| Course | NRNP 6635 Psychopathology and Diagnostic Reasoning |
|---|---|
| Week | Week 7 |
| Paper type | Differential grid |
| Length | About 750 words, 5 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | MSN Psychiatric Mental Health Nurse Practitioner (PMHNP) |
| Updated | October 2026 |
Free sample paper for NRNP 6635 Week 7
Psychotic Symptom Differential Grid: Six Explanations for Voices in a 20-Year-Old Daily Cannabis User, Every Cell Carrying Evidence
Student Name
College of Nursing, Walden University
NRNP 6635: Psychopathology and Diagnostic Reasoning
Instructor Name
Month Day, Year
Psychotic Symptom Differential Grid: Six Explanations for Voices in a 20-Year-Old Daily Cannabis User, Every Cell Carrying Evidence
The Presentation
Composite patient: a man of 20, a community college student who stopped attending 2 months ago. His mother brought him in after he told her the neighbors were broadcasting his thoughts. Voices commenting on his actions began about 4 months ago; he has believed his thoughts are being broadcast for about 6 weeks. He has smoked high-potency cannabis concentrate daily for 2 years, and more since the voices began, "to quiet them." His mother describes 2 weeks of low mood and tearfulness last winter, before the voices, which resolved. No mood episode now. No head injury, seizures, or fever; no prescription medications. Examination and basic laboratory tests are unremarkable; urine drug screen positive for cannabinoids only.
The Grid
Columns: total duration; timing of mood symptoms relative to psychosis; substance history; medical and neurological findings; course of functioning. Each cell: evidence, then a mark (supports, against, or uncertain).
Schizophrenia. Duration: about 4 months of active symptoms, less than the 6 months required (against). Mood: brief low mood last winter, before psychosis, not during it (supports, since mood episodes are not concurrent). Substance: daily cannabis could induce or unmask psychosis (uncertain). Medical: normal examination and laboratory tests (supports). Function: dropped out of college, withdrew from friends (supports).
Schizophreniform disorder. Duration: 4 months, within the 1 to 6 months required (supports). Mood: no concurrent mood episode (supports). Substance: same uncertainty (uncertain). Medical: normal (supports). Function: decline present, though not required (supports).
Schizoaffective disorder. Duration: sufficient for psychosis (supports). Mood: requires a major mood episode concurrent with psychotic symptoms for the majority of the illness; his only mood symptoms preceded the psychosis and were brief (against). Substance: (uncertain). Medical: normal. Function: declined.
Depressive or bipolar disorder with psychotic features. Duration: n/a. Mood: psychotic symptoms occur without any current mood episode; the winter low mood was 2 weeks and did not include psychosis (against). Substance: (uncertain). Medical: normal. Function: declined.
Substance- or medication-induced psychotic disorder. Duration: symptoms have persisted for 4 months with continuing daily use, so no abstinence period yet exists to test whether they would resolve (uncertain). Mood: n/a. Substance: daily high-potency cannabis for 2 years, increased since onset (supports). Daily use of high-potency cannabis was associated with nearly five times the odds of psychotic disorder compared with never using, in a multicenter case-control study (Di Forti et al., 2019). Medical: normal. Function: declined, consistent with either.
Psychotic disorder due to another medical condition. Duration: n/a. Mood: n/a. Substance: n/a. Medical: no fever, seizures, focal signs, or delirium; normal basic laboratory tests (against). Autoimmune encephalitis and other medical causes are less likely without neurological features, but brain imaging and further tests are indicated if any appear. Function: n/a.
A Conclusion That Cites the Grid
Reading the grid across: schizophreniform disorder and cannabis-induced psychotic disorder are the two rows with no cell marked against; every other row has at least one. The grid cannot separate these two now, because the deciding column, the course during sustained abstinence from cannabis, has not yet been observed. DSM-5-TR asks whether symptoms persist for a substantial period, about a month, after cessation of use (American Psychiatric Association, 2022). The working diagnosis is therefore substance-induced psychotic disorder, with schizophreniform disorder as the close alternative to be revisited after a month of abstinence. Even if the first label holds, the risk of later serious mental illness is high: in a national registry cohort, 47% of people with a cannabis-induced psychosis later received a diagnosis of schizophrenia or bipolar disorder (Starzer et al., 2018). The plan treats him with that risk in view.
The Plan That Follows the Grid
The plan follows from the one column the grid could not fill. He is offered treatment for the psychosis now, since its duration and his functional decline warrant it whatever the final label, together with a structured plan to stop cannabis, with his mother's support and a referral to a program for young people with first-episode psychosis. The diagnosis is revisited after a month of confirmed abstinence: if the voices and the broadcasting belief resolve, the substance-induced label stands; if they persist, schizophreniform disorder becomes the working diagnosis, and schizophrenia if the total duration passes 6 months.
Neurobiology, Kept Brief
Cannabis's main psychoactive compound acts on cannabinoid receptors that modulate dopamine signaling in circuits implicated in psychosis; this is a plausible mechanism for the association, not a test that can be applied to him.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Di Forti, M., Quattrone, D., Freeman, T. P., Tripoli, G., Gayer-Anderson, C., Quigley, H., Rodriguez, V., Jongsma, H. E., Ferraro, L., La Cascia, C., La Barbera, D., Tarricone, I., Berardi, D., Szöke, A., Arango, C., Tortelli, A., Velthorst, E., Bernardo, M., Del-Ben, C. M., . . . EU-GEI WP2 Group. (2019). The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): A multicentre case-control study. The Lancet Psychiatry, 6(5), 427-436. https://doi.org/10.1016/S2215-0366(19)30048-3
Starzer, M. S. K., Nordentoft, M., & Hjorthøj, C. (2018). Rates and predictors of conversion to schizophrenia or bipolar disorder following substance-induced psychosis. The American Journal of Psychiatry, 175(4), 343-350. https://doi.org/10.1176/appi.ajp.2017.17020223
The Walden NRNP 6635 Week 7 instructions
The seventh NRNP 6635 week usually asks for a differential diagnosis grid for a psychotic presentation. You list candidate diagnoses including substance and medical causes, fill each cell with evidence from the case, conclude by citing the grid and plan next steps. Faculty reward completeness and cells that carry evidence. Cite DSM-5-TR and research on substance-related psychosis in APA 7. Duration and timing of symptoms are critical. A medical row is expected. Neurobiology can be brief. NRNP 6635 faculty want every cell filled with a phrase from the case, not a check mark. Include a medical row with the tests that would address it. State symptom duration clearly. Let the conclusion point to specific cells. The plan should follow from the leading rows.
