Review the Case of Annie before beginning this discussion.
****Eighteen year old college student Annie grew up in a family where academic achievement was a central value and focus. Letter grades of A were expected on all assignments, and when Nancy came home with a 96 on a paper, test or quiz, her father would ask “What happened to the other four points?” Nancy is afraid of fat. She is preoccupied with exercise, dieting, and losing weight. She counts calories at every meal and her ideal body image is someone is tall and very thin. At 5’5”, she is tallish only when wearing platform shoes, but thinness remains at the forefront of her mind and a primary goal.
She traces her obsession with food, fat, and body image to her mother teasing her when she gained a little weight in the fifth grade (“be careful or you’ll get a butt as big as Texas”). When her daughter was 10 years old, Nancy’s mother emphasized the importance of being thin and attractive to attract a spouse. When Nancy was in high school, she joined an online group that exchanged information regarding weight loss and there she learned about purging through taking pills and self- induced vomiting. A member of this online group described how she was able to eat as much as she wanted because then she would just throw up everything afterwards. Although she knew it involved risk, Nancy began experimenting with this technique, and it quickly became an ingrained habit for the past 2 years.
Like many people, she is concerned about her appearance and remains concerned about gaining weight. She exercises every day (runs daily, even in the middle of snow and ice storms in the winter) and sometimes fasts for protracted periods. Nancy worries about how these behaviors and preoccupations are affecting her physically, emotionally, and socially. Her parents worry that this obsessiveness with her weight and appearance could impact her academic performance, and her ability to socialize and meet someone to spend the rest of her life with.******
Based on the information in the case study, address the following questions using headings to match content in each bullet point:
How would you incorporate the DSM-5 and the relational codes into the assessment phase with this couple or family? It may be helpful to use Section II of your text, Desk Reference to the Diagnostic Criteria From DSM-5®.
What other diagnostic or assessment processes would you use?
How do larger systems impact the development of eating disorders? These systems might include sociocultural background, family of origin (that is, the family a person grew up in), current relationship dynamics, and the influence of the media.
What additional information would you seek to support a confident diagnosis? What is your rationale and specific criteria for your diagnosis?
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