Luisa is a 38-year-old office manager referred to counseling by her employer through the company's employee assistance program. Her boss has become increasingly concerned as she has noticed that Luisa seems to be on edge quite often over the last several months.

Approximately nine months ago, Luisa discovered her husband was having an extramarital affair. Upon learning of the relationship, Luisa's husband abruptly left their marriage of six years, filed divorce papers, and moved in with his girlfriend. Since this time, Luisa has begun to experience significant anxiety around simple and routine tasks. She's often consumed with worry about mistakes at work and finds herself tense and fatigued quite often. Luisa has also begun to worry excessively about money and to scrutinize every penny she spends. She consistently seeks reassurances from her co-workers and family, but with little positive effect.

Increasing fear has caused Luisa to isolate over the past three months. She avoids going out even during the daytime. She states that she feels scared and vulnerable even walking her dog around the block. Her fear is that something horrible will happen and no one will come to her rescue. She knows that this is irrational but feels that so much of her anxiety is beyond her control.

Luisa stated that she had been sad for a few weeks after her husband left, but denies thoughts for self-harm, or revenge to her husband. She does not have a history of alcohol or substance abuse. Her sleep has been erratic but her physical health has been relatively normal. Her score on the Beck Anxiety Inventory was 27 indicating a severe level of anxiety.

In the discussion, address the following using headings to match content in each bullet point:

• Review the questions in domain IV of the Level I Cross-Cutting Symptom Measure in the Assessment Measures of the DSM, which you can find in the Week 4: Anxiety Diagnosis and AssessmentLinks to an external site.reading list. Describe how each of the three items would be scored. What additional information is needed to rate these items?
• At the same link, scroll down to locate the WHODAS. Which assessment domains may provide required information to fully assess the extent of Luisa's symptoms?
• Explain the DSM disorder that appears to be most accurate for Luisa and include your rationale.

Support your ideas with references to the course texts, articles from this learning week, articles from the Optional Readings, or articles from peer-reviewed journals that you locate in the Week 4: Anxiety Diagnosis and AssessmentLinks to an external site.. Refer to the Counseling & MFT Masters Research GuideLinks to an external site.. Refer to the COUN5107 Reading List.

Nancy's life centers around food. She traces her obsession back to her childhood where there was a lot of discord in her family. She found that eating calmed her and helped her deal with the stress. When she began gaining weight, her mother teased her saying that no one would like her if she were fat. As a result, her thoughts of eating and her body image tended to dominant her thinking. When she was in high school she read an article about a young woman who engaged in binge eating then caused herself to vomit. Although she knew it was quite risky, she began experimenting with the technique. It quickly became an ingrained habit that she's been using for the last 17 years. Like many people with this disorder, she is concerned about her appearance. Nancy remains concerned about gaining weight. She exercises compulsively each day and sometimes fasts for protracted periods.

Nancy worries about how her eating disorder is affecting her family. In particular, her 12-year-old son has developed poor eating habits and was deemed over weight for his age by his pediatrician. Nancy is concerned that she has passed her eating disorder onto her son.

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,which you can find in theDSM-5-TRLinks to an external site. reading list,and the relational codes into the assessment phase with this couple or family?
• 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.

Support your ideas with references to the course texts, articles from this learning week, articles from the Optional Readings for Principles of Psychopathology list, or articles from peer-reviewed journals that you locate in the Capella University LibraryLinks to an external site.. Refer to the Counseling & MFT Masters Research GuideLinks to an external site. and the COUN5107 Reading List.