NRNP 6635 Psychopathology And Diagnostic Reasoning Full Course
Module 1: Foundations Of Psychopathology And Diagnostic Reasoning
What’s Happening With This Module?
This course is composed of three modules covered over the course of 11 weeks. Each module consists of an overarching topic, and each week within the module includes specific subtopics for learning. As you work through each module, you will have an opportunity to draw upon the knowledge you gain in various assignment components that are due throughout each of the modules.
Module 1: Foundations of Psychopathology and Diagnostic Reasoning, is a 2-week module that focuses on the theoretical basis for psychopathology and the foundations of assessing patients and applying diagnostic reasoning. In this module, you will learn more about historical and currently recognized biological, psychological, and sociocultural factors that inform the expression, course, and prevalence of psychopathology. You will also explore elements of the psychiatric interview, history, and examination as well as the appropriate uses of psychiatric rating scales.
| What do I have to do? | When do I have to do it? |
| Review your Learning Resources. | Days 1–7, Weeks 1 and 2 |
| Discussion: Factors That Influence the Development of Psychopathology | Post by Day 3 of Week 1 and respond to your colleagues by Day 6 of Week 1. |
| Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales | Post by Day 3 of Week 2 and respond to your colleagues by Day 6 of Week 2. |
Week 1: History And Theories Of Psychopathology
The history of the diagnosis of mental disorders is fraught with examples of how cultural norms and prejudices interfere with and warp a diagnosis. The result is that normal behavior and orientations have been pathologized as an illness or disease. An example of this would be the story of Alan Turing, the famous British computer scientist of the 20th century, who was instrumental in inventing modern computers and deciphering German code in World War II.
He was convicted in 1952 in England of gross indecency for being gay. Turing was forced by the courts to undergo 12 months of hormone therapy and could no longer work for the British government. At the time, homosexuality was pathologized as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders and was criminalized in most Western countries. It was not until 1973 that the American Psychiatric Association (APA) finally removed homosexuality from the DSM.
Historically, the process of rendering a diagnosis has been used to pathologize those who fell outside what was considered the cultural norm of human behavior. This process often marginalized diagnosed populations and prevented individuals from receiving appropriate care. It is of utmost importance to consider cultural issues that influence how you as a clinician interpret a client’s behavior and how cultural issues influence how a client may express behavior. This week, you explore the history of psychopathology and the evolution of theoretical perspectives in the field.
Learning Objective Students will:
■ Analyze historical and currently recognized biological, psychological, and sociocultural factors that inform the expression, course, and prevalence of psychopathology
Learning Resources
Required Readings (click to expand/reduce)
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
■ Chapter 1, Neural Sciences
■ Chapter 2, Contributions of the Psychosocial Sciences
■ Chapter 3, Contributions of the Sociocultural Sciences
■ Chapter 4, Theories of Personality and Psychopathology
■ Chapter 31.17c, Child Psychiatry: Other Conditions: Identity Problem Butcher, J. N., & Kendall, P. C. (2018). Introduction to childhood and adolescent psychopathology. In J. N. Butcher & P. C. Kendall (Eds.), APA handbook of psychopathology: Child and adolescent psychopathology., Vol. 2. (pp. 3–14). American Psychological Association.
https://doi-org.ezp.waldenulibrary.org/10.1037/0000065-001Cheung, F. M., & Mak, W. W. S. (2018). Sociocultural factors in psychopathology. In J. N. Butcher & J. M. Hooley (Eds.), APA handbook of psychopathology: Psychopathology: Understanding, assessing, and treating adult mental disorders., Vol. 1. (pp. 127–147). American Psychological Association. https://doi-org.ezp.waldenulibrary.org/10.1037/0000064-006
Jackson, C. E., & Milberg, W. P. (2018). Examination of neurological and neuropsychological features in psychopathology. In J. N. Butcher & J. M. Hooley (Eds.), APA handbook of psychopathology: Psychopathology: Understanding, assessing, and treating adult mental disorders., Vol. 1. (pp. 65–90). American Psychological
Association.https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1037/0000064-004 Masten, A. S., & Kalstabakken, A. W. (2018). Developmental perspectives on psychopathology in children and adolescents. In J. N. Butcher & P. C. Kendall (Eds.), APA handbook of psychopathology: Child and adolescent psychopathology., Vol. 2. (pp. 15–36). American Psychological Association. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1037/0000065-002
Document: NRNP 6635 Midterm Study Guide Assignment
Practicum Manual Acknowledgment
The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.
■ Field Experience: MSN Nurse Practitioner Practicum Manual
Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program.
