Reference no: EM133667643

Assignment:

Case Application Activity 6

Clinical Vignette

Arina is a nutritionist major at Texas Tech University and is a member of the track/field team and is on athletic scholarships. Since high school Arina's coaches have spoken at length about the correlation between body weight and speed, with the lower your body weight being the more time you can cut off your run times. Arina has run competitively since she was in 5th grade but recalls going on training runs with her parents who were both competitive runners since she was in first grade.

When Arina moved away from her family to attend Texas Tech, she struggled with feeling isolated and trying to adjust to all the stressors associated with not only college but being a collegiate athlete. She reports that she was a strong student while completing her general education requirements, but the increased workload and difficulty of courses associated with her major, has greatly impacted her level of stress by her junior year. Arina reports that over the first few weeks of the semester she has done poorly on several examinations and the longer hours required to study has impacted her performance at practice. The track and field coach have talked to her about reducing the number of events she typically competes in from four to two, but she fears she is in jeopardy of losing a place on the team and then no longer having her athletic scholarship.

Arina learns through her nutrition classes about healthy food to increase energy. She decides if she focuses on what she puts in her body more then she will be more competitive in track and field events. Arina remembers that when she dieted in high school, she did better in some of her events, and that she used to engage in several dieting tactics that other track team members taught her with good success. It has been a few years since she has tried these dieting behaviors, but maybe tacking back control in this area of her life will lead to successes elsewhere, especially with her newfound knowledge from her classes. Over the next two months, Arina pays very close attention to her diet: any sweets are completely off limits, absolutely no sugar; she no longer can eat fast food, and she tries to minimize her carbohydrate intake to being just a meal before track competitions.

She uses Myfitnesspal to track her calories and has even been using laxatives more than the recommended amount to ensure that her digestive system is working at its best. She has been spending a lot of time looking up different nutrients and food to determine the best foods to eat. Anytime that Arina has a forbidden food she reminds herself what she is working towards and will throw up the food. At first this was occurring only once or twice a week, but as she lost weight and saw results in his races, she started increasing the amount to four or five times a week, over the past three months. She has started to feel more fatigued the past week, despite maintaining her dieting plan. She has started to have shin splints, causing her a great deal of pain in her legs when she runs and when she lays down for bed at night. She decides that it is finally time to speak to a trainer about her performance issues.

Discussion Questions:

1. What DSM 5 criteria does Arina meet, based on the case summary? Provide specifics on how you determined this.
2. What other assessment questions would you need to ask Arina, to rule out differential diagnoses?
3. Based on the above questions what is the best diagnosis to provide Arina and why?
4. Is there a diagnosis not recognized in the DSM that would fit better, if so why or why not?