Module 8 Discussion 2 - Weekly Dicussion and diagnosis assignment PDF

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Weekly Dicussion and diagnosis assignment...

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Watch As Good as it Gets, what were the identifying problems/symptoms noted for Melvin Udall? Identify at least 5 strengths for Melvin. What diagnosis would you give Melvin, state the clinical criterion to justify your diagnosis (as well as DSM 5 coding)? How was he able to cope and what supportive, interpersonal, and social factors were evident in his environment? In the beginning of the movie we are introduced to Melvin Udall and a plethora of compulsions that he has no control over, they rather control him. He washes his hands in blazing hot water and uses 2 bars of soap and discards them after 2 seconds of use, he refuses to step on cracks, he can’t stop the rude thoughts that play in his head from parting his lips, he sticks with the same restaurant and seat every day, he can’t be late, his home is meticulous and extremely organized, Identify at least 5 strengths for Melvin: As the movie progresses we see that the introduction of the dog into his life changes his routine which ultimately changes his life and gives us a first hand look at the strengths Melvin possesses. He recognizes that he has the ability to adapt when he takes on watching Verdell and he also recognizes the sense of fulfillment and happiness that having a companion brings to him. Another strength he has is his career and financial stability which gives him the freedom to help others that he has grown to care about. Melvin is removed from his comfort zone and slowly he starts to do things that helps lessen his compulsions. He makes friends, finds love and as he does this his compulsions to lock the door 5 times in a row. He begins to almost naturally go with the flow. He is also shown to be selfless when he cares for you- takes on the medical expenses and treatment of Carol’s son and moves Simon his neighbor into his house when his neighbor becomes homeless. He also shows that he can try new things when he goes on the road trip despite his fear- while on this trip he also conquered many fears despite his compulsions, one being talking about his upbringing and the abuse he endured by his father. What diagnosis would you give Melvin, state the clinical criterion to justify your diagnosis (as well as DSM 5 coding)? I would diagnose Mr. Udall with Obsessive-Compulsive Disorder Code: 300.3 (F42.2) Diagnostic Criteria300.3 F42.2 With absent insight/delusional beliefs: The individual is completely convinced that obsessive-compulsive disorder beliefs are true.

1. Presence of obsessions, compulsions, or both: 1. Obsessions are defined by (1) and (2): 2. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress. 3. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion). 4. Compulsions are defined by (1) and (2):

5. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. 6. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive. 2. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 3. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. 4. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder). How was he able to cope and what supportive, interpersonal, and social factors were evident in his environment? Melvin coped with his disorder by developing a regimen that was acceptable for his lifestyle. He was able to find a job that he was good at that he was able to work at his own pace, he was mobile even though the cracks in the sidewalks made it hard to get by and he lived a fulfilling life, for the most part. We see as the movie progresses that by stepping outside of his comfort zone, Melvin was able to find friends and love and a support system that he never had or knew existed. Helping people and being needed gave Melvin a sense of normalcy and calmed his compulsions. Possible V/Z codes related to Mr. Udall:

V61.20 (Z62.820) Parent-Child Relational Problem V15.41 (Z62.810) Personal history (past history) of physical abuse in childhood V62.89 (Z60.0)

Phase of Life Problem

V60.3 (Z60.2)

Problem Related to Living Alone

V62.4 (Z60.4)

Social Exclusion or Rejection...