Personality disorders can arise through trauma, and they often carry added stigma. In this Discussion, you analyze a case study focused on a personality disorder while also reflecting on how power, privilege, and stigma affect such diagnoses. To prepare: Review the case provided by your instructor for this week’s Discussion and consider your differential diagnostic process for them. Be sure to consider any past diagnoses and what influence those might have on their current diagnosis and needs. Finally, return to the Week 1 resources on stigma and reflect on stigma related to personality disorders. Post a 300- to 500-word response in which you address the following: Provide the full DSM-5 diagnosis. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may need clinical attention). Keep in mind a diagnosis covers the most recent 12 months. Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis. Support your decision by identifying the symptoms which meet specific criteria for each diagnosis. Identify any close differentials and why they were eliminated. Concisely support your decisions with the case materials and readings. Explain how diagnosing a client with a personality disorder may affect their treatment. Analyze how power and privilege may influence who is labeled with a personality disorder and which types of personality disorders. Identify how trauma affects the case, either precipitating the diagnosis and/or resulting from related symptoms or treatment of diagnosis. CASE of SHANICE Intake Date: January 2021 IDENTIFYING/DEMOGRAPHIC DATA:      Shanice is a 32 year old, single African American female, with no siblings.  Shanice reports never being married.  She works full time at the library. CHIEF COMPLAINT/PRESENTING PROBLEM:      Shanice reported having sudden attacks and feeling anxious.  She described feelings coming over her so quickly where her heart was pounding, and she couldn’t breathe.  Recently when shopping, she wanted to just run out of the store because she suddenly was so dizzy she wanted to vomit.  She even stopped going to the library.  HISTORY OF PRESENT ILLNESS:      Shanice notes “I like people, but I don’t deal well with them.  I never seem to meet a lot of people.  I guess I have always been this way.  I remember rarely inviting other kids to my birthday parties.  “I didn’t think they really wanted to come”.      Shanice described feeling anxiety and panic over the past three weeks when she was assigned a new boss.  She believes her work is unsatisfactory and feels very dissatisfied with her job.  She doesn’t like the anxiety she is now experiencing.  Over the past two years, her other boss would cover up for her mistakes when her concentration was off, and she couldn’t make a decision.  She may need to quit her job.  She cannot believe that she ge.

1. Personality disorders can arise through trauma, and they often
carry added stigma. In this Discussion, you analyze a case study
focused on a personality disorder while also reflecting on how
power, privilege, and stigma affect such diagnoses.
To prepare:
Review the case provided by your instructor for this week’s
Discussion and consider your differential diagnostic process for
them. Be sure to consider any past diagnoses and what influence
those might have on their current diagnosis and needs. Finally,
return to the Week 1 resources on stigma and reflect on stigma
related to personality disorders.
Post
a 300- to 500-word response in which you address the
following:
Provide the full DSM-5 diagnosis. Remember, a full diagnosis
should include the name of the disorder, ICD-10-CM code,
specifiers, severity, and the Z codes (other conditions that may
need clinical attention). Keep in mind a diagnosis covers the
most recent 12 months.
Explain the diagnosis by matching the symptoms identified in
the case to the specific criteria for the diagnosis.
Support your decision by identifying the symptoms which meet
specific criteria for each diagnosis.
Identify any close differentials and why they were eliminated.
Concisely support your decisions with the case materials and
readings.

2. Explain how diagnosing a client with a personality disorder may
affect their treatment.
Analyze how power and privilege may influence who is labeled
with a personality disorder and which types of personality
disorders.
Identify how trauma affects the case, either precipitating the
diagnosis and/or resulting from related symptoms or treatment
of diagnosis.
CASE of SHANICE
Intake Date: January 2021
IDENTIFYING/DEMOGRAPHIC DATA:
Shanice is a 32 year old, single African American female,
with no siblings. Shanice reports never being married. She
works full time at the library.
CHIEF COMPLAINT/PRESENTING PROBLEM:
Shanice reported having sudden attacks and feeling anxious.
She described feelings coming over her so quickly where her
heart was pounding, and she couldn’t breathe. Recently when
shopping, she wanted to just run out of the store because she
suddenly was so dizzy she wanted to vomit. She even stopped
going to the library.
HISTORY OF PRESENT ILLNESS:
Shanice notes “I like people, but I don’t deal well with
them. I never seem to meet a lot of people. I guess I have
always been this way. I remember rarely inviting other kids to
my birthday parties. “I didn’t think they really wanted to

