1. What diagnosis would you give to the following client?
2. How did you arrive at that diagnosis? Be specific. Include the symptoms of the diagnosis that are present and specific examples of those symptoms.
3. Name a plausible diagnosis that you ruled out.
4. Why did you rule out the diagnosis listed in #3? In other words, what symptoms were either present or absent that made you say that the diagnosis in #3 would NOT be correct? Be specific and provide examples.
Frank, a 25-year-old single man, lives with his mother and brother. He works as a nighttime security guard at a shopping center, a job he has had since he dropped out of college after 2 years. His chief complaint is of "nervousness." He says that right
now he is "just going through the motions" and wants "to lead a normal life and go back to college."
During his adolescence and young adulthood, Frank had no close friends and usually preferred to be by himself. When he entered college, he had a couple of close friendships but became "super self-conscious" when speaking to strangers, classmates,
and sometimes even friends. He would feel nervous, and his face would become so "stiff" that he had difficulty speaking. He had a "buzzing" in his head, felt as if he were going to pass out. He said that he had hot flashes and sweated profusely. These
"panic attacks" came on suddenly, within seconds, and only when he was with people.
When a classmate spoke to him, he sometimes "couldn't hear what the classmate was saying because of his nervousness. Outside class, Frank began to feel increasingly uncomfortable with people. "I think that I was afraid of saying or doing
something stupid. He began to turn down invitations to parties and to withdraw from social activities. Eventually, he dropped out of college entirely. Frank explains that the reason he chose to work the graveyard shift as a security guard is because his
job does not require him to deal with people.
Frank states that he is in good health. He has no complaints with the exception of an old elbow injury that causes him pain every now and then. He has some difficulty with his brother. Frank says that his brother, who is 2 years younger, just "doesn't
get him". They argue occasionally. He states that it's mostly because his brother wants to go out and do things with him. Frank tries to explain that the idea of being around other people makes him so nervous that he just can't do it. His brother thinks
that Frank is just being "stupid". Frank also feels that his mother is pressuring him. She keeps asking when he's going to get a girlfriend. The idea of dating is just too scary right now for him. His mom thinks that Frank just needs a nice girlfriend to get
him out of this "funk".