Fear,” according to the DSM-5, “is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2013). All anxiety disorders contain some degree of fear or anxiety symptoms (often in combination with avoidant behaviors), although their causes and severity differ. Trauma-related disorders may also, but not necessarily, contain fear and anxiety symptoms, but their primary distinguishing criterion is exposure to a traumatic event. Trauma can occur at any point in life. It might not surprise you to discover that traumatic events are likely to have a greater effect on children than on adults. Early-life traumatic experiences, such as childhood sexual abuse, may influence the physiology of the developing brain. Later in life, there is a chronic hyperarousal of the stress response, making the individual vulnerable to further stress and stress-related disease. For this Assignment, you practice assessing and diagnosing patients with anx

CC (chief complaint): “Sadness and fear.”

HPI: D.J is a 19-year-old male patient who came in for a psychiatric evaluation to seek answers to some questions. He reports being sad and afraid following the recent announcement that he has been activated with the Navy Reserves. The patient is currently in the U.S Navy reserves and finds it difficult to talk about his sexuality once he is back in service. He is scared of being rejected or treated differently when important people in his life found out that he is gay. He also fears that they might not approve of him. He reports suicidal thoughts due to the fear of rejection. He has been presenting with these symptoms since about two months ago when he realized that he is going to be deployed. Denies a history of suicidal attempts.

Past Psychiatric History:

  • General Statement: No history of any other mental disorder other than the current concerns. Reports suicidal thoughts due to the fear of rejection because of his sexuality.
  • Caregivers (if applicable): The patient is the only child, staying with both his parents.
  • Hospitalizations: Reports no history of hospitalization.
  • Medication trials: Denies use of any medication for the management of his psychiatric symptoms.
  • Psychotherapy or Previous Psychiatric Diagnosis: No history of psychiatric diagnosis or use of psychotherapy.

Substance Current Use and History: The patient denies the use of alcohol, cigarettes, or any other illicit drug of abuse.

Family Psychiatric/Substance Use History: Reports no family member having a history of any mental disorder or substance use.

Psychosocial History: The patient is an only child and lives with both his parents in Columbus, OH. He has a dog by the name of Chance. He currently works part-time on a construction site, as he is currently in U.S Navy Reserve. He sleeps adequately every night and tries to eat healthily. His current mental symptoms started two months ago when he was informed that he is being activated with the army reserves.

Medical History: No history of any other medical problem reported at the moment.

  • Current Medications: Denies use of any drug.
  • Allergies: No known drug, food, or seasonal allergies
  • Reproductive Hx: The patient is homosexual (gay), but currently single. Denies ever engaging in sex before. Reports no history of sexually transmitted infections.

ROS:

  • GENERAL: No fatigue, weight changes, chills, fever, fatigue or general weakness, or night sweats.
  • HEENT: Head: atraumatic. Eyes: No visual changes, blurred vision, use of corrective lenses, or red/itchy eyes. Nose: No congestion, irritations, inflammation, nose bleeding, or sinus problems. Throat & Mouth: No sore throat, bleeding gums, or swallowing difficulties.
  • SKIN: No rashes, hives, ulcers, blisters, or lumps. Warm, with uniform color.
  • CARDIOVASCULAR: No history of cyanosis or hurt murmurs. Denies chest pain or palpitations. Pulmonary: No cough, shortness of breath, wheezing, or sneezing. Denies pleuritic pain.
  • RESPIRATORY: Denies wheezing, shortness of breath, sputum, cough, emphysema, bronchitis, pneumonia, or history of tuberculosis.
  • GASTROINTESTINAL: No Tenderness, diarrhea, vomiting, abdominal pain or discomfort, bloating, jaundice, constipation, or changes in bowel movement.
  • GENITOURINARY: No changes in urine frequency, burning sensation on urination, difficulties in initiating urination, or nocturnal enuresis or dysuria.
  • NEUROLOGICAL: Denies dizziness, loss of consciousness, nausea, vomiting, ataxia, and paresthesia of syncope.
  • MUSCULOSKELETAL: Exhibits full ranges of movement in both upper and lower extremities. No joint stiffness or pain.
  • HEMATOLOGIC: No bleeding problems or prolonged healing of wounds.
  • LYMPHATICS: No signs of enlarged lymph nodes.
  • ENDOCRINOLOGIC: Denies polyuria, polyphagia, or polydipsia. No hypothyroidism.

Objective:

Physical exam: Vitals: T- 97.0 P- 70 R 18 116/68 Ht 5’9 Wt 175lbs

Diagnostic results: Routine blood works were ordered to assess the normal functioning of the patient’s different body systems. Such tests include complete blood cell count, lipid profile, blood sugar test, metabolic panel, CRP analysis, thyroid function test, enzyme marker tests, clotting factor and coagulation profile, DHEA, and screenin

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