3. come”.
Shanice described feeling anxiety and panic over the past
three weeks when she was assigned a new boss. She believes
her work is unsatisfactory and feels very dissatisfied with her
job. She doesn’t like the anxiety she is now experiencing.
Over the past two years, her other boss would cover up for her
mistakes when her concentration was off, and she couldn’t make
a decision. She may need to quit her job. She cannot believe
that she gets accommodations at work. She cannot figure out
why.
PAST PSYCHIATRIC HISTORY:
Shanice initially started psychiatric treatment at 18 years old
after her mother complained about her depressed mood and lack
of social activity. She just lost all interest in trying to do things
because it just did not work. Shanice believes she is just not
the type that has a lot of energy for things. She states she did
not know how to go about being social. After several years, she
finally admitted to her mother that she always thought about
killing herself. She remembers being upset because her fingers
bled because she would pull the extra skin off by her nails, and
then her nail would look terrible. Everything was “going
haywire” at that time. Her energy was “zapped”, she did not
want to try and build her social circle, her sleeping and eating
habits got worse. At 25, she made a suicide attempt by drinking
a glass of wine and taking valium. She describes being unsure
how much valium she needed, so she took half a pill. At this
time, Shanice was admitted to a psychiatric unit for thirty days.
Shanice reports being involved in psychotherapy previously,
over a ten year period. She would attend one session, then
never go back. There was only one clinical social worker that
she stayed with for any length of time. Shanice states she
enters treatment when she feels anxious or depressed. Most of

4. the time, her mother would bring her to the first session. She
has been prescribed Prozac and Paxil in the past - ten years ago
and five years ago, respectively. Shanice reports both
medications helped “somewhat” but did not really help much.
SUBSTANCE USE HISTORY:
About one year after discharge from the psychiatric hospital,
Shanice’s depressive symptoms were still present, so she started
drinking at home. Her drinking increased so much over that one
year that she knew it was contributing to her depression.
Shanice’s mother confronted her about the drinking and brought
Shanice for alcohol treatment. She completed outpatient
treatment and slowly began attending AA meetings. She states
she is a recovering alcoholic for five years. Shanice denies any
other drug use. She has never had a sponsor, and does not
attend any AA functions other than a meeting. Presently, she
attends one AA meeting a week. It is on a Friday afternoon
during lunch time. Shanice reports always enjoying this
meeting in the past because all three attendees get a chance to
talk if they want. Over the last two years, Shanice reports
losing interest even in attending this AA meeting, but she goes
because they serve lunch.
MEDICAL HISTORY:
Shanice had her tonsils removed at 8 years old. She denies
any other distinguishing medical problems. Shanice has used
Paxil and Prozac in the past when her anxiety became
overwhelming. She stopped her Paxil three years ago because
she felt better.
FAMILY HISTORY INCLUDING MEDICAL AND
PSYCHIATRIC:
Her parents were divorced when she was 11 years old.

5. Shanice resides with her mother in Austin, TX. Shanice
describes her relationship with her mother as “very close.” She
does worry about disappointing her mother since mom, for as
long as she can remember, complained about Shanice being
depressed all the time.
CURRENT FAMILY ISSUES AND DYNAMICS:
Shanice reports never having many friends because of her
relationship with her mother. She believes if she moved out of
her house she would be able to increase her social circle.
Shanice reports having a boyfriend in college, who she knew
since childhood, but she didn’t know really how to be a
girlfriend. She stopped taking his phone calls. She remembers
going to the movies with him a few times. Shanice reports
being unsure how to act on a date. Shanice would like to get
married and have children.
MENTAL STATUS EXAM:
Shanice presented in a very plain non-descript manner. She
was dressed appropriately in casual attire, a skirt and blouse.
She apologized for not wearing makeup, but she described
herself as being unable to be like other woman who know how
to put makeup on. Shanice spoke in almost a whisper, with
very flat affect.
She states her concentration is definitely affected by her
lack of sleep since she wakes up every couple of hours. She
sees herself as more irritable than ever, even her mother
commented on her irritability. Shanice states she also is feeling
some muscle tension.
She denies homicidal ideation. When asked about suicidal
ideation Shanice responded “You mean right now, or this

6. moment, no, but they are there. I don’t think I’ll ever kill
myself, but you never know, do you?”.