Reference no: EM131711961

Using the information provided in the following two vignettes, provide the most appropriate DSM-S diagnosis (or diagnoses). Make certain that you specify the bases for your diagnosis (e. g. criteria met). A complete response would also include the reasons you decided to exclude possible alternative diagnoses (rule outs).

A 26-year-old woman from Dutch new Guinea (South America), now living in Chicago, is referred to a psychiatrist. Her social worker and family doctor are worried because she sees funeral cars everywhere and says she wants to commit suicide. She reports that sometimes she begins to tremble violently, her eyeballs roll upward, her arms and hands twist, and she utters strange words and no longer understands English. She also reports that typically after about 5 minutes she regains consciousness, and it possible for people to get in contact with her. She does not remember anything that happens during these attacks, but behaves as if she has undergone an exhausting experience. Since coming to America seven years ago she has been 'haunted' four times by evil spirits who push her good spirits aside and take over her body. These spirits appear during difficult periods and want her dead. During these crises she also suffers from headaches, abdominal pain, sleeping problems, sever lack of energy, and a loss of appetite.

Since her arrival in Chicago, the client has worked at cleaning jobs and finally got a position in a linen room of a hospital. She became involved with a co=worker, she got pregnant, and they decided to marry. Despite taking birth control pills, she became pregnant again not long after the birth of her first child. The client also reports that after the birth of the unplanned baby she began experiencing increasing fatigue in both arms, pain under her breasts, and pain behind her left breast, which at times radiated down her back. She felt too tired to care for her children ot to make love with her husband. Now three months later, she has pain everywhere is frightened, cannot sleep, and feels feeble and unable to concentrate. She continually sees funeral cars following her, and she ruminates about killing herself. Her husband indicates to the psychiatrist that he will no participate in the client's therapy. Over the past few years they have spent an enormous amount of money on diviners/shamen/healers. He is fed up with her stories about spirits, her insistence that he has to enter his house backward, and her interpretation of every draft in the house as the presence of spirts.