Using DSM-5-TR criteria, what diagnosis would you hypothesize may be most suitable for Abbie given the limited informaSon provided?
Case Description:
Abbie is a 31-year-old Chinese-born woman who is referred by her GP to consult a psychologist for assessment and intervention. In the referral, the GP outlines that Abbie originally presented to the GP clinic for assistance with longstanding sleep difficulties, as she has been feeling fatigued and having a hard Qme concentrating at work. Upon further questioning, Abbie reported to the GP that she has been feeling particularly anxious before bedtime, noting it oeen takes her several hours to sefle to sleep as worries keep entering her mind. She also described checking that the stove is off, and the doors and windows are all locked before she feels she can finally sefle into bed. The referral also states that Abbie spends most of her time at home alone outside of work hours. Abbie’s scores on the Depression Anxiety Stress Scale (DASS, Lovibond and Lovibond, 1995) administered by the GP are Depression= 10, Anxiety= 10 and Stress= 34. No prior mental health diagnoses and no medical explanation are evident.
As planned, Abbie schedules an appointment with the psychologist. In their initial consultation, Abbie explained that she has noticed her anxiety has increased significantly since she moved from China to Australia 10 months ago for a new employment role. She explains she had lived in China all her life, and her mother, father, younger sister, and grandparents, with whom she is very close, remain there. Abbie reports that since moving she is finding it difficult to cope and feels she spends “most of her day worrying”. She reports that ever since she was a small child, she always tended to “expect the worst”. Abbie describes herself as a “perfectionist” and noted that her worry has oeen helped to prepare her when things go wrong. Abbie admits to worrying about her family in China, as well as worrying about her performance in her new job, and whether she will become financially unstable. Abbie also reports worrying about her own health and safety. At times, she decides to manage these worries by doing a “cleaning spree”, in which she disinfects surfaces of her house, checks items in her fridge to ensure they have not expired, and check that her smoke alarm is working. However, she explains that she has been doing this less often, because of how fatigued she feels much of the time. Abbie also notes that she feels tense most days, and oeen finds it difficult to control her worried thoughts. The psychologist also notes that throughout the appointment Abbie appears to be nervous, frequently checking to see if she has answered a question correctly or provided enough detail.