Review the case study:

CASE of FARAJI INTAKE DATE: May xxxx IDENTIFYING/DEMOGRAPHIC DATA: This is a voluntary admission for this 14 year old African-American male. This is Faraji's first intake. Faraji is in the 8th grade. He lives at home with his parents, two sisters and a brother. CHIEF COMPLAINT/PRESENTING PROBLEM: Faraji was brought in by his parents because of their concern about his most recent behavior. Faraji began hanging around with a new crowd over this past year and has become argumentative and has stolen items from his parents' house. Faraji had his head bending down and sitting carelessly in the initial interview. HISTORY OF PRESENT ILLNESS: Faragi recently moved to a new area and began a new friend group that appears to be "rougher" than groups he would be with in the past. His parents have become very concerned and decided to bring him in for an evaluation. PAST PSYCHIATRIC HISTORY: Faraji lacks focus while studying, class work is often incomplete. Teachers complained that he disturbed other children in class. He would not tell his parents about what happened in school, he would hide his exam answer sheets. Initially they attributed the change in him to the new environment and thought he would overcome it. But instead, as the year progressed, he became more aggressive. If he was scolded him he would shout back, show anger by banging on doors and crying loudly. SUBSTANCE USE HISTORY: After several drug screen tests, which were all negative, there is no indication of drug use. PAST MEDICAL HISTORY: Faraji had mild measles episode when he was about ten months old and chickenpox when he was three years. His parents said that from childhood he was very obstinate, he would keep food in his mouth for hours; nobody could force him to complete eating it. When his mother was gone for sometime he would wail loudly until she come back in spite of other relatives trying to console him. In

school his grades were good until this past year when due to his father's job they shifted to another city when they noticed changes in his behavior. FAMILY MEDICAL AND PSYCHIATRIC HISTORY: Faraji is the oldest child who was born after ten months of marriage. Mother and father did not have any major health conditions. All parameters were within normal range. As per his parents his milestones were all normal and he had a healthy childhood except for mild colds occasionally. CURRENT FAMILY ISSUES AND DYNAMICS: Faraji has poor sportsman. If he lost in any game he would throw tantrums and use abusive words. He displayed emotions like jealousy and possessiveness. When enquired about his behavior at school, the father revealed that in school, he would often complain that other children are troubling him and would indulge in frequent fights with them. He hides his report cards, would not inform parents of school activities, and would take other children's belongings without asking. He does not seem to fear anything, in fact he would tease and trouble stray dogs. A few times his parents noticed that there would be items which did not belong to him but when asked he would say someone has given it to him. He has a habit of lying smoothly so it became difficult to know if he was saying the truth or not. MENTAL STATUS EXAM: Faraji was casually dressed who appears his stated. Posture is relaxed. Facial expressions are appropriate to thought content. Motor activity is appropriate. Speech is clear and there are no speech impediments noted. Thoughts are logical and organized. There is no evidence of delusions or hallucinations. Faragi denies suicidal or homicidal ideation. On formal mental status examination, Faraji is found to be oriented to three spheres. Fund of knowledge is appropriate to educational level. Recent and remote memory appear intact.

Review the following questions-

The diagnosis should appear on one line in the following order.

Code + Name + Specifier (appears on its own first line) Z code (appears on its own line next with its name written next to the code)

Explain how you support the diagnosis by specifically identifying the criteria from the case study.

Describe in detail how the client's symptoms match up with the specific diagnostic criteria for all the disorder that you finally selected for the client.

Identify the differential diagnosis you considered.

Explain why you excluded this diagnosis/diagnoses.

Explain the specific factors of culture that are or may be relevant to the case and the diagnosis, which may include the cultural concepts of distress.

Explain why you chose the Z codes you have for this client. Remember: When using Z codes, stay focused on the psychosocial and environmental impact on the client within the last 12 months.