Anxiety disorder

I will diagnosis Storme with the following:

F93.0 Separation anxiety disorder

F41.9 Unspecified anxiety disorder

Z60.2 Problem related to living alone

Z60.9 Unspecified problem related to social environment

Individuals who experience F93.0 meet criteria A, B, and C. They experience persistent and excessive fear or reluctance about being alone or without significant attachment figures at home or in other settings. They may also experience significant disruption in work or social experiences. Stormé reported that when her sister began a romantic relationship five years ago, she began to feel very anxious and cried often. She continues to cry periodically for no known reason. Stormé moved into an apartment down the hall in the building and began to pull the hair from her head, hiding her hair loss by wearing wigs. This behavior occurred at different times and resulted in scabbing. Moving away from her sister caused her anxiety as she depended upon her sister for transportation and a sense of social and emotional connection. Also, Storme stated she experienced simultaneous symptoms of feeling anxious, often crying for no reason, lack of good sleep, and difficulty concentrating, which are all linked to an unspecified anxiety disorder.

A differential diagnosis includes obsessive-compulsive disorder (OCD) F42 and Trichotillomania (Hair-Pulling Disorder) F63.3. In the case of both conditions, a person suffers from a feeling of being unable to avoid a particular behavior or performing a specific action associated with reducing anxiety. The result causes the individual to cause harm to themselves (Morris, 2014). Stormé displayed symptoms of both these disorders. She constantly pulls her hair to ease her anxiety. Stormé also reports a common concern for germs, keeping her house clean, and orderliness. OCD and Trichotillomania get characterized by someone most likely to take personal risks to ease tension or anxious feelings. I will keep these diagnoses as they meet the criteria.

Panic attacks are abrupt surges of intense fear or intense discomfort that reach a peak within minutes, accompanied by physical or cognitive symptoms. Although a panic attack may be used as a descriptive specifier for any anxiety disorder and other mental disorders, Storme failed to meet the criteria. As such, the social worker has eliminated the diagnosis.

Agoraphobia- individuals with agoraphobia are fearful and anxious about two or more of the following situations:

· Using public transportation

· Being in open spaces

· Being in enclosed places

· Standing in line or being in a crowd

· Being outside of the home alone in other situations

The individual fears these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms.

Cognitive-behavioral therapy is a highly effective treatment of health anxiety and depression. Ay, Kühne, & Weck (2019) conducted a research study to investigate the role of patients' skills acquired during CBT and exposure therapy (ET) for patients diagnosed with health anxiety. The authors used an observer‐based rating scale for the skills assessment of patients with health anxiety (SAPH). The SAPH was used on 66 patients, and the assessment skills demonstrated good interrater reliability and internal consistency. In CBT, a core component is the support of patients to learn and develop or change a repertoire of behaviors and thoughts. The learned behaviors and thoughts may be understood as skills that help individuals reach certain goals. In this review, a significant increase in skills due to treatment and skills indicated symptom reduction.

The recommended evidence-based assessment for Stormé is Beck's Anxiety Inventory (BAI). The assessment method would assess the presence of anxiety or depression and the intensity of anxiety symptoms; this would further help identify the specific cause of the patient's anxiety (Ay, Kühne, & Weck, 2019)

The best method for Stormé's treatment would be Cognitive Behavioral Therapy (CBT). The intervention explores the connection between a patient's mental and physical actions surrounding factors that may trigger the patient's distress. Since Stormé is diagnosed with separation anxiety, CBT would effectively identify the root cause of the problem and plan an effective intervention.

References:

American Psychiatric Association. (2013) "Assessment Measures." In Diagnostics and Statistical Manual of Mental Disorders (5th ed,). Arlington, VA: Author.

https://dsm.psychiatryonline.org/doi/10.1176/appi.books.9780890425596.dsm05

Ay, D. S., Kühne, F., & Weck, F. (2019). The assessment of cognitive‐behavioral therapy skills in patients diagnosed with health anxiety: Development and pilot study on an observer‐based rating scale. Clinical

Psychology & Psychotherapy, 26(6), 639–649. https://doi.org/10.1002/cpp.2387

Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.