Compare and contrast the two diagnoses and then select one that you consider the most appropriate DSM diagnosis. Explain why one is more likely than the other.
Emotional Disorder—Male Vignette
Nadif is a seven-year-old Somali-American boy who is homeschooled by his mother. When Nadif was four years old, his family immigrated to the United States from war-torn Somalia after living in a refugee camp. His family has been concerned about him from the time they lived at the camp. He used to have an average appetite and slept relatively well. Now, he wakes in the night, often with nightmares in which he becomes lost or separated from his family. Nadif’s appetite has also been affected. He often reports stomachaches and lack of appetite. His parents describe him as “nervous” most of the time, particularly when his mother is not home. Nadif is too afraid to attend school away from his parents, so his mother has chosen to homeschool him until he feels more secure when away from his family.
Nadif seems to feel relatively comfortable out in public, as long as his family accompanies him on outings. His parents are somewhat puzzled by his anxiety, as he has never been lost. Although they all experienced hardships in Somalia, none of them was a direct victim of any intensely traumatic event. Nadif claims he does not remember much of his time in Somalia. His family hopes therapy will help Nadif feel calmer when they are not present, so that he can attend school, develop friendships, and become increasingly more independent.
Emotional Disorder—Female Vignette
Jada is a sixteen-year-old African American girl enrolled as a junior at the local public high school. She has won numerous honors throughout her educational career for her academic performance; but her greatest joy comes from playing the piano and singing in her church choir. Jada’s vocal instructor raves about her singing voice and about her potential for a career in music.
Jada hopes to attend a prestigious music school in New York City upon graduating from high school, but worries about the cost and how much she will miss her family. The pressure of an upcoming audition at school has caused Jada a great deal of stress. She fears she will not be accepted or will not be able to attend for financial reasons. The stress has begun to affect her daily functioning. She is having difficulty sleeping, has lost weight due to decreased appetite, and is beginning to feel hopeless about her future. Jada’s friends describe her as being “irrational” about the situation and “catastrophizing.” Despite their best efforts, they cannot convince her that she has a strong chance. At her weakest moments, Jada has even spoken passively of wishing she would die, so she would not have to face the stress anymore.
During the past two weeks, Jada has been sad and tearful on most days and has lost interest in her favorite activities. Last weekend, she was caught drinking alcohol with some friends. She admitted to her parents that she has had alcohol on three separate occasions because it helps her “stop feeling stressed.”
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