Vignette #: 7 I’m Not Right Up Here Axis I: 309. 21 Separation Anxiety Disorder, early onset, 313. 81 Oppositional Defiant Disorder, 315. 9 Learning Disorder NOS Axis II: V62. 3 Academic problem Axis III: R Axis IV: Victim of Child abandonment (Mother) Axis V: GAF = 31 (current) Phillip meets criteria for Separation Anxiety Disorder Criteria A by meeting three (or more) symptoms: 1)Phillip showed anxiety at separation from his grandmother when he began school Criteria B is met with duration, Phillip anxiety began when he was separated from his mother after age five.
His mother was not fully involved in his after he was born. Criteria C is met, Phillips’s onset was before age 18. Criteria E are met because this disturbance causes clinically significant distress in his life. Phillip is encountering problems because he has problems sleeping from fear that his grandmother may leave him Phillip meets criteria form Oppositional Defiant Disorder by four (or more) symptoms Criteria A 1)Phillip loses his temper often and gets into fights 2)Phillip defies and refuses to comply with adults’ request and rules as described in the letter from school.
He refused the request from the teaches to report to the principal office 3)Phillip deliberately annoys his classmates by teasing, stealing and fighting other children on the bus and in the lunchroom. Criteria B are met because the disturbances cause impairments in Phillips social environment. He cannot participate positively in a school setting with other children or follow direction from authority figures. Criteria C is met since behaviors do not occur with Psychotic or Mood Disorder
Phillip does not meet criteria for any specific learning disorder, although there are problems with his school achievement, as he is only at the third – and low fourth-grade level. R/O 314 Attention-Deficit/Hyperactivity Disorder Phillip meets Criteria A 1)(A) Phillip does not give close attention to details to schoolwork or other activities (B) Not met, Phillip pays attention, but he is disruptive in does not play nicely with other children (C) Does not listen when spoken to directly (D) Not met, difficulty in follow through on tasks
Phillip does not meet Criteria B because hyper-active-impulsive symptoms’ were not present before age 7 years Criteria C is not met by symptoms present in two or more settings (e. g. , at school and home). Phillip behaves at home R/O 312. 81 Conduct Disorder, Childhood Onset Phillip does not meet the criteria A for at least six months Aggression to people and animals, he is not cruel to animals Destruction of property, he is not destructive with property Deceitfulness or theft, meets criteria Serious violation of rules, is not truant from school