Diane is a 30-year-old divorced female who presents with complaints of irritability, anxiety, and confusion. She states that she cannot seem to make decisions about her career, family, or even where she should live. She spends many nights excessively worrying about her future to the point that she can't sleep, becomes restless and tense, and has thought blocking. At times she will then make impulsive decisions about her life (i.e. apply for numerous jobs, apply for school, look for apartments, etc. all at the same time). She lives with her mother who she states "she can't get along with me!" She is employed as a secretary for an attorney and feels that she can get a better job.

Diane reports feeling uncomfortable at work because her boss tells her that she needs to lose weight. She is mildly overweight. She is a high school graduate and has attempted college 3 times for different careers (quit each time). She married Ken at age 20 and divorced him at age 22. She dated Rob throughout college, off and on during her marriage to Ken and continues to date him now (13 years total). She had a son by Rob 1 years ago (while living with her mother). Her son was taken into custody by the Department of Child and Family Services 9 months ago due to reports made by her sister that she was physically abusive to her son. She explains that she was angry one day at Rob when he was leaving her house for the evening. Rob ignored her as she was talking to him. When Rob proceeded to drive away, she put her son into the car and proceeded to follow Rob. When they stopped their cars, she "shook" the baby in the car seat while looking at Rob and stated "if you don't come and talk to me now, I will keep doing this to him" (while shaking their son).

Diane has had 8 psychiatric hospitalizations throughout her life. She reports a history of sexual abuse from her grandfather. Her son currently lives with her sister and family. She visits her son 2 times a week, attends 2 parenting classes a week, and is currently prescribed an antidepressant. She has been involved with the legal system for "stalking" Rob 2 years ago. She has a history of alcohol use but she has been abstinent for 5 years. She has always had a strained relationship with her sister. She is extremely jealous of her sister who has a career and family. Her ultimate goal in life is to marry Rob and have their son returned.

Diane has not been hospitalized in the past 18 months. She attends Alcohol Anonymous 2 times a week. She has a history of suicidal ideation but no attempts. She demonstrates extreme levels of anger at times, then quickly becomes tearful and "quiet". She feels uncomfortable when alone. She needs constant reassurance and advice when making decisions. Rob has never asked her to marry him. She continues to contact Ken when she needs money, a tv, her car repaired, etc.

diagnosis for diane?

evidence based treatment recommendations for dianne?