Optional Discussion Forum: PMHNP Study Support Lounge
The PMHNP Study Support Lounge is offered throughout the course as a place of academic refuge, where you can ask questions, offer insights, and interact with your peers. Your Instructor may also weigh in to provide global feedback to the group based on trends, common problems, and common strengths in student posts.
As a peer, you are encouraged to provide constructive, helpful feedback to your peers. Advanced practice nurses always benefit from the feedback of others. Your Study Support Lounge posts may be procedural (“How do I attach a Kaltura video to a Discussion post?”), conceptual (“How does this relate to the other therapy approaches we have studied?”), or analytical (“What do these diagnostic results actually mean in the context of this specific patient case?”). Although not mandatory, this is an opportunity to interact and study together as you navigate the assignments, so you are highly encouraged to take part in this activity. Full participation in activities like these is a statistically significant predictor of success.
To Participate in this Optional Discussion:
PMHNP Study Support Lounge
Discussion: Factors That Influence The Development Of Psychopathology
In many realms of medicine, objective diagnoses can be made: A clavicle is broken. An infection is present. TSH levels meet the diagnostic criteria for hypothyroidism. Psychiatry, on the other hand, deals with psychological phenomena and behaviors. Can these, too, be “defined objectively and by scientific criteria (Gergen, 1985), or are they social constructions?” (Sadock et al., 2015).
Thanks to myriad advances during recent decades, we know that psychopathology is caused by many interacting factors. Theoretical and clinical contributions to the field have come from the neural sciences, genetics, psychology, and social-cultural sciences. How do these factors impact the expression, classification, diagnosis, and prevalence of psychopathology, and why might it be important for a nurse practitioner to take a multidimensional, integrative approach?
To Prepare:
■ Review this week’s Learning Resources, considering the many interacting factors that contribute to the development of psychopathology.
■ Consider how the theoretical perspective on psychopathology impacts the work of the PMHNP.
By Day 3 Of Week 1
Explain the biological (genetic and neuroscientific); psychological (behavioral and cognitive processes, emotional, developmental); and social, cultural, and interpersonal factors that influence the development of psychopathology.
Read a selection of your colleagues’ responses By Day 6 Of Week 1
Respond to at least two of your colleagues on 2 different days by explaining the implications of why, as an advanced practice nurse, it is important to adopt a multidimensional, integrative model of psychopathology.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission And Grading Information Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post By Day 3 Of Week 1 And Respond By Day 6 Of Week 1 To Participate in this Discussion:
Week 1 Discussion
Week 2: Assessment And Diagnosis Of The Psychiatric Patient
A sensitively crafted intake assessment can be a powerful therapeutic tool. It can establish rapport between patient and therapist, further the therapeutic alliance, alleviate anxiety, provide reassurance, and facilitate the flow of information necessary for an accurate diagnosis and appropriate treatment plan.
—Pamela Bjorklund, clinical psychologist
Whether you are treating patients for physical ailments or clients for mental health issues, the assessment process is an inextricable part of health care. To properly diagnose clients and
develop treatment plans, you must have a strong foundation in assessment. This includes a working knowledge of assessments that are available to aid in diagnosis, how to use these assessments, and how to select the most appropriate assessment based on a client’s presentation.
This week, as you explore assessment and diagnosis of patients in mental health settings, you examine assessment tools, including their psychometric properties and appropriate uses. You also familiarize yourself with the DSM-5 classification system.
Reference: Bjorklund, P. (2013). Assessment and diagnosis. In K. Wheeler (Ed.), Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.) (pp. 95–168). Springer Publishing Company.
Learning Objectives Students will:
■ Evaluate elements of the psychiatric interview, history, and examination
■ Analyze psychometric properties of psychiatric rating scales
■ Justify appropriate use of psychiatric rating scales in advanced practice nursing Learning Resources
Required Readings (click to expand/reduce)
American Psychiatric Association. (2013). Section I: DSM-5 basics. In Diagnostic and statistical manual of mental disorders (5th ed., pp. 5–29). Author.
Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer.
■ Chapter 34, Writing Up the Results of the Interview
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
■ Chapter 5, Examination and Diagnosis of the Psychiatric Patient
■ Chapter 6, Classification in Psychiatry
■ Chapter 31, Child Psychiatry (Sections 31.1 and 31.2 only)
American Academy of Child and Adolescent Psychiatry (1995). Practice parameters for the assessment and treatment of children and adolescents. https://www.aacap.org/App_Themes/AACAP/docs/practice_parameters/psychiatric_assessment
American Psychiatric Association. (2016). Practice guidelines for the psychiatric evaluation of adults (3rd ed.). https://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2017). Classification in psychiatry. In Kaplan and Sadock’s Concise Textbook of Clinical Psychiatry (4th ed., pp. 1–8). Wolters Kluwer.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2017). Psychiatric interview, history, and mental status examination. In Kaplan and Sadock’s Concise Textbook of Clinical Psychiatry (4th ed., pp.
