Posted: December 16th, 2022

NRNP 6635: Psychopathology and Diagnostic Reasoning

Week (enter week #): (Enter assignment title)

Student Name
College of Nursing-PMHNP, Walden University
NRNP 6635: Psychopathology and Diagnostic Reasoning
Faculty Name
Assignment Due Date
Psychopathology refers to the scientific study of mental disorders, including their symptoms, causes, and treatments. It involves understanding the nature, development, and course of mental disorders, as well as the various factors that contribute to them.

Diagnostic reasoning is the process of evaluating and identifying the presence of a mental disorder in an individual. It involves gathering information from various sources, such as a patient’s history, physical examination, and laboratory tests, and using this information to arrive at a diagnosis.

The process of diagnostic reasoning in psychopathology involves several steps:

Obtaining a thorough history of the patient, including their symptoms, medical history, and family history of mental illness.

Conducting a physical examination and ordering laboratory tests, as needed, to rule out physical causes for the patient’s symptoms.

Using diagnostic criteria, such as those outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), to determine the presence and severity of a mental disorder.

Considering other potential contributing factors, such as substance abuse or medical conditions, that may be contributing to the patient’s symptoms.

Formulating a treatment plan that takes into account the patient’s individual needs and preferences.

It’s important to note that diagnostic reasoning in psychopathology is not an exact science and that different mental health professionals may arrive at different diagnoses for the same patient. It’s also important to recognize that mental disorders are complex and often have multiple causes, and that treatment may involve a combination of therapies and medications.
Subjective:
CC (chief complaint):
HPI:
Past Psychiatric History:
• General Statement:
• Caregivers (if applicable):
• Hospitalizations:
• Medication trials:
• Psychotherapy or Previous Psychiatric Diagnosis:
Substance Current Use and History:
Family Psychiatric/Substance Use History:
Psychosocial History:
Medical History:

• Current Medications:
• Allergies:
• Reproductive Hx:
ROS:
• GENERAL:
• HEENT:
• SKIN:
• CARDIOVASCULAR:
• RESPIRATORY:
• GASTROINTESTINAL:
• GENITOURINARY:
• NEUROLOGICAL:
• MUSCULOSKELETAL:
• HEMATOLOGIC:
• LYMPHATICS:
• ENDOCRINOLOGIC:
Objective:
Physical exam: if applicable
Diagnostic results:
Assessment:
Mental Status Examination:
Differential Diagnoses:
Reflections:
References
—

TO PREPARE:
• Review this week’s Learning Resources. Consider the insights they provide about assessing and diagnosing mood disorders.
• Download the Comprehensive Psychiatric Assessment Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Assessment Exemplar to see an example of a completed Assessment document.
• By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the Assessment template in mind.
• Consider what history would be necessary to collect from this patient.
• Consider what interview questions you would need to ask this patient.
• Identify at least three possible differential diagnoses for the patient.
BY DAY 7 OF WEEK 3
Complete and submit your Comprehensive Psychiatric Assessment, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:
• Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
• Objective: What observations did you make during the psychiatric assessment?
• Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

DIFFERENT VIDEO CASE STUDIES (SELECT ONE)
Select one of the following videos to use for your Assignment this week. Then, access the document “Case History Reports” and review the additional data about the patient in the specific video number you selected.
• Symptom Media. (Producer). (2016). Training title 2 Links to an external site.[Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-2
• Symptom Media. (Producer). (2016). Training title 8 Links to an external site.[Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-8
• Symptom Media. (Producer). (2017). Training title 18 Links to an external site.[Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-18
• Symptom Media. (Producer). (2016). Training title 28 Links to an external site.[Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-28
• Symptom Media. (Producer). (2016). Training title 38 Links to an external site.[Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-38
• Symptom Media. (Producer). (2016). Training title 43 Links to an external site.[Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-43
• Symptom Media. (Producer). (2018). Training title 118 Links to an external site.[Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-118
• Symptom Media. (Producer). (2018). Training title 144 Links to an external site.[Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-144
• Symptom Media. (Producer). (2018). Training title 150 Links to an external site.[Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-150

Use these case histories to supplement the information about the patients in the video case
studies.
Week 3: Mood Disorders
Training Title 2
Name: Ms. Natalie Crew
Gender: female
Age:17 years old
T 97.4 P-82 R-1 20 128/84 Ht 5’2” Wt 192lbs

