Psychodiagnostic Assessment of Mental Disorders - Case Study Example

Running Head: Psychodiagnostic Assessment of Mental Disorders Psychodiagnostic Assessment of Mental Disorders [Institute’s Psychodiagnostic Assessment of Mental Disorders BORDERLINE PERSONALITY DISORDER Introduction Depth and unpredictability of moods and frequent mood swings are observed during extended disturbances of function in an individual’s personality, and such description has been referred as Borderline Personality Disorder or BPD based on the psychiatric analysis as per DSM-IV Personality Disorders 301.83, (American Psychiatric Association, 2000) which is the diagnosis code of this disorder. (Gunderson, 2001) Typically, individuals experience instability in their relationships, personal behavior, mood swings, and thinking patterns in an unusual manner. People end up in suicidal thinking in extreme cases of borderline personality disorder. Studies have indicated that patients confront a number of difficulties during the disorder, and they are affected personally, psychologically, as well as, socially. Diagnosis A mental health professional is considered a qualified expert to assess the disorder in a clinical manner. It is noted that experiences are recorded by professionals during the interviews and observations, which facilitate in better diagnosis of the disorder. Nowadays, emotional abnormality and instability in self-image are displayed by individuals confronting the mentioned disorder, and such individuals are referred as non-psychotic people. It is observed that anxiety and depression are the two major disorders that are developed in people having borderline personality disorder, as indicated by the mental health professionals. DSM-IV TR Clinicians are now facilitated by the American Psychiatric Association for diagnosing different mental illnesses, such as BPD, depression, anxiety, bipolar disorder, etc. In this regard, the Diagnostic and Statistical Manual of Mental Disorders is the latest version of criteria followed by the psychiatrists during the diagnosis of their patients. This version is also referred as DSM-IV TR in clinical terminology, and particularly, BPD has been classified as Axis II disorder, (American Psychiatric Association, 2000) rather than an Axis I disorder. In terms of DSM.IV TR, criteria have been set by the American Psychiatric Association, which should be fulfilled, in order to refer an individual as a BPD patient. (Zanarini, 2005) According to the criteria, an individual endeavors anxiously to stay away from any kind of rejection during the abovementioned disorder. Moreover, such individuals are not able to keep a stable interpersonal relationship due to switching from devaluation to idealization alternatively. In addition, self-image is disturbed and becomes unstable, which results in the disturbance of self-identity of the patients. Individuals start damaging themselves by involving in substance abuse or different eating disorder. (Gunderson, 2001) In extreme cases, individuals express suicidal behavior at frequent times, and clinicians have observed cases involving threats, and even cutting by the individuals. Extreme instability is observed in mood swings of such individuals, which often results in anxiety and depression, or frequent feelings of loneliness or dejection. People confronting borderline personality disorder are unable to control their anger resulting in recurrent expression of temper and exchange of blows in some cases. An individual is referred as a BPD patient, if more than eighty-five percent of features are observed during the examinations and interviews by the mental health professionals during the diagnosis. Associated Features It is noted that a number of studies have been carried to understand the specific features and characteristics of the borderline personality disorder; however, empirical research has not been able to come up with a specific and concrete features of the mental illness. As earlier mentioned in the paper, frequent periods of tension, anxiety, and depression are experienced by individuals with such disorder, and results in prolonged loneliness and rejection. (Freeman, 2003) Moreover, extreme sensitivity is shown by such individuals due to extreme shifts from positive to negative or constructive to destructive behavior during the illness. Generally, individuals refer their surroundings as dangerous and hazardous for them, which can be unacceptable in the society, and often considered as a danger for people around them. In this regard, it is very imperative that family members of such individuals should be aware of abovementioned criteria, in order to deal with such cases in an efficient and adequate manner. Prevalence and Etiology Occurrence of borderline personality disorder is observed in a number of variations, which has resulted in difficulties for mental health professionals in predicting the prevalence of this disorder in humans. However, it is indicated that women are more likely to experience BPD, as compared with men. Some of the experts have associated a shocking and hurtful childhood with the occurrence of BPD in individuals; however, such belief has not been accepted on empirical basis. (Zanarini, 2005) Moreover, stressful events during adolescence have also been connected with this illness. Furthermore, child abuse is one of the factors that are observed in more than a few studies related to BP disorder in humans. Individuals who have been abused physically, as well as, emotionally are more vulnerable to experience BPD in their lives, and thus, it is believed that child abuse plays a crucial role in the development of borderline personality disorder in individuals. In some families, opinions and thoughts of youth are not encouraged and denied by the elders, which also play an adverse role in their lives. In this regard, inadequate parental care is another major factor that results in the mental disorder of borderline personality. It is indicated by literature review that genes also play a vital role in the development of BPD in individuals. Still, there is a lot of confusion in practical issues of such relation of genes; however, some of the cases have indicated that if personality is heritable, then individuals can also get BPD from genes. (Freeman, 2003) Differential Diagnosis It is observed that disorders related to mood swings, such as bipolar disorders are appeared simultaneously with the occurrence of borderline personality disorder. In this regard, mental health professionals confront difficulties in diagnosing the patients due to overlapping of characteristics of BPD with other disorders. ‘Mood swings’ is the common term that is referred by clinicians to refer symptoms of both disorders during differential diagnosis. However, emotional irregularity is considered in BPD, which results due to different external psychosocial factors. (Gunderson, 2001) On the other hand, sleep and eating disorders have been related to bipolar disorder, which is also related to frequent mood swings in humans. Still, clinicians have not acquired a concrete explanation to the debate of differential diagnosis, and thus, it is still a continuous process in medical science. Treatment Psychotherapy Traditionally, psychological treatment of BPD has confronted a lot of disