Mental Health Case Study: Diagnosis, Stress Vulnerability Model, and Recovery Process

This nursing assignment discusses the diagnosis of mental disorders, stress vulnerability model, and mental health recovery process. It includes a case study analysis of a patient with panic disorder and the role of social support in mental health recovery.

Running head: NURSING ASSIGNMENT
Mental health case study
Name of the Student
Name of the University
Author Note

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Answer 1
Mental disorders or mental illness refer to a set of mental behaviour and patterns,
responsible for causing significant impairment or distress in the personal functioning of a person.
These mental illnesses are generally remitting, relapsing or persistent. However, they might also
occur in the form of a single episode. In order to classify a mental state as a particular disorder,
there needs to be some form of dysfunction in the affected individual (Walker, McGee & Druss,
2015). The Mental Status Examination (MSE) forms an important part of clinical assessment in
psychiatric practice. It is most commonly referred to as a structured way that helps in providing a
description to the psychological functioning of a patient at any given point of time. In other
words, the primary purpose of the Mental State Examination is to gather a comprehensive and
cross-sectional description of the mental state of an affected person (Trzepacz et al., 2015).
When combined with the historical and biographical information of patient’s psychiatric history,
MSE assists the clinician in making an accurate diagnosis of the condition that needs treatment.
Some of the most common domains that are encompassed in this examination are perception,
thought content, combination, thought process, judgement, and insight. Upon analysing the case
study it can be suggested that the two most common elements of MSE that are affected in the
patient include his thought process and speech (Gluhm et al., 2013).
Thought process is commonly referred to the tempo, quantity and form of thoughts, and
cannot be directly observed. These are most commonly described in the form of input from the
speech that a patient gives. Presence of a pattern of disorganisation or interruption of thought
processes were found in the client that helped in identifying a formal thought disorder, which
specifically contributed to tangential thinking and loosening of association (Fox et al., 2015).
Chung was found to portray a flat mood and was severely affected by environmental stressors,

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which resulted in his reluctance to participate in any momentous activity. Speech of the client
was also affected, since it was slow and purposeful. Speech is usually observed by assessing
spontaneity and with the use of specific language function tests that address standard thought
processes. Structured assessment of speech most often encompasses evaluation of the expressive
language and form an integral part of the MSE (Luria, 2014).
Although time and again, anxiety has been identified as integral part of human life, some
people face long-lasting anxiety that is associated with a persistent worry and fear and overly
concern about general matters. These are most commonly associated with major problems in
concentration, irritability, restlessness, disturbances in sleep, and muscle tension. An analysis of
the case study suggests that the client Chung suffered from anxiety disorder, more specifically
panic disorder that is primarily characterized by recurring panic attack. These attacks are defined
as sudden periods of severe fear that include shaking, sweating, shortness of breath, palpitation
and feeling of something terrible happening (Kossowsky et al., 2013). People suffering from this
episode also display a strong wish of escaping from the events that triggered the attack. Similar
symptoms were presented by Chung which helped in diagnosing the condition as panic disorder,
based on the DSM-V diagnostic criteria for panic disorder 300.01 (F41.0) (American Psychiatric
Association, 2013).
Answer 2
The stress vulnerability model is an essential psychological theory that aims to provide an
explanation to any mental disorder, as a result of an interaction between stress, due to life
experiences and predisposition or vulnerability. The factors that might often contribute to stress
in a person exist in the form of psychological, genetic, situational or biological components

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(McEwen & Morrison, 2013). The predisposition often interacts with subsequent stress response
in an individual. In other words, stress is defined as a series of life events that plays an important
role in disrupting the psychological equilibrium of a person, and subsequently catalysing
development of a mental disorder. Therefore, the stress vulnerability model explores the role of
genetic and biological stressors and their interaction with environmental influences, to produce
disorder like anxiety or depression (Drake, Pillai & Roth, 2014). Some of the most common
stressful events that lead to mental disorders in a person include getting terminated from a job,
engaging in conflicts with acquaintances, or death of a beloved person (Zannas & West, 2014).
Chung faced extreme stress in his workplace due to his job at the Emergency Department
and the subsequent monitoring and supervision that he had to undergo, as a result of medication
error that breached patient safety. These events increased his susceptibility to panic disorder.
Owing to the extreme pathological effects of anxiety, it is essential to recognise the role of social
support as a major protective factor. Social support from loved ones and family members has
often been found to buffer the impact of anxiety, and it is an essential mechanism in boosting the
overall mental health of a person (Budge, Adelson & Howard, 2013). The fact that he was not in
close contact with his family members acted as a significant stressor for development of panic
disorder.
Most individuals experience anxiety and stress from time to time that occurs in the
presence of multiple competing demands. Such forms of stress also trigger events that makes the
affected person feel nervous and frustrated. However, when anxiety and stress begin interfering
with the daily life of the individual, it indicates the presence of serious mental issues. Some of
the other factors that might have contributed to development of the mental illness in Chung
include life events that comprised of lack of participation in daily activities, and strained

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relationship with friends and family. Staying far away from home and failure of his parents to
participate in his wedding program created a significant negative impact on his life and made
him feel more isolated. Following birth of his child, his wife suffered from an infection and
required care in addition, to facing mobility problems. Long working hours at the Emergency
Department prevented Chung from actively participating in taking care of his wife and daughter,
thereby widening the gap between them. These environmental stressors also made him isolated
and he did not participate in any focused activities such as, parenting. The aforementioned
factors exacerbated suicidal feelings in Chung.
Answers 3
A mental health recovery process refers to the way by which a person can become active
and take control of mental health, thereby working towards accomplishing meaningful goals. For
most people, the concept of mental illness recovery encompasses having a control in their life, in
place of the elusive state of return to certain pre-morbid stages of functioning. Such an approach
does not focus on resolution of the complete symptoms, but places an emphasis on control and
resilience over life problems. This approach also argues against providing just treatment of the
simple management of symptoms (Drake & Whitley, 2014). Instead, it elaborates on building
resilience among individuals with mental illness, and providing support to people who are in
emotional distress. The recovery process is capable of providing a holistic view of people with
mental illness, and postulates that they can successfully lead a meaningful life, and that the entire
process is a journey rather than reaching a destination. Recovery processes also calls for
commitment from the individual, suffering from mental disorders, their family members,
associated mental health professionals, and the community. It is largely influenced by the
attitudes and expectations of people residing with them (Drapalski et al., 2013).

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Stating that a person suffers from mental illness does not necessarily mean an end of his
life. With appropriate help support and hope, the person can achieve his or her life ambitions.
Hope generally comes from the inner desire to live and regain optimal health. It is achieved
through assurances of key stakeholders and other people, who care about the affected person or
through those who have had lived experiences. Instilling a faith of hope in the mentally ill
individual will help the latter to gain a better understanding of the mental state, thereby taking
responsibility for self-management and reaching out other people for help. Dignity is also
imperative in the mental recovery of a person (Chronister, Chou & Liao, 2013). It commonly
refers to the inherent values and worth of an individual and is strongly correlated with
recognition, respect, and self worth, in addition to the possibility and capability of making
choices for self. The fact that many people are denied the opportunity to participate in public
affairs or decision making processes often affects them and triggers mental disorders.
Presence of discrimination and stigma in the society regarding prevalence of mental
illness aggravates the condition (Moran et al., 2013). Efforts must be taken to provide
community based services that encompass recovery approach by inspiring hope and helping
Chung to achieve his aspirations and goals. By respecting his autonomy and demonstrating an
awareness and knowledge regarding his Chinese culture, will also help in ensuring his access to
good care services, whilst respecting his choices preferences and values (Hu, Li & Arao, 2015).
This will also be facilitated by adoption of an empowering attitude by engaging in effective
communication. This will promote management of ill health and will also provide assistance to
Chung to become an active partner in managing the disease. Implementation of the recovery
based practice will therefore help him gain a better understanding and the control over his life, to
improve health related life circumstances.

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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(DSM-5®). American Psychiatric Pub.
Budge, S. L., Adelson, J. L., & Howard, K. A. (2013). Anxiety and depression in transgender
individuals: the roles of transition status, loss, social support, and coping. Journal of
consulting and clinical psychology, 81(3), 545.
Chronister, J., Chou, C. C., & Liao, H. Y. (2013). The role of stigma coping and social support in
mediating the effect of societal stigma on internalized stigma, mental health recovery,
and quality of life among people with serious mental illness. Journal of Community
Psychology, 41(5), 582-600.
Drake, C. L., Pillai, V., & Roth, T. (2014). Stress and sleep reactivity: a prospective investigation
of the stress-diathesis model of insomnia. Sleep, 37(8), 1295-1304.
Drake, R. E., & Whitley, R. (2014). Recovery and severe mental illness: description and
analysis. The Canadian Journal of Psychiatry, 59(5), 236-242.
Drapalski, A. L., Lucksted, A., Perrin, P. B., Aakre, J. M., Brown, C. H., DeForge, B. R., &
Boyd, J. E. (2013). A model of internalized stigma and its effects on people with mental
illness. Psychiatric Services, 64(3), 264-269.
Fox, K. C., Spreng, R. N., Ellamil, M., Andrews-Hanna, J. R., & Christoff, K. (2015). The
wandering brain: Meta-analysis of functional neuroimaging studies of mind-wandering
and related spontaneous thought processes. Neuroimage, 111, 611-621.

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Gluhm, S., Goldstein, J., Loc, K., Colt, A., Van Liew, C., & Corey-Bloom, J. (2013). Cognitive
performance on the mini-mental state examination and the montreal cognitive assessment
across the healthy adult lifespan. Cognitive and behavioral neurology: official journal of
the Society for Behavioral and Cognitive Neurology, 26(1), 1.
Hu, H. H., Li, G., & Arao, T. (2015). The association of family social support, depression,
anxiety and self-efficacy with specific hypertension self-care behaviours in Chinese local
community. Journal of human hypertension, 29(3), 198.
Kossowsky, J., Pfaltz, M. C., Schneider, S., Taeymans, J., Locher, C., & Gaab, J. (2013). The
separation anxiety hypothesis of panic disorder revisited: a meta-analysis. American
Journal of Psychiatry, 170(7), 768-781.
Luria, A. R. (2014). The role of speech in the regulation of normal and abnormal behavior.
Elsevier.
McEwen, B. S., & Morrison, J. H. (2013). The brain on stress: vulnerability and plasticity of the
prefrontal cortex over the life course. Neuron, 79(1), 16-29.
Moran, G. S., Russinova, Z., Gidugu, V., & Gagne, C. (2013). Challenges experienced by paid
peer providers in mental health recovery: a qualitative study. Community Mental Health
Journal, 49(3), 281-291.
Trzepacz, P. T., Hochstetler, H., Wang, S., Walker, B., & Saykin, A. J. (2015). Relationship
between the Montreal Cognitive Assessment and Mini-mental State Examination for
assessment of mild cognitive impairment in older adults. BMC geriatrics, 15(1), 107.

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Walker, E. R., McGee, R. E., & Druss, B. G. (2015). Mortality in mental disorders and global
disease burden implications: a systematic review and meta-analysis. JAMA
psychiatry, 72(4), 334-341.
Zannas, A. S., & West, A. E. (2014). Epigenetics and the regulation of stress vulnerability and
resilience. Neuroscience, 264, 157-170.