• Name: Jennifer L.

• Age: 32

• Sex: Female

• Marital Status: Divorced

• Children: Two (ages 4 and 7)

• Occupation: Elementary School Teacher

• Medical History: Generalized Anxiety Disorder (GAD) diagnosed at age 28

• Medications: Sertraline 50 mg daily

• Family History: Mother with history of depression

• Social History: Non-smoker, occasional alcohol use, no substance abuse

Jennifer reports that her best friend of 15 years died unexpectedly in a car accident two weeks ago. She describes this friend as her “lifeline” and someone she saw or spoke to daily. Since the loss, Jennifer has had difficulty performing daily tasks, parenting her children, and maintaining work responsibilities. She feels guilty about being unable to “be strong” for her children. 

Mental Health Assessment:

• Mood: Anxious and tearful

• Affect: Blunted

• Thought Process: Logical, but fixated on the loss

• Insight/Judgment: Fair

• Suicidal Ideation: Denies current SI, but endorses feelings of emptiness

• PHQ-9 Score: 19

• GAD-7 Score: 15

Questions:

1. Which of the following symptoms most strongly suggests complicated grief rather than normal bereavement?
A. Sadness
B. Yearning
C. Persistent guilt and functional impairment weeks after the loss
D. Crying when thinking about the deceased

2. What tool is commonly used to assess generalized anxiety symptoms?
A. Beck Depression Inventory
B. PHQ-9
C. GAD-7
D. MMS

3. Which of the following coping strategies would be most beneficial to Jennifer at this time?
A.  Journaling and supportive therapy
B. Increase work responsibilities
C. Avoid discussing the loss
D. Isolation and withdrawal

Answers:

1.  C. Persistent guilt and functional impairment weeks after the loss

2. C. GAD-7

3. A. Journaling and supportive therapy