An important consideration when working with patients is their cultural background. Understanding an individual’s culture and personal experiences provides insight into who the person is and where he or she may progress in the future. Culture helps to establish a sense of identity, as well as to set values, behaviors, and purpose for individuals within a society. Culture may also contribute to a divide between specific interpretations of cultural behavior and societal norms. What one culture may deem as appropriate another culture may find inappropriate. As a result, it is important for advanced practice nurses to remain aware of cultural considerations and interpretations of behavior for diagnosis, especially with reference to substance-related disorders. At the same time, PMHNPs must balance their professional and legal responsibilities for assessment and diagnosis with such cultural considerations and interpretations.
For this Assignment, you will practice assessing and diagnosing a patient in a case study who is experiencing a substance-related or addictive disorder. With this and all cases, remember to consider the patient’s cultural background.
Resources
Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Review this week’s Learning Resources and consider the insights they provide.
Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.
By Day 7 of Week 8
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
submission information
This PMHNP assignment asks you to assess and diagnose a substance-related or addictive disorder from a case, with attention to cultural considerations and professional/legal responsibilities. Reason from DSM-5-TR criteria while weighing culture and ethics.
Key takeaways
- Apply DSM-5-TR criteria for substance use disorders (the 11 criteria; severity by count).
- Weigh cultural considerations in interpreting behavior and diagnosis.
- Balance professional, ethical, and legal responsibilities.
- Build the assessment and differential from case evidence.
- Cite the DSM-5-TR and scholarly sources in APA.
Apply the DSM-5-TR criteria
Assess the case against the 11 substance use disorder criteria grouped as impaired control, social impairment, risky use, and pharmacological (tolerance, withdrawal). Severity is rated mild (2–3), moderate (4–5), or severe (6+). Map the case’s evidence onto specific criteria.
Cultural considerations
Discuss how culture shapes what’s considered normative vs. problematic use, help-seeking, and stigma — and why the PMHNP must avoid cultural bias in diagnosis. What one culture views as acceptable another may not.
Professional and legal responsibilities
Address the balance: accurate diagnosis, confidentiality and its limits, mandatory reporting, patient safety, and nonjudgmental care.
Build the assessment
Present the MSE findings, the diagnosis with justification, a differential, and a plan. Cite the DSM-5-TR and scholarly sources. Our psychiatric assessment guide covers the diagnostic method.
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