Assignment Scenario

Context: Colton was seen for evaluation at a major urban hospital. You are members of the behavioral health team, charged with developing a biopsychosocial evaluation. This should not be a treatment plan, but an assessment of the person's current problems and level of functioning based on the information provided.

Personal Information: Colton is a 46-year old African American male who has been married for 26 years. He and his wife have four children ranging in age from 16 to 25 years old. They live in a suburb outside of a large urban area. Two adolescent children remain at home.

Current Problems: Colton was diagnosed with hypertension 15 years ago. His blood pressure is currently 170/110, even when controlled by medication. He is also on insulin and other medications for Type II diabetes, which he was diagnosed with 6 years ago. He does not like to go to doctors and has only had two visits in the past 3 years. His wife was instrumental in this visit, because he complained of shortness of breath and occasional chest pains.

Psychosocial Data: Colton was raised with three older brothers by both parents. Both parents have a history of hypertension and his father had diabetes. His mother is alive and his father is deceased, dying of heart disease at age 55. He describes a normal upbringing in a lower-middle-class home, with good relationships among family members. Two of his brothers have hypertension. Colton has 3 years of college education, stating that he needed to leave college to support his family. He was an athlete in high school and college. He had a reputation for being competitive. He has worked as a manager for a retail chain for 16 years. He has had some recent problems on the job because of anger toward his co-workers. Relationships with his spouse and children are very close and his wife is concerned about his health status, especially in light of his family's health history.

Appearance and Behavior: Colton is a male of average build who looks about his stated age, with a high energy level. Mental status is generally normal, although there were occasional signs of hostility. He is fast to answer questions and appears somewhat hyperactive. He became quite angry about some of the questions asked of him during the assessment.

Psychological Profile: Colton has no history of mental health evaluation and treatment, aside from seeing a counselor from the employee assistance program at work. He became angry with a supervisor and several co-workers, and was referred by his supervisor. He attended six sessions with her and was counseled in anger management. He is pessimistic about his future. He admits that he is afraid of early death because of hypertension and diabetes.

Behavioral Health Data: Colton has a normal appetite and reports some weight gain over the past decade. He tends to eat fast food for breakfast and lunch. Sleep patterns are disturbed by early awakening insomnia; he typically goes to sleep rapidly but awakens at 2 or 3 p.m., and is unable to fall back to sleep for several hours. He describes himself as a "social" drinker and smoker. He claims he has "a few beers" with friends several times a week and may smoke cigarettes when he is drinking. He uses no other drugs. He used to work out at the gym regularly, but has no current exercise routine.

I would like three slides with speaker notes, at least a peer-reviewed article, references and citations;

Discuss Colton's most critical biological concerns and risk factors. How would this be conceptualized using the life course perspective, including age-related aspects of health and illness?