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Psychological Testing Instrument

Psychological Testing Instrument Order Description The case study to answer by is attached as a file here Complete the appropriate Level 1 cross cutting measure from the DSM-5. The Cross-Cutting Measures can be found on the “Online Assessment Measures” page of the American Psychiatric Association website. Once the Level 1 Cross-Cutting Measure is completed, complete the relevant Level 2 Cross-Cutting measure. Write a 500- to 750-word paper discussing the results of the Cross-Cutting Measures. Include the following in your paper: 1.The purpose of each cross-cutting measure 2.How these measures are administered in practice 3.The results of each measure for the chosen case study 4.The implications of the results for treatment of the person in the case study Include at least two scholarly references in your paper. Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Case 5.10 The Golden Girls’ Sophia Petrillo Introducing the Character Sophia Petrillo is the eldest character of the four-woman ensemble cast of NBC’s The Golden Girls, which aired between 1985 and 1992. Sophia was played by the late actress Estelle Getty. The show was set in Miami Beach, Florida, at the home of Blanche Devereaux, a close friend of Mrs. Petrillo’s older daughter, Dorothy, played by the late comic actress Bea Arthur. At the beginning of the series, we meet Sophia, who was forced out of the Shady Pines Retirement Home following a mysterious fire. Later we learn that the fire was caused inadvertently by Sophia and her Shady Pines roommate, who were secretly making s’mores—the hot dessert snack that combines graham crackers, marshmallows, and melted chocolate—on a hotplate. Throughout the series, Sophia was the typically unflappable and perennially caustic “house mother” whose stroke earlier in life “rendered her permanently annoying” according to her daughter, Dorothy. During each episode, Sophia is full of bristling commentary on the plight of women, the importance of traditional family values, and other assorted topics, including love, sex, relationships, and religion. The following basic case summary and diagnostic impressions present our view of Sophia as she begins to experience multiple cognitive deficits later in her life. Basic Case Summary Identifying Information. Sophia Petrillo is an 85-year-old, widowed Italian American woman who lives with her 63-year-old daughter and two other women, a household group she refers to as the “Golden Girls.” Medical reports indicate that Mrs. Petrillo is in good health and of good strength for her age, with no indications of diseases of the central nervous system or other systems; however, she did experience and apparently recover from a stroke several years ago. She presents as a woman of diminutive stature and frail appearance; however, her caustic wit contributes to the impression that she is much larger in stature. Presenting Concern. Mrs. Petrillo was accompanied to the Greater Miami Counseling Center by her daughter, Dorothy, who was concerned that “Mom has finally lost it.” Although Mrs. Petrillo is reportedly capable of taking care of her daily needs, her daughter has noticed that of late, “Mom has been particularly sarcastic, says she can’t remember who I am, and walks around the house at night calling out the name of my father.” She appears to have forgotten her housemates’ names at times. On several occasions, Dorothy found her mother on her knees in the garden planting tomato seeds, which would not otherwise be disturbing; however, it was wintertime, and Mrs. Petrillo was dressed only in her nightgown. Her daughter also reported that Mrs. Petrillo no longer seems able to plan meals, follow a recipe, or organize her weekly FOR THE USE OF GRAND CANYON UNIVERSITY STUDENTS AND FACULTY ONLY. NOT FOR DISTRIBUTION, SALE, OR REPRINTING. ANY AND ALL UNAUTHORIZED USE IS STRICTLY PROHIBITED. Copyright © 2015 by SAGE Publications, Inc. Case 5.10 The Golden Girls’ Sophia Petrillo ? 275 shopping and other outings. Dorothy reported that Mrs. Petrillo’s symptoms had become gradually more noticeable to her and her housemates over “a long while.” Background, Family Information, and Relevant History. Sophia Petrillo was born in Sicily, Italy, the middle of five children to Don and Eleanor. Mrs. Petrillo reportedly was successful in school and enjoyed her studies. She was planning to become a nurse (one of the few vocations open to women in her context) when, instead, at her parents’ insistence, she changed plans and prepared to marry her parents’ selection of a potential husband. However, deciding at the last minute that “I wasn’t going to live somebody else’s life,” Mrs. Petrillo left her fiancé at the altar and came to New York. Within several months she met and married Salvatore Petrillo, who worked by day in a grocery store, but who also is