the first degree relative of someone who has had or is currently having an eating disorder is 7 to 12 times exposed to the condition. Concerning the cognitive theory, cognitive attentional bias impact eating disorders.

Individuals at high risk of developing anorexia nervosa

The peak of anorexia nervosa begins during adolescence and early adulthood. This implies that teenage girls and young women have high-risk factors for the development of this condition (Batista et al., 2018).

Non-evidence and Evidence-based treatment options

The gold standard evidence-based treatment for adolescents with anorexia nervosa is family-based treatment. This treatment approach is specifically manualized for eating disorder-focused family therapy. There is also cognitive-behavioral therapy and interpersonal therapy (Resmark et al., 2019). The non-evidence approach can involve not being critical about a person's appearance. These individuals have low self-esteem and focusing on their appearance might worsen the situation. Nevertheless, there was statistical variations in psychiatric disease comorbidity and distress, demographics, and the age of the anorexia onset.

VI. Limitations of DSM-5 Manual

The limitation of this tool is linked to the increase in mentally ill persons and pathology of normal behavior as a result of the expanded diagnostic criteria. This leads to thousands of new patients being exposed to medications.

VII. The general view of the diagnosis from the theoretical orientations

According to the biological theory, eating behavior is a complex process under the control of the neuroendocrine system whereby the hypothalamus-pituitary-adrenal-axis (HPA) forms a major component. The dysregulation of the HPA axis leads to eating disorders for example irregularities in amount and elevated levels in anorexia and bulimia. In terms of genetic theory, a person in the first degree relative of someone who has had or is currently having an eating disorder is 7 to 12 times exposed to the condition. Concerning the cognitive theory, cognitive attentional bias impact eating disorders.

VIII. Individuals at high risk for anorexia nervosa development

The peak of anorexia nervosa begins during adolescence and early adulthood. This implies that teenage girls and young women have high-risk factors for the development of this condition (Batista et al., 2018).

IX. Non-evidence and Evidence-based treatment options

The gold standard evidence-based treatment of the comndition is family-based treatment. This treatment approach is specifically manualized for eating disorder-focused family therapy. There is also cognitive-behavioral therapy and interpersonal therapy (Resmark et al., 2019). The non-evidence approach can involve not being critical about a person's appearance. These individuals have low self-esteem and focusing on their appearance might worsen the situation.

X. References

Batista, M., Antić, L. Ž., Žaja, O., Jakovina, T., & Begovac, I. (2018). Predictors of eating disorder risk in anorexia nervosa adolescents. Acta Clinica Croatica, 57(3), 399. doi: 10.20471/acc.2018.57.03.01

Dakanalis, A., Timko, C. A., Colmegna, F., Riva, G., & Clerici, M. (2018). Evaluation of the DSM-5 severity ratings for anorexia nervosa in a clinical sample. Psychiatry Research, 262, 124-128. DOI:  10.1016/j.psychres.2018.02.009

Gibson, D., Workman, C., & Mehler, P. S. (2019). Medical complications of anorexia nervosa and bulimia nervosa. Psychiatric Clinics, 42(2), 263-274.

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. doi: 10.3390/jcm8020153

Smith, K. E., Ellison, J. M., Crosby, R. D., Engel, S. G., Mitchell, J. E., Crow, S. J., ... & Wonderlich, S. A. (2017). The validity of DSM‐5 severity specifiers for anorexia nervosa, bulimia nervosa, and binge‐eating disorder. International Journal of Eating Disorders, 50(9), 1109-1113. doi: 10.1002/eat.22739