Substance Abuse, Eating Disorders, Impulse Control Disorders no. 5026

Substance Abuse, Eating Disorders, Impulse Control Disorders no. 5026

QUESTION: A client is brought to the psychiatric clinic by family members, who tell the admitting nurse that the client repeatedly drives while intoxicated despite their pleas to stop. During an interview with the nurse, which statement by the client most strongly supports a diagnosis of psychoactive substance abuse?

✘O a.) "I'm not addicted to alcohol. In fact, I can drink more than I used to without being affected."
✘O b.) "I only spend half of my paycheck at the bar."
✘O c.) "I just drink to relax after work."
✓O d.) "I know I've been arrested three times for drinking and driving, but the police are just trying to hassle me."

RATIONALE

RATIONALE: According to the <i>Diagnostic and Statistical Manual of Mental Disorders,</i> 4th edition, diagnostic criteria for psychoactive substance abuse include a maladaptive pattern of such use, indicated either by continued use despite knowledge of having a persistent or recurrent social, occupational, psychological, or physical problem caused or exacerbated by substance abuse or recurrent use in dangerous situations (for example, while driving). For this client, psychoactive substance dependence must be ruled out; criteria for this disorder include a need for increasing amounts of the substance to achieve intoxication (option 1), increased time and money spent on the substance (option 2), inability to fulfill role obligations (option 3), and typical withdrawal symptoms.
NURSING PROCESS STEP: Assessment
CLIENT NEEDS CATEGORY: Psychosocial integrity
CLIENT NEEDS SUBCATEGORY: None
COGNITIVE LEVEL: Analysis