Background: Recently started an accelerated high school business program in Chicago, Illinois
after growing up and living in New Orleans her whole life. Grew up with both parents and four
brothers. Currently lives in on a specialty high school campus dormitory. Currently a full-time
student and works part time in the local coffee shop. Not married, currently single. She has no
previous psychiatric history; takes no medications. There is history of depression, denied
substance use history for her or family. No legal hx NKDA
Symptom Media. (Producer). (2016). Training title 2 [Video].
https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa
tch/training-title-2

Training Title 8
Name: Mrs. Abrianna Tilman
Gender: female
Age: 27 years old
T- 98.6 P- 88 R 18 154/92 Ht 5’1 Wt 230lbs
Background: Recently had her first child two months ago. Currently married; stay at home
mother after working in community library for 5 years. Grew up with her mother after her
parents divorced when she was 16; has two sisters in Troy, Alabama. Completed education
through bachelor’s level, majoring in English Literature. No previous suicidal gestures. Brother
committed suicide via GSW. She denied drugs/alcohol; brother was addicted to
methamphetamines. Hx of HTN-prescribed Trandate 100mg twice daily, admits to missing doses
due to forgetting. No legal hx. Allergies: PCN

Symptom Media. (Producer). (2016). Training title 8 [Video].
https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa
tch/training-title-8

Training Title 18
Name: Ms. Rosario Campbell
Gender: female
Age:25 years old
T-97.7 P-70 R-18 118/72 Ht 5’3 Wt 123lbs
Background: Currently living off-base in El Paso, Texas, active duty in the Army, MOS 92M
Mortuary Affairs Specialist. Grew up in McAllen TX with both parents and one brother.
Completed education through high school. Currently partnered. No children. Mother history of
depression; brother hx of cannabis use. No medical history. No legal hx; allergy: cipro previous
medication trials: sertraline, fluoxetine both with good effects when taking.
Symptom Media. (Producer). (2017). Training title 18 [Video].
https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa
tch/training-title-18

Training Title 28
Name: Mrs. Ada Carson
Gender: female
Age: 54 years old
T- 97.6 P- 94 R 22 162/84 Ht 5’5 Wt 144lbs
Background: Currently living in Sioux Falls, South Dakota, working full-time as a contract
negotiator in a financial company. Has an MBA. Lives with her husband and two teenage twin
sons. Born and raised in Trenton, NJ, with her father and two brothers, her mother deceased
when she in MVA when she was 12 years old. Brother has depression; mother has history of
being a “functioning alcoholic”. Recently informed by her PCP she has a “fatty liver.” Allergies:
codeine

Symptom Media. (Producer). (2016). Training title 28 [Video].
https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa
tch/training-title-28

Training Title 38

Name: Mr. Elijah Loman
Gender: male
Age:18 years old
T- 98.3 P- 93 R 22 118/68 Ht 5’7 Wt 149lbs
Background: Currently lives with his sister and two parents in Durham, NC. Not currently
employed. Completed high school, not currently in school. Hx of treatment for mood disorder
began age 15, previous trials of risperidone, quetiapine off and on, side effects of wt. gain. Has
hx of a six-day hospitalization one year ago after found wandering at night in the mall parking
lot without clothes. He refused medication due to previous experiences. Not currently partnered.
He has been sexually inappropriate with comments to female neighbors; pulled his pants down in
the mall. Denies any recent alcohol or substance use. Father has history of bipolar disorder. No
history of self-harm behaviors, no family suicides. Mother reports he has slept 4-5 hours in past
week, up spending money buying and playing new video games and says he is writing a book on
how others can be a video game master. Appetite is decreased. No medical hx; Hx of vandalism
as a juvenile. Has pending court date for indecent exposure. Allergies: latex

Symptom Media. (Producer). (2016). Training title 38 [Video].
https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa
tch/training-title-38