suspected of having some minor involvements with local organized crime. Over the next several years, Mrs. Petrillo and Salvatore had three children: Dorothy, who along with her husband had one child; Gloria, who briefly married into wealth; and Phil, a devoted husband and father, who, unbeknownst to the family, was cross-dressing. Mrs. Petrillo worked tirelessly to raise her children, particularly after her husband was killed in gang violence. She worked in a number of vocations during her 30s, 40s, and 50s, including at Bloomingdale’s in the perfume department, in a neighborhood wine store, as a front desk manager at a Holiday Inn on Staten Island, New York, as well as a substitute teacher in the same school where Dorothy was working. Over the years, Mrs. Petrillo had endeared herself to friends and coworkers with her sharp wit, ever-ready smile, and willingness to lend a hand to others in need. All were shocked when shortly after her 65th birthday, Mrs. Petrillo began to experience disturbing and erratic behaviors and the seeming inability to restrain herself from making hurtful and sarcastic comments about other people. These changes were followed soon after by a stroke that left her partially paralyzed on the left side of her body. Her speech, much to the chagrin of her daughter, was left intact. Soon after the stroke, Mrs. Petrillo was moved to the Shady Pines Nursing Home by her daughter, who was surprised when her mother, after only 6 months in the facility, married fellow resident Max Winestock. When the facility burned to the ground, Mrs. Petrillo was invited to live with Dorothy, who was not able to accommodate Mr. Winestock. He was subsequently transferred to another facility, and over the years, he and Mrs. Petrillo maintained a very cordial (and occasionally sexual) relationship. As of this writing, Mrs. Petrillo had been comfortably living with her daughter and two other housemates for 2 years and was appreciative of the opportunity to, in her words, “Be with the people I love . . . even though they are a pain in my royal ass if you know what I mean.” Problem and Counseling History. Mrs. Petrillo was accompanied to the intake by her daughter, Dorothy, who had her arm wrapped gently around her mother’s shoulder and who escorted her to one of the interviewing chairs. As she sat down, Mrs. Petrillo pushed her daughter’s hand away and brusquely said, “I can sit down myself; FOR THE USE OF GRAND CANYON UNIVERSITY STUDENTS AND FACULTY ONLY. NOT FOR DISTRIBUTION, SALE, OR REPRINTING. ANY AND ALL UNAUTHORIZED USE IS STRICTLY PROHIBITED. Copyright © 2015 by SAGE Publications, Inc. 276 ? DIAGNOSIS AND TREATMENT PLANNING SKILLS stop treating me like an old woman.” Each time that Dorothy attempted to relate details of her mother’s most recent experiences, Mrs. Petrillo interrupted her and announced, “Oh, now you’re going to talk for me also.” Mrs. Petrillo was a very animated, articulate, and astutely oriented octogenarian who freely and easily offered information and details about her life, both recent and remote. Placid at times while irritable at others, she proudly proclaimed, “I’ve lived this long without any help from anyone, and I just need them to know that I’m fine.” Mrs. Petrillo denied experiencing the personality and behavioral changes that her daughter noticed, in which regard she said, “I get a little more tired than usual, but I’d like to see if they have half the spirit that I do when they get to be my age . . . with or without a stroke.” Goals for Counseling and Course of Therapy to Date. At the end of the intake session, Mrs. Petrillo was invited to participate in the “Golden Girls Senior Activity Program,” which includes social and craft activities, cooking classes, as well as individual and group counseling. Upon hearing this Mrs. Petrillo proclaimed, “Oh, so now you think I’m nuts and want to lock me in this crazy joint … no way José.” She got up from her chair, turned her back, and walked abruptly out of the room. Her daughter agreed to encourage Mrs. Petrillo to return for further assessment and also agreed to participate in an in-home evaluation conducted by a licensed clinical social worker. The primary goals of the follow-up interview and in-home evaluation will be (a) to confirm clinically significant decline in the form of memory loss and other cognitive deficits; and (b) assist the client and her daughter in determining an appropriate plan of action. Diagnostic Impressions 331.83 (G31.84) Mild Neurocognitive Disorder Due to Possible Alzheimer’s Disease, With Mild Behavioral Disturbance (Agitation); 436 (I63.9) History of Stroke (CVA). Other factors: Widowed; V61.03 (Z63.5) Disruption of family by separation or divorce, separated from her current husband. Discussion of Diagnostic Impressions Sophia Petrillo was accompanied to the Greater Miami Counseling Center by her daughter because she was concerned that Sophia