Respond to at least two colleagues in the following ways: (Be detailed in response and use subheadings and 2 APA references)

  • Compare the diagnosis you provided and the process in which you reached the diagnosis with those of your colleague.
  • Explain how the Z codes (other conditions that may be a focus of clinical attention) that your colleague identified may influence Bogdan’s upcoming treatment.

My Response

Provide a full DSM-5 diagnosis of Bogdan. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.

F84.0 Autism Spectrum Disorder(ASD): ICD-10-CM code 299.00

Specifiers: Requiring support for social communication and requiring very substantial support for restricted, repetitive behaviors, without accompanying intellectual impairment, with accompanying language impairment, not associated with a known medical or genetic condition or environmental factor.

Severity Level is 2: “Requiring substantial support”

Z codes: (Z62.820) Parent-Child-Relational Problems

(Z55.9) Academic or Educational Problems

(Z60.9)Unspecified Problem Related toSocial Environment

Identify which four diagnoses you initially considered in the case of Bogdan, using the DSM-5 diagnostic criteria to explain why you selected these four items. In one or two sentences each, explain why three of these diagnoses were excluded.

  • Obsessive-compulsive disorder (F42.1): the symptoms of this disorder include repeated, persistent and unwanted thoughts along with ritualistic behavior, social isolation, and persistent repetition of words or actions (APA, 2017). This diagnosis was excluded because several symptoms of the disorder are not present in the case of Bogdan.
  • Attention-deficit hyperactivity disorder (ADHD) (F90.9): Bogdan has displayed many of the symptoms of ADHD. This diagnosis was excluded because although he blurts out answers and interrupts the class, displays aggression, lack of restraint, and persistent repetition of words or actions, but he has not displayed sign of hyperactivity.
  • Reactive Attachment disorder (F94.1): Bogdan has many of the symptoms associated with this disorder. This diagnosis was excluded because although he is withdrawn, does not interact with his caregivers, has unexplained withdrawal, he has several other symptoms not associated with the mental health disorder.
  • Oppositional defiant disorder (F91.3): Bogdan has several symptoms of this disorder including aggression, antisocial behavior, impulsivity, irritability. This diagnosis was excluded because Bogdan is not purposively defiant.

Explain any obvious eliminations that could be made from within the neurodevelopmental spectrum.

Eliminations that could be made from within the neurodevelopmental spectrum include Bogdan’s food behaviors. He overeats and hides food which is likely the cause of something in his past.

Describe in detail how Bogdan’s symptoms match up with the specific diagnostic criteria for the primary disorder that you finally selected for him. Note two other relevant DSM-5 criteria for that illness from the sections on “diagnostic features” and “development and course” that fit his case.

Making a sound diagnosis requires understanding the symptoms (Morrison, 2014). The diagnosis of Autism spectrum disorder was the result of diagnostic criteria including (1) Persistent deficits in social communication and social interaction. Bogdan has trouble interacting with others or sharing emotion. He has trouble with nonverbal communicative behaviors, developing and maintaining relationships, and has trouble adjusting. (2)Restricted, repetitive patterns of behavior, interests, or activities, Bogdan plays with the same object and has a fascination with World War II. He insists on sameness and does not like changes to his environment.

References

American Psychiatric Association. (2017, October 1). Changes to ICD-10-CM codes for DSM-5

diagnoses. Washington, DC: Author. Retrieved from

https://www.psychiatry.org/psychiatrists/practice/…

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

2 Peer Responses

Response to Henry

Bogdan is a 12-year-old male who was adopted from Russia as a toddler. Bogdan’s adoptive mother witnessed Bogdan attempting to suffocate his younger siblings when they were babies (Plummer, Makris, & Brocksen, 2013). Bodgan has lived with his adoptive family since he was three years of age. There is very little that is known about Bodgans biological parents.

Bogdan has been exhibiting behaviors that raised some suspicion because of some of the things he has been doing over time. This was excluded based on there had to a minimum of a year for outburst to be and Bogdan had just begun this behavior within the school year. I decided to give him a diagnosis of Autism Spectrum Disorder. Autism Spectrum Disorder is specified as persons having communication deficits. The ICD-10-CM code is 299.0 (F84.9). The specifiers are with accompanying intellectual impairment and with accompanying structural language impairment.

Bogdan’s symptoms include all of them and his inability to understand to empathize with the feelings of his family explains why he tried to suffocate his siblings, lack of respect for authority, abnormal behavior toward food, etc. (Plummer, Makris, & Brocksen, 2013). There may be several diagnoses that would fit Bogdan’s issues. Attention deficit hyperactive disorder, (ADHD), is a possible diagnosis based on Bogdan’s physical and mental development at his age, coupled with his aggressive and violent behaviors toward his parents and siblings. Post-Traumatic Stress Disorder and (F94.1) is another diagnosis that I would have given to Bogdan. Autism spectrum disorder – failure of normal back and forth communication, failure to respond to social interactions, difficulties adjusting. Severity includes abnormal social approach, poorly integrated social communication, absence of interest in peer relationships, and repetitive patterns of behaviors (American Psychiatric Association, 2013). I also considered for Bogdan was Oppositional Defiant Disorder (ODD) because he displayed symptoms and signs of “[a] pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months” (APA, 2013).

There are many disorders that have deficits that often relate to another disorder. There were more symptoms that Bogdan demonstrated that related to ADHD. An obvious elimination within the neurodevelopmental spectrum was Bogdan’s academic progress. The collateral contacts substantiate this in combination with what Bogdan’s Mother explains. It appears that as Bogdan enters into the adolescent years, he continues to display poor impulse control as evidenced by ‘meltdowns’ when he doesn’t get his way and appears to display antisocial behaviors. As Bogdan becomes an adolescent, his hyperactive symptom development and course may improve as he ages, however, he may continue to have problems with his impulse control.

Reference:

Plummer, S.-B., Makris, S., & Brocksen, S. (2013). Social work case studies: Concentration year. Baltimore, MD: Laureate Publishing.

American Psychiatric Association. (2013). Neurodevelopmental disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm01

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Response to Rhonda

Full DSM-5 Diagnosis

Bogdan is a 12-year old male who presented with the following problems at home and in school settings: Aggressive and disruptive behavior, difficulty paying attention, restlessness, difficulty and with change.

F90.8 Other Attention-Deficit/Hyperactivity Disorder with insufficient hyperactivity and inattention symptoms

Z62.820 Parent-child relational problem

Z62.891 Sibling relational problem

Four Diagnoses

Four disorders that I initially considered were Disruptive Mood Dysregulation Disorder;

Oppositional Defiant Disorder because the patient didn’t meet the angry/irritable mood, vindictive, and argumentative/defiant behavior criteria, Conduct Disorder, and Tic disorder because the client didn’t meet full criteria to consider.

Obvious Eliminations

One obvious elimination within the neurodevelopmental spectrum was:

-Intellectual Developmental Disorder because Bogdan’s mother stated he managed to keep up with his school work until 6th grade.

-Global Developmental Delay.

-Language Disorder.

-Childhood Onset Fluency Disorder.

-Social Communication Disorder.

– Autism Spectrum Disorder.

While Bogdan’s symptoms displayed inattention and hyperactivity, he didn’t meet the full criteria in both areas. One other relevant DSM-5 criteria for ADHD is impulsivity.

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