Clinical Diagnosis Sally presents with preoccupation of how she perceives her skin to appear and focuses on improving the defects she sees by picking. Sally’s repetitive picking behaviors are made worse by stress at her job where she is required to be in front of many people who may see what she perceives as defects; this leads to missed days from work due to her wanting to hide her skin from others. Because of her high expectations for herself Sally is constantly worrying over her career, appearance, family, and future relationships causing her to be restless and have muscle tension. Sally is presenting with comorbid Body Dysmorphic Disorder and Generalized Anxiety Disorder. Sally meets the criteria for both of these diagnoses with most, if not all, the criteria for each diagnosis. For Generalized Anxiety Disorder (GAD), …show more content…
Sally also had a generalized psychological vulnerability that was instilled by her father’s Obsessive Compulsive Disorder. Her specific psychological vulnerability came from her fathers constant dieting and worry over body shape and size. While her family life was focused around diet and exercise, Sally did not fit the desired look of the family. At age 15 due to the stress of family and friends teasing her, Sally counted calories and lost weight. While this made her feel good she started noticing red marks on her skin and this is when the picking of perceived imperfections began. She continued to worry about her skin excessively what others thought of her skin and could focus on nothing else while out with friends.
Prognosis
Sally will have a chronic prognosis with both the Body Dysmorphc Disorder and Generalized Anxiety Disorder. Therapy could dramatically improve the Generalized Anxiety Disorder and might temporarily improve the symptoms of Body Dysmorphic Disorder, though there is a high chance of relapse of picking.