9–15). Wolters Kluwer.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2017). Medical assessment and laboratory testing in psychiatry. In Kaplan and Sadock’s Concise Textbook of Clinical Psychiatry (4th ed., pp. 16–21). Wolters Kluwer.
Required Media (click to expand/reduce)
Classroom Productions. (Producer). (2015). Diagnostic criteria [Video]. Walden University.
MedEasy. (2017). Psychiatric history taking and the mental status examination | USMLE & COMLEX [Video]. YouTube. https://www.youtube.com/watch?v=U5KwDgWX8L8
Psychiatry Lectures. (2015). Psychiatry lecture: How to do a psychiatric assessment [Video]. YouTube. https://www.youtube.com/watch?v=IRiCntvec5U
Getting Started With The DSM-5
If you were to give a box of 100 different photographs to 10 people and ask them to sort them into groups, it is very unlikely that all 10 people would sort them into the exact same groups. However, if you were to give them a series of questions or a classification system to use, the chances that all 10 people sort them exactly the same increases depending on the specificity of the system and the knowledge of those sorting the photographs.
This is not unlike what has occurred in the process of classifying mental disorders. A system that provides enough specificity to appropriately classify a large variety of mental disorders while also attempting to include all of the possible symptoms, many of which can change over time, is a daunting task when used by a variety of specialists, doctors, and other professionals with varied experience, cultures, expertise, and beliefs.
The DSM has undergone many transformations since it was first published in 1952. Many of these changes occurred because the uses for the DSM changed. However, the greatest changes began with the use of extensive empirical research to guide the creation of the classification system and its continued revisions.
In order to assess and diagnose patients, you must learn to use the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, usually abbreviated as the DSM-5, to render a diagnosis. In this second week of the course, you will examine how DSM-5 is organized and how clinicians use it to render diagnoses.
Review the Learning Resources this week, with special emphasis on viewing the Diagnostic Criteria video. This video explains the purpose and organization of the DSM-5 classification system, the purpose of the ICD-10 coding system, their relationship to one another, and the importance to the PMHNP role.
Discussion: The Psychiatric Evaluation And Evidence-Based Rating Scales
Assessment tools have two primary purposes:
1) to measure illness and diagnose clients,
2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy.
To Prepare:
■ Review this week’s Learning Resources and reflect on the insights they provide regarding psychiatric assessment and diagnosis.
■ Consider the elements of the psychiatric interview, history, and examination.
■ Consider the assessment tool assigned to you by the Course Instructor.
By Day 3 Of Week 2
Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important. Explain the psychometric properties of the rating scale you were assigned. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner psychiatric assessment. Support your approach with evidence-based literature. Read a selection of your colleagues’ responses.
By Day 6 Of Week 2
Respond to at least two of your colleagues on 2 different days by comparing your assessment tool to theirs.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Week 3: Mood Disorders
While most people experience sadness or grief at some point in their lives, it is typically of short duration and may occur in response to some type of loss. Clinically significant depression, on the other hand, is more disruptive and serious. It lasts longer and has more symptoms that interfere with daily functioning.
This week, you will explore the differences among mood disorders such as depressive, bipolar, and related disorders, and you will examine challenges in properly differentiating among them for the purpose of accurately rendering a diagnosis. You also will look at steps that can be taken to increase the likelihood that patients who are diagnosed with these disorders benefit from treatment and refrain from physically harming themselves or others.
Learning Objectives Students will:
■ Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information
■ Formulate differential diagnoses using DSM-5 criteria for patients with mood disorders across the lifespan
Learning Resources
Required Readings (click to expand/reduce)
American Psychiatric Association. (2013). Bipolar and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm03
American Psychiatric Association. (2013). Depressive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
■ Chapter 8, Mood Disorders
■ Chapter 31, Child Psychiatry (Section 31.12 only) Document: Comprehensive Psychiatric Evaluation Template Document: Comprehensive Psychiatric Evaluation Exemplar Required Media (click to expand/reduce)
Classroom Productions. (Producer). (2015). Bipolar disorders [Video]. Walden University. Classroom Productions. (Producer). (2015). Depressive disorders [Video]. Walden University.
