Case Study: April - Anorexia Nervosa
Case Study: April - Anorexia Nervosa
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Pennsylvania State University
Case Study: April - Anorexia Nervosa
Presenting Concerns April was a 17-year-old high school freshman who presented with severe emaciation due to self-starvation and excessive exercise. Despite being severely underweight, April indicated an intense fear of gaining weight. She bragged about how much weight she had recently lost, though she indicated that her "butt was still too fat." She also reported that she was constantly fatigued, had become socially withdrawn and depressed, and that her menstrual period had become highly irregular. The clinician noted a provisional diagnosis of 307.1 Anorexia Nervosa (American Psychiatric Association [DSM-IV-TR], 2000), as she was fairly certain that April would meet the full diagnostic criteria for the disorder but currently lacked adequate information to support a firm diagnosis.
Diagnosis and Differential Diagnosis Initially, April was subjected to both a physical and a neurological examination in order to rule out a primary medical condition as the reason for her weight loss and other reported symptoms. During the medical exam, April elaborated that she had not had her menstrual period for six months, thus indicating amenorrhea. She also informed the doctor that she had been having abdominal pains, was often very cold, and had developed a light, fluffy hair on her torso, which the doctor informed her was called lanugo. Most notably, April’s body weight was only 65% of what it should have been for a young woman of her age, height and build. It was determined that these issues were unrelated to a general medical condition and thus, the Axis III diagnosis was listed as “None.” Based upon April’s symptoms and the absence of a general medical condition to explain her symptoms, it was believed that she had an Axis I clinical disorder. She refused to maintain a minimally normal body weight, indicated an intense fear of gaining weight, and despite
XXXX
Pennsylvania State University
Case Study: April - Anorexia Nervosa
Presenting Concerns April was a 17-year-old high school freshman who presented with severe emaciation due to self-starvation and excessive exercise. Despite being severely underweight, April indicated an intense fear of gaining weight. She bragged about how much weight she had recently lost, though she indicated that her "butt was still too fat." She also reported that she was constantly fatigued, had become socially withdrawn and depressed, and that her menstrual period had become highly irregular. The clinician noted a provisional diagnosis of 307.1 Anorexia Nervosa (American Psychiatric Association [DSM-IV-TR], 2000), as she was fairly certain that April would meet the full diagnostic criteria for the disorder but currently lacked adequate information to support a firm diagnosis.
Diagnosis and Differential Diagnosis Initially, April was subjected to both a physical and a neurological examination in order to rule out a primary medical condition as the reason for her weight loss and other reported symptoms. During the medical exam, April elaborated that she had not had her menstrual period for six months, thus indicating amenorrhea. She also informed the doctor that she had been having abdominal pains, was often very cold, and had developed a light, fluffy hair on her torso, which the doctor informed her was called lanugo. Most notably, April’s body weight was only 65% of what it should have been for a young woman of her age, height and build. It was determined that these issues were unrelated to a general medical condition and thus, the Axis III diagnosis was listed as “None.” Based upon April’s symptoms and the absence of a general medical condition to explain her symptoms, it was believed that she had an Axis I clinical disorder. She refused to maintain a minimally normal body weight, indicated an intense fear of gaining weight, and despite
References: American Psychological Association HealthCenter. (1998). Eating disorders: psychotherapy’s role in effective treatment. Retrieved from http://www.myedhelp.com/pdf/APATreatmentGuidelines.pdf Arnett, J.J Bruch, H. (1979). Golden Cage: The Enigma of Anorexia Nervosa. New York, NY: Vintage Books. Murphy, M.J., Cowan, R., & Sederer, L. (2003). Blueprints in Psychiatry (3rd Ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Oltmanns, T.F., Martin, M.T., Neale, J.M., & Davison, G.C. (2009). Case Studies in Abnormal Psychology (8th ed). Hoboken, NJ: John Wiley & Sons, Inc.