was experiencing memory impairment (forgetting her daughter’s and her housemates’ names) and disturbances in her everyday activities (gardening in a nightgown late on a winter night; failing to follow the steps of a familiar recipe in the kitchen). Her daughter thought Mrs. Petrillo’s memory loss and other behavioral changes had developed gradually over time. The DSM-5 section Neurocognitive Disorders contains a variety of mental disorders featuring significant deficits in cognitive abilities that signify a clear change from a person’s previous level of cognitive functioning. Included are delirium (disturbance in consciousness) due to substance use, a medical problem, or multiple sources; and FOR THE USE OF GRAND CANYON UNIVERSITY STUDENTS AND FACULTY ONLY. NOT FOR DISTRIBUTION, SALE, OR REPRINTING. ANY AND ALL UNAUTHORIZED USE IS STRICTLY PROHIBITED. Copyright © 2015 by SAGE Publications, Inc. Case 5.10 The Golden Girls’ Sophia Petrillo ? 277 major and mild neurocognitive disorders (impairment in memory plus multiple other cognitive deficits) due to various medical etiologies or sources (e.g. Alzheimer’s Disease, Traumatic Brain Injury, HIV infection, Parkinson’s Disease, Huntington’s Disease, etc.). One of these disorders that is especially important to the everyday practice of counseling professionals who work with older adults in various inpatient and outpatient settings is Neurocognitive Disorder Due to Alzheimer’s Disease. In this case example, Mrs. Petrillo presented multiple cognitive deficits later in her life, manifested by memory impairment in the form of an inability to recall previously learned information, and other deficits in the form of disturbance in executive functioning (such as planning, organizing, and following sequences). The onset of Mrs. Petrillo’s cognitive decline was gradual, continuing, and causing impairment in social and other functioning. Although she does have a history of stroke, the current symptoms of cognitive decline were not attributable to the stroke or to any other medical condition or substance use. In such cases the diagnosis is Mild Neurocognitive Disorder Due to Possible Alzheimer’s Disease. Mrs. Petrillo’s cognitive symptoms were accompanied by behavioral disturbances that were clinically significant, such as gardening on a winter night, and increased agitation. Therefore, the specifier is With Behavioral Disturbance and the subtype is Mild. Distinguishing among physical, cognitive, affective, and behavioral factors influencing changes in older adult clients’ functioning requires the counselor’s special attention (Schlossberg, 1995). In the case of Neurocognitive Disorder Due to Alzheimer’s Disease, perhaps the most important consideration regarding differential diagnoses pertains to etiology: Neurocognitive Disorders due to a general medical condition, due to substance use, and due to multiple known etiologies might be considered. However, in Mrs. Petrillo’s case, there is no evidence from lab tests or physical examinations to suggest any of these causes. Generally speaking, Schizophrenia also might be a differential consideration when considering symptoms of a Neurocognitive Disorder; however, in Mrs. Petrillo’s case, there is no lifelong history at all of Schizophrenia. Alternatively, Major Depressive Disorder may feature impairment in memory, concentration, and thinking—and clinicians are alerted that depressive disorders may be difficult to differentiate from cognitive impairment in older adults (Chapman & Perry, 2008). However, in Mrs. Petrillo’s case, no other symptoms of a mood disorder were observed or reported, and the nature of, and gradual onset of, symptoms conform to the criteria for Mild Neurocognitive Disorder Due to Possible Alzheimer’s Disease. To finish the diagnosis, Mrs. Petrillo’s history of stroke is listed alongside her primary mental health diagnosis, and her important family and social stressors are emphasized in the “Other factors” section. This supplemental information is consistent with the primary diagnosis describing Mrs. Petrillo’s onset of concerns. Case Conceptualization During Mrs. Petrillo’s first visit to the Greater Miami Counseling Center, the intake coordinator obtained present-day and background information about the behaviors FOR THE USE OF GRAND CANYON UNIVERSITY STUDENTS AND FACULTY ONLY. NOT FOR DISTRIBUTION, SALE, OR REPRINTING. ANY AND ALL UNAUTHORIZED USE IS STRICTLY PROHIBITED. Copyright © 2015 by SAGE Publications, Inc. 278 ? DIAGNOSIS AND TREATMENT PLANNING SKILLS and consequences leading Mrs. Petrillo’s daughter, at this point, to seek professional consultation. Based on the intake visit, neuropsychological testing, and medical record information, the coordinator developed diagnostic impressions of Mild Neurocognitive Disorder Due to Possible Alzheimer’s Disease, With Mild Behavioral]]>

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