Classroom Productions. (Producer). (1992). Mood disorders [Video]. Walden University.
Classroom Productions. (Producer). (2005). Bipolar disorder in children [Video]. Walden University.
MedEasy. (2017). Mood disorders (depression, mania/bipolar, everything in between) | USMLE & COMLEX [Video]. YouTube. https://www.youtube.com/watch?v=59umGpQyaHs
Video Case Selections for Assignment (click to expand/reduce)
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 [Video].
Symptom Media. (Producer). (2016). Training title 8 [Video].
Symptom Media. (Producer). (2017). Training title 18 [Video].
Symptom Media. (Producer). (2016). Training title 28 [Video].
Symptom Media. (Producer). (2016). Training title 38 [Video].
Symptom Media. (Producer). (2016). Training title 43 [Video].
Symptom Media. (Producer). (2018). Training title 118 [Video].
Symptom Media. (Producer). (2018). Training title 144 [Video].
Symptom Media. (Producer). (2018). Training title 150 [Video].
https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/training-title-150 Document: Case History Reports
Assignment: Assessing And Diagnosing Patients With Mood Disorders
Accurately diagnosing depressive disorders can be challenging given their periodic and, at times, cyclic nature. Some of these disorders occur in response to stressors and, depending on the cultural history of the client, may affect their decision to seek treatment. Bipolar disorders can also be difficult to properly diagnose. While clients with a bipolar or related disorder will likely have to contend with the disorder indefinitely, many find that the use of medication and evidence-based treatments have favorable outcomes.
To Prepare:
■ Review this week’s Learning Resources. Consider the insights they provide about assessing and diagnosing mood disorders.
■ Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation 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 evaluation 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 Evaluation, 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 symptomatology 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 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.).
Week 5: Disruptive, Impulse-Control, And Conduct Disorders; Dissociative And Somatic Symptom-Related Disorders
Consider the following two scenarios:
Tim is a 6-year-old boy brought to the family medicine clinic for an initial visit. On entering the examination room, the physician observed Tim spinning in circles on the stool while his mother pleaded, “If I have to tell you one more time to sit down….” Tim was not permitted to begin first grade until his immunizations were updated. His mother explained that Tim had visited several physicians for immunization but was so disruptive that the physicians and nurses always gave up. She hoped that with a new physician, Tim might comply. The mother described a
several-year history of aggressive and destructive behavior as well as four school suspensions during kindergarten. He often becomes “uncontrollable” at home and has broken dishes and furniture. Last year, Tim was playing with the gas stove and started a small fire.
Tim frequently pulls the family dog around by its tail. Tim’s older sisters watched him in the past but have refused to do so since he threw a can of soup at one of them. Tim’s father is a long-haul truck driver who sees Tim every 3 to 4 weeks (Searight et al., 2001).
Wallace is a recently retired 55-year-old man and is the primary caregiver for his wife, who is currently undergoing chemotherapy for breast cancer. As his wife became weaker from the treatment, Wallace became increasingly anxious about his own ability to care for his wife and
his sense of agency in the situation. After a serious infection led his wife to be hospitalized, Wallace’s symptoms grew worse. He stopped eating and lost 25 pounds during a matter of weeks. On a trip to the grocery store to purchase food for the household, Wallace had to stop and ask directions to get back to the house at which he had lived for 15 years. This further exacerbated his depression and anxiety and he grew fearful of leaving the home, often sitting in one chair for hours without moving.
This week, you explore three disparate groupings of disorders. With the first—disruptive, impulse-control and conduct disorders—patients experience issues with self-control of emotions or behavior that involve aggression, destruction/violating others’ rights, defiance, or violating societal norms.
Secondly, dissociative disorders involve a disconnection from elements in a person’s life, such as sense of identity, memories, environment, or perception of time. Lastly, somatic symptom-related disorders deal with excessive thoughts, feelings, or behaviors related to physical symptoms (e.g., pain, gastrointestinal issues) that cannot be fully explained by diagnosed medical conditions.
Conduct Disorder: Diagnosis and Treatment in Primary Care by Searight, H. R., Rottnek, F., Abby, S. L., in American Family Physician, Vol. 63/ Issue 8. Copyright 2001 by American Academy of Family Physicians. Reprinted by permission of American Academy of Family Physicians via the Copyright Clearance Center.
