¶ … Hilde

Develop a list of four possible diagnoses and a brief rationale for each diagnosis. Provide examples of Hilde's behaviors for each diagnosis. (1) Hilde could be depressed. She has sadness and cries a lot. (2) Hilde could have a personality disorder. She is very apathetic and childish, and does not perform well when she does not get her way. (3) Hilde could have an anger issue. Perhaps the years of being treated like a child and prized for looks have taken their toll. (4) Hilde could also have an alcohol or drug problem that she is hiding very well and that her husband has not noticed because the couple seems to have drifted so far apart and he is 'tired of her.'

Are her symptoms "clinically significant"? Hilde's symptoms are clinically significant in that they are affecting the way that she lives her life and the way that she interacts with others. These are also symptoms that have appeared recently over time but have not always been a part of her life. Her past, however, is likely still a contributing factor where these symptoms are concerned.

3. What information would you like to have to aid in making a diagnosis? Knowing more about Hilde's childhood might be helpful, but only if it could be provided in a more 'in depth' way. She is only touching the surface right now and is not really willing to look deeper into why she feels the way she does. It would also be important to know whether Hilde has interests that she has never been able to pursue because so much of her life was based around her looks. Whether she was ever prized or applauded for anything else is an important consideration here.

4. Use the five-axial model to provide a complete diagnosis for Hilde. Use DSM IV TR. The five-axial model diagnosis for Hilde would be: Axis I - Major depressive disorder; Axis II - Personality disorder; Axis III - None; Axis IV - Marital problems, Axis V - 75. Hilde functions normally in a lot of settings, but her desire to withdraw and the martyr complex that she seems to have developed, as well as her general apathy indicate deep-seated problems that need treatment.