Inside the NRNP 6635 Week 7 example
A single wide page holds the grid. Rows carry six explanations: schizophrenia, schizophreniform disorder, schizoaffective disorder, a depressive or bipolar disorder with psychotic features, substance or medication-induced psychotic disorder, and psychotic disorder due to another medical condition. Columns hold the features on which they diverge: total duration of the disturbance, the timing of mood symptoms relative to psychosis, the substance history, medical and neurological findings in the case, and the course of functioning. Each cell carries a short phrase of evidence from the composite, a man of about twenty, and a mark showing whether it supports or weakens that row. A paragraph under the grid names the leading explanation and the one feature most likely to shift it. A brief note explains positive symptoms through the dopamine hypothesis, stated as a hypothesis rather than as settled fact.
Reading the NRNP 6635 Week 7 rubric
Grids earn credit for completeness and for cells that carry evidence. A grid listing six diagnoses with ticks, and no phrase from the case in any cell, has organized recall without applying it. The most costly omission is the substance-induced row, particularly in a young adult, and close behind it the medical row; markers treat their absence as a failure of rule-out reasoning. Confusing schizophreniform disorder and schizophrenia on duration costs accuracy, as does placing mood symptoms without stating their timing relative to psychosis. A conclusion that ignores the grid above it wastes the format. Stigmatizing or dramatic language about hallucinations costs professionalism quickly. Grids that add antipsychotic choices have strayed into material other courses assess, and neurobiology overstated as established fact costs precision.
Common NRNP 6635 Week 7 mistakes, and how to avoid them
Grids lose credit when cells contain ticks instead of evidence from the case. Put a phrase in every cell. Another common gap is leaving out a medical row, though a new psychosis needs basic medical workup. Add it. Writers also blame cannabis without examining timing. Ask whether symptoms began before heavy use and persist during abstinence. Avoid confusing schizophrenia and schizophreniform disorder; the duration decides. Keep his age and history consistent. Make the plan follow the grid. Close with what would move one row up or down. Writers also forget a safety assessment, since command voices or paranoia can raise risk. Record it. Another frequent slip is ignoring family history, which affects the likelihood of a primary psychotic disorder. Ask about it. Keep the grid readable by limiting each cell to a short phrase.
Get a NRNP 6635 Week 7 example written to your instructions
Drop the Week 7 prompt and case into a request along with the marking rubric; the grid gets laid out for that presentation, rival explanations as rows and evidence in the cells. Your first custom sample is free and ready within 24-48 hours, written as coursework rather than as clinical opinion about any person.
More NRNP 6635 papers and PMHNP samples
- NRNP 6635 Week 1: Diagnostic Classification Post
- NRNP 6635 Week 2: Symptom Neurocircuitry Brief
- NRNP 6635 Week 3: Anxiety Rule-Out Note
- NRNP 6635 Week 4: Psychiatric Evaluation
- NRNP 6635 Week 5: Mood Timeline Analysis
- NRNP 6635 Week 6: Trauma Criteria Map
- NRNP 6635 Week 8: Substance-Induced Analysis
- NRNP 6635 Week 9: Personality Pattern Write-Up
- NRNP 6635 Week 10: Neurodevelopmental Analysis
- NRNP 6635 Week 11: Integrated Psychiatric Evaluation
- NRNP 6644 Week 7: Care Plan
- NRNP 6634 Week 7: Treatment Plan
- NRNP 6654 Week 7: Policy Analysis
- NRNP 6624 Week 7: Group Therapy Discussion
NRNP 6635 Week 7 questions, answered
Why does the grid include a medical row?
Because psychosis can arise from neurological, endocrine, infectious and other medical conditions, and a differential that leaves them out is incomplete regardless of how the psychiatric rows look. The grid sets down whatever medical findings the case supplied and whether any of them point toward a physical cause. It does not direct any workup; it shows the reasoning your marker expects to see.
How does the grid treat cannabis or other substance use?
As evidence to be weighed, with timing at the center. The substance row asks whether the psychosis began during or soon after use and whether it persisted through a period of abstinence, both of which the case either supplies or leaves open. The row states which. Judgment about the young man's use appears nowhere in the grid, which describes rather than moralizes.
Can the grid format work for a different presentation?
Yes. Any presentation with several plausible explanations can be laid out as rows of rivals and columns of separating features. The rows and columns change with the disorder, but the discipline of filling every cell with evidence stays constant. If your prompt centers on a different presentation, the grid you receive is built for that case.
Where can I find a free NRNP 6635 Week 7 sample paper?
The six-row psychosis grid is reproduced here with evidence in every cell, the conclusion that cites it, the plan and a brief neurobiology section.
How many explanations does the NRNP 6635 Week 7 grid set out?
Six, including schizophrenia, schizophreniform disorder, substance-induced psychosis and depression with psychotic features.