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Case: Jax is a 66-year-old Caucasian female whose wife has encouraged her to seek treatment. She has never been in therapy before, and has no history of depression or anxiety. However, her alcohol use has recently been getting in the way of her marriage, and interfering with her newly-retired life. She describes drinking increasing amounts over the last year, currently consuming approximately a six-pack of beer per day. She notes that this amount "doesn't give me the same buzz as it used to." She denies ever experiencing "the shakes" or any other withdrawal symptoms if she skips a day of drinking.
Jax comments that her wife is her biggest motivation to decrease her alcohol use. She tells Jax that she gets argumentative and irritable when she drinks, though she does not always remember these incidents. She has also fallen while intoxicated twice, causing bruises both times and hitting her head on one of the occasions.
Question 1: Describe the presenting problems/issues. Is there any information that was not provided that you would need to formulate a diagnosis?
Question 2: Generate a primary and differential diagnosis using the DSMS and ICD 10 codes.
Question 3: What physiological and psychological processes lead to substance dependence?
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