NRNP-6645 Mother and Daughter a Cultural Tale Video Family Assessment Assignment NRNP/PRAC 6645 Comprehensive Psychiatric

NRNP-6645 Mother and Daughter a Cultural Tale Video Family Assessment Assignment NRNP/PRAC 6645 Comprehensive Psychiatric

Chief Complaint (CC):
Mother presents with dependency on her adult children, symptoms of depression, a history of abuse from her marriage, and pain issues from past surgeries. The daughter seeks independence from her mother and believes that her mother needs to adapt and allow her children to live their lives.

History of Present Illness (HPI):
A 40-year-old Iranian mother and her 23-year-old daughter are seeking therapy consultation due to conflicts in their mother-daughter relationship. The mother desires her adult children’s presence to alleviate loneliness and depression when alone. Conversely, the daughter, along with her own children, feels overwhelmed by the mother’s constant presence and wishes to gain independence. The daughter sees this stage of life as an opportunity for personal growth, while the mother’s behavior is heavily influenced by her Iranian culture.

Past Psychiatric History:
The mother acknowledges experiencing depression but does not specify if it was diagnosed by a psychiatrist.

General Statement:
The mother expresses feelings of loneliness and depression, seeking more time with her adult children. In contrast, her adult children are seeking independence from her.

– Caregivers (if applicable): None; both adults live independently.
– Hospitalizations: The mother had past surgeries, but there are no known past psychiatric hospitalizations.
– Medication Trials: None.
– Psychotherapy or Previous Psychiatric Diagnosis: None mentioned.

Substance Current Use and History:
There is no reported substance use or history of it for both the mother and daughter.

Family Psychiatric/Substance Use History:
There is no reported substance use or history of it in the family.

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Psychosocial History:
The patients consist of a 40-year-old Iranian female with no educational history and her 23-year-old daughter. The mother was married at the age of 16 to a husband chosen for her by her family. She endured verbal and physical abuse from her husband. They have five children together, with the two youngest currently residing at home. The mother mentions depression, but it is unclear if she was officially diagnosed. Her abusive husband continues to exert control over her despite not living together.

Medical History:

– Current Medications: No medication reported during therapy.
– Allergies: No known allergies reported.
– Reproductive History: The mother has five children: three daughters aged 24, 23, and 21, and two sons aged 18 and 15.

Review of Systems (ROS):
No system assessment was conducted in the video.

– GENERAL: The mother appears overweight and older than her stated age. The daughter appears to be in good health, with no personal health information provided.
– HEENT: N/A
– SKIN: N/A
– CARDIOVASCULAR: N/A
– RESPIRATORY: N/A
– GASTROINTESTINAL: N/A
– GENITOURINARY: N/A
– NEUROLOGICAL: N/A
– MUSCULOSKELETAL: N/A
– HEMATOLOGIC: N/A
– LYMPHATICS: N/A
– ENDOCRINOLOGIC: N/A

Physical Exam:
No physical examination was performed in the video.

Diagnostic Results:
No laboratory results were discussed during the session.

Mental Status Examination:
Both the mother and daughter were alert and oriented to self, place, and time. The mother appeared overweight and older than her stated age. The daughter appeared to be in good physical health. Both appeared stressed about their current mother-daughter relationship.

Differential Diagnoses:

Three potential differential diagnoses for this patient case are:

1. Post-Traumatic Stress Disorder (PTSD):
– The patient experienced physical and verbal abuse in her marriage, potentially leading to PTSD. DSM-5 criteria include physical symptoms like fatigue or sleep disturbances and stress reactions such as irritability, all of which are present in this case.

2. Persistent Depressive Disorder (PDD):
– PDD, a milder form of depression, may be a diagnosis for the patient due to her depressive symptoms, hopelessness, and low self-esteem, which align with PDD criteria.

3. Dissociative Disorders:
– The patient’s past traumas affecting her family relationships could suggest a diagnosis of dissociative disorders, which share similarities with PTSD and involve symptoms related to past traumas.

Case Formulation and Treatment Plan:
The most suitable treatment plan for this patient should address her potential PTSD. It should include individual therapy, group therapy involving her children, and consideration of antianxiety and antidepressant medications. Approaches such as exposure therapy, anxiety management/relaxation training, cognitive-behavioral therapy (CBT), and supportive psychotherapy may be beneficial.

The daughter should also be evaluated independently, and appropriate resources provided to address her concerns.

Reflections:

This case highlights the complex dynamics within the family, influenced by cultural factors and past traumas. Both the mother and daughter could benefit from mental health evaluation and treatment. Medications and psychotherapy may be necessary to address the potential diagnoses, improving their overall well-being.

References:

Miller, L. (2019). PTSD and other traumatic disability syndromes: Differential diagnosis. SpringerBriefs in Psychology, 25-42.

Ogundele, M. O. (2018). Behavioral and emotional disorders in childhood: A brief overview for pediatricians. World journal of clinical pediatrics, 7(1), 9.

Piotrowski, N. A., PhD, & Range, L. M., PhD. (2020). Post-traumatic stress disorder. Magill’s Medical Guide.

Rumball, F., Happé, F., & Grey, N. (2020). Experience of trauma and PTSD symptoms in autistic adults: risk of PTSD development following DSM‐5 and non‐DSM‐5 traumatic life events. Autism Research, 13(12), 2122-2132.