Training Title 43

Name: Mr. Elijah Loman
Gender: male
Age:20 years old
T- 97.2 P- 84 R 18 118/68 Ht 5’7 Wt 156lbs
Background: Currently lives with his sister and her husband who are his legal guardians as
parents deceased when he was 15 and he was deemed to need a fiduciary and guardian by the
court system. Not currently employed. Completed high school, not currently in school. Hx of
treatment for mood disorder began age 15, previous trials of Depakote, Quetiapine off and on,
side effects of akathisia. Has hx of a multiple hospitalization, last was 4 months ago when he
exposed his genitals to girls at the mall. . Not currently partnered. He is currently in hospital
admitted one week ago, was initiated on lithium 300mg po three times daily and risperidone 1mg
at bedtime. Denies any recent alcohol or substance use. Paternal uncle has history of bipolar
disorder. No history of self-harm behaviors, no family suicides. Appetite is decreased. No
medical hx; hospital admission labs within normal ranges, UDS negative; Hx of truancy as a
juvenile. Has pending court date for indecent exposure. Allergies NKDA

Symptom Media. (Producer). (2016). Training title 43 [Video].
https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa
tch/training-title-43

Training Title 150
Name: Ms. Cheyenne Lisenbe
Gender: female
Age:18 years old
T- 97.4 P- 94 R 22 136/86 Ht 5’2 Wt 121
Background: Currently living with her parents in Locust Grove, Oklahoma along with two
younger sisters and 1 older brother. She is a senior in high school, not currently partnered,
reports she is bisexual, lately hyper-sexual reporting increase of unprotected sex. She has been
stealing money out of her grandmother’s purse to buy clothes, shoes, purses, “and just other
things. She has history of treatment since age 9 for conduct disorder, depression, history of
taking citalopram which worsened her irritability, aggression, impulsivity. She has been in a 90-
day teen residential mental health facility discharged three months ago with lithium 300mg in am
and 600mg at bedtime, aripiprazole 2.5mg in the morning. When discharged, her labs were
within normal ranges and urine toxicology negative. She was positive for cannabis upon
admission. Her parents believe she is hiding her medication as she has made comments “they
slow me down; they make me not think fast” She has hx of domestic violence toward her older
brother with juvenile assault charge. No current legal issues. Her grandmother has hx of bipolar
disorder; her mother and her maternal aunt have anxiety. She is sleeping 2-3hrs/24 hrs. Reports
her appetite “ravishing.” She has no medical issues; has Nexplanon implant; hx of self-harm with
cutting, last engaged in the behavior 6 months ago.

Symptom Media. (Producer). (2018). Training title 150 [Video].
https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa
tch/training-title-150

Training Title 118

Name: Mr. Connor Walsh
Gender: male
Age: 57 years old
T- 97.2 P- 94 R 20 156/88 Ht 5’8 Wt 163lbs
Background: Born and raised in Peru Indiana Is staying at a shelter after being homeless in
MacArthur Park for 1 year in Los Angeles. He lost his apartment and his job working part-time
at Home Depot. Enjoys playing music. He has long hx of mental health treatment since age 19.
Previous medication trials include lithium (was effective), Depakote (gastric upset), aripiprazole
(akathisia), risperidone (hyperprolactinemia), haloperidol (dystonia), quetiapine (didn’t give a
fair trial), Poor historian. divorced once, reports being gay, no children; estranged from only
living sister, parents deceased. He is not sure of his family mental health or substance use history
but feels like he is most like his aunt, she has history of mental health treatment “but
I’m not sure for what.” States that he got a master’s degree in music theory at Stanford. Admits
to 3-6 drinks of alcohol when “playing music in the clubs”, denied illicit drugs, has history of
intentional drug overdose at age 22, history of 8 inpatient psychiatric hospitalization, most recent
was 8 months ago. hx of one detox admission 15 years ago Allergies: bee stings

Symptom Media. (Producer). (2018). Training title 118 [Video].
https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa
tch/training-title-118

Training Title 144

Name: Ms. Amy Hartford
Gender: female
Age: 26 years old
T- 98.2 P- 70 R 18 128/76 Ht 5’0 Wt 152lbs
Background: Currently lives in Scottsdale, AZ, divorced with two children a daughter age 8 and
son age 4. Born and raised in Mesa, AZ with her mother and two sisters Works as paralegal, has
an associate degree; no legal hx; allergic to dicyclomine; history of rosacea

Symptom Media. (Producer). (2018). Training title 144 [Video].
https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa
tch/training-title-144

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Tags: NRNP 6635: Psychopathology and Diagnostic Reasoning, PRAC6635