Dan is a 15 yo AAM who has been residing in a group home for the past 4 months. He was admitted to the in-patient
psychiatric unit for physical aggression towards staff and breaking furniture. This occurred because the staff
confronted Dan about being disrespectful after asking him to clean his room. He shows no remorse for his actions.
Dan has had a troubled childhood and his aggression began in preschool. He was physically abused by his father who
has untreated bipolar disorder and has a history of frequent incarceration. His mother has been absent most of his life
and suffers from SUD, PTSD, and bipolar disorder. Dan has a history of speech impediment, aggression, anger,
impulsiveness, bedwetting, and defiance. He has been in CPS care since kindergarten. He is now in the 8th grade and
is on an IEP. He is positive for bad dreams and states he sometimes hears someone call his name when no one is
around. All other ROS is negative. He has been treated in the past with amphetamines and failed. He has also been
treated with clonidine and imipramine. He is currently not on any medications.
Symptoms to be treated: aggression with physical attacks, defiance, impulsiveness, and anger.
A. Identify appropriate history questions to be asked of your patient to discriminate critical characteristics
or attributes about the above presenting complaint. Incorporate COLDSPA (Characteristics, Onset,
Lingering, Duration, Stressors, Precipitating factors/triggers, Alleviating factors).
Characteristics- loss of temper, aggressiveness, easily, annoyed, angry, argues with authority,
deliberately annoys others.
• Can you tell me about your thoughts on the recent situation?
• I’d like to know about Dan, can you tell me about yourself?
• I understand that you were upset, how often do you feel you are upset?
• Do you feel as if people provoke you on purpose?
• Do you feel that you lose your temper easily?
• When do you hear someone call your name?
• Does the voice sound familiar?
• Do you have flashbacks from any particular event in your life?
• Are you having trouble falling asleep? Staying asleep?
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