Learning Resources
Required Readings (click to expand/reduce)
American Psychiatric Association. (2013). Disruptive, impulse-control, and conduct disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm15
American Psychiatric Association. (2013). Dissociative disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm08
American Psychiatric Association. (2013). Somatic symptoms and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm09
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
■ Chapter 12, Dissociative Disorders
■ Chapter 13, Psychosomatic Medicine
■ Chapter 19, Disruptive, Impulse-Control, and Conduct Disorders
■ Chapter 31, Child Psychiatry (Sections 31.13 and 31.14 only) Required Media (click to expand/reduce)
Classroom Productions. (Producer). (2015). Dissociative disorders [Video]. Walden University.
Classroom Productions. (Producer). (2016). Impulse and conduct disorders [Video]. Walden University.
Classroom Productions. (Producer). (2016). Somatic symptoms and related disorders [Video]. Walden University.
MedEasy. (2017). Somatic symptoms and factitious disorders | USMLE & COMLEX [Video]. YouTube. https://www.youtube.com/watch?v=n-NN8fHB_a4
Assessing And Diagnosing Patients With Disruptive, Impulse-Control, Conduct, Dissociative, And Somatic Symptom-Related Disorders
Assessing patients with symptoms related to the disorders you are exploring this week pose some particular challenges for which the PMHNP should be prepared. Disruptive,
impulse-control, and conduct disorders may involve aggressive outbursts, anger, deceitfulness, and unpredictability. Eliciting the needed interview and history data requires special care,
self-control, and deliberateness on the part of the clinician. Several structured or
semi-structured clinical interview tools exist for patients and, in the case of minors, for parents as well.
There is no Assignment due this week. Use this quiet week to work on your practicum Comprehensive Psychiatric Evaluation and Case Presentation if you are taking the two courses concurrently.
Week 6: Eating, Sleeping, And Elimination Disorders
The process of assessment and diagnosis is complex. At the initial meeting, clients may want to vent about multiple areas in their lives, and they may not necessarily understand the assessment process or what kind of information the advanced practice nurse needs to elicit to diagnose.
PMHNPs must strike a balance between keeping the assessment focused and structuring it in such a way that clients are encouraged to paint a complete picture of their chief complaint and history of present illness. If a client says that he or she is having a hard time dealing with family, difficulty in relationships, not eating regularly, or not sleeping, counselors must know how to listen and ask questions that can pull more information needed for an accurate diagnosis.You are now at the halfway point of the course and have explored the assessment and diagnosis of many categories of disorder from the DSM-5. This week, you put your knowledge of concepts related to psychopathology and diagnostic reasoning to the test by completing a midterm exam. Your Learning Resources this week focus on eating, sleeping, and elimination disorders. Although you will not complete a comprehensive client assessment on a patient with these disorders, be sure to review the resources on them because they are included in the midterm.
Learning Objective Students will:
■ Apply concepts related to psychopathology and diagnostic reasoning in advanced practice nursing care in psychiatric and mental health settings
Learning Resources
Required Readings (click to expand/reduce)
American Psychiatric Association. (2013h). Feeding and eating disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm10
American Psychiatric Association. (2013). Elimination disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).
American Psychiatric Association. (2013). Sleep-wake disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
■ Chapter 15 Feeding and Eating Disorders
■ Chapter 16 Normal Sleep and Sleep-Wake Disorders
■ Chapter 31.9 Feeding and Eating Disorders of Infancy or Early Childhood
■ Chapter 31.10 Elimination Disorders Required Media (click to expand/reduce)
Classroom Productions. (Producer). (2016). Eating disorders [Video]. Walden University.
Classroom Productions. (Producer). (2013). The new DSM-5 diagnosis: Understanding & treating binge eating disorder [Video]. Walden University.
Classroom Productions. (Producer). (2016). Elimination disorders [Video]. Walden University. Classroom Productions. (Producer). (2016). Sleep disorders [Video]. Walden University.
MedEasy. (2017b). Eating disorders (anorexia, bulimia, and binge-eating disorder) | USMLE & COMLEX [Video]. YouTube. https://www.youtube.com/watch?v=bD8KCcipGaY
Midterm Exam
This exam will cover the following topics relevant to assessment and diagnosis across the lifespan:
■ History and theories of psychopathology
■ The psychiatric interview, history, and examination
■ Rating scales
■ Mood disorders
■ Anxiety disorders, PTSD, OCD
■ Disruptive, impulse-control, and conduct disorders
■ Eating, sleeping, and elimination disorders
Prior to starting the exam, you should review all of your materials. There is a 2.5-hour time limit to complete this 100-question exam. You may only attempt this exam once.
This exam is a test of your knowledge in preparation for your certification exam. No outside resources—including books, notes, websites, or any other type of resource—are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.
