Brian is a bright and articulate 19-year-old student who is.
Brian is a bright and articulate 19-year-old student who is… Brian is a bright and articulate 19-year-old student who is currently in his second year of university. He isliving in an apartment with two other young men of a similar age, with whom he is good friends. He wasreferred to the clinic by his parents, who seek to better understand his attention profile and learningchallenges.Brian has spent the last two summers working as a camp counsellor where he describes being well-likedby both his peers and campers. He notes that he has recently been experiencing anger outbursts withhis girlfriend, who he has been seeing for the past year. While they have many common interests, hefinds that he sometimes lashes out at her when feeling frustrated.He is challenged by low motivation and is struggling with perceived academic underachievement. Brianis creative and intelligent, but has been disappointed by his academic performance in the last year. Lastsemester he was placed on academic probation – this was a large motivator for him coming into theclinic. Brian reports a tendency to “shut down” when he becomes overwhelmed by stress. He attributesthis tendency as the reason he performed poorly on his last set of exams, and why he was placed onacademic probation.There is evidence of escalating behavioral challenges since Grade 9. Brian also reports that he struggleswith feelings of internal restlessness, an inconsistent ability to concentrate, and difficulty with timemanagement. He indicates that he has always had a difficult time concentrating in class, and that hismind has a tendency to wander. He states that at times his immediate reaction to anger and frustrationis to become verbally defensive and irritable. He sometimes breaks things if he is really angry or getsinto arguments with his girlfriend.Brian admits to having a daily dependence on marijuana. He states that this smoking helps to “calm” hismind and to decrease the perceived “non-stop” restlessness of his thoughts. While he has been trying tocut back on his marijuana usage, he smokes half a pack of cigarettes per day, and reports some concernthat he has begun replacing marijuana with alcohol use. “Binge” drinking with friends is increasing.His parents are concerned, especially when he had previously been successful academically and sociallyin high school when he was living at home. As you review Brian’s case, what are your differential diagnoses? What is your working diagnosis? Why? (Provide your rationale.) What labs or imaging will you order? What is/are your rationales for any labs/diagnostics you order?View keyboard shortcutsWhat screening or assessment tool(s) will you consider for use with Brian? What is your rationale? What pharmacological therapies will you consider for Brian? What is your rationale? If you don’t plan to prescribe a medication, what is your rationale?What non-pharmacological therapies will you consider for Brian? What is your rationale? Health Science Science Nursing PSYC PSYC 4321
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