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Assignment: Case of Storme
Denise Johnson
Master of Social Work, Walden University
SOCW 6090: Psychopathology for Social Work
Dr. Downing
October 1, 2023
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Assignment: Case of Storme
Diagnosis:
F93.0 Separation Anxiety Disorder
F63.3 Trichotillomania (Hair-Pulling Disorder)
F42.9 Unspecified Obsessive-Compulsive and Related Disorder
Z62.29 Upbringing Away from Parents
Z60.2 Problem Related to Living Alone
Explain how you support the diagnosis by specifically identifying the criteria from the case
In the case study of Storme, there is a historical and current fear of being separated from
family. Storme reported once she moved from out her sister’s apartment into her own due to her
sister starting a romantic relationship she began to cry periodically for no reason. Even though
this romantic relationship with her sister started five years ago, it continues to make Storme
worry. The client also reported she has a fear of worrying her sister about her transportation,
social and emotional needs and these worries limit her everyday functioning. Another symptom
Storme discusses is the need to clean her home everyday and is in worry of someone coming to
the home and it not being clean, even with her physical disabilities, she still makes time in her
daily schedule to clean every day.
Identify the differential diagnosis you considered. Explain why you excluded this diagnosis.
The differential diagnosis I considered was Generalized anxiety disorder. I considered
this because Storme is experiencing anxiety with different things such as her needs being met
and a visitor coming to her home without it being clean. However, the DSM-5-TR (2022), states
the main difference between the two is separation anxiety focuses on the concern with separation
from attachment figures (p. 220). In the case of Storme, her worry is circled around her sister and
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how will she meet her basic needs if she is no longer to utilize her sister for support. Storme
shared that her worrying and hair pulling from the worrying came when she moved into a
separate apartment from her sister, even though they are still in the same building.
Explain the specific factors of culture that are or may be relevant to the case and the
diagnosis, which may include the cultural concepts of distress.
The specifics of culture to consider is that Storme is African American and the
importance of hair in her culture. According to Neal-Barnett et al. (2010), hair is an emotional
issue in the African American culture and can define how one views themselves and how they
think society views them. This goes into additional cultural factors that need to be considered on
how hair is affected in views of being able to go to the hairdresser or participate in family events
arounds hair. Another factor to consider according to the DSM-5-TR (2022), are the cultural
variations when it comes to tolerating separation. In the case of Storme, she reported her parents
passing away when she was younger, no attachment to her parental figure, her aunt, but an
ongoing attachment to her sister after major life events occurred such as marriages ending and a
dependence for her needs to be met.
Explain why you chose the Z codes you have for this client.
I chose the Z code, upbringing away from family due to Storme being raised by her aunt
which she described the home as having “no love.” I do see this as something that should have a
clinical attention to this factor as Storme formed attachment with her older sister. The other Z
code I chose, problem related to living alone, because Storme reported she felt more anxious and
began hair pulling when she moved out of the apartment with her sister and into her own. Storme
did report anxiety in the past, but reported the hair pulling symptoms came about when that
specific separation occurred.
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References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders
(DSM-5-TR) (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Neal‐Barnett, A., Statom, D., & Stadulis, R. E. (2010). Trichotillomania Symptoms in African
American Women: Are they Related to Anxiety and Culture? CNS Neuroscience &
Therapeutics, 17(4), 207–213. https://doi.org/10.1111/j.1755-5949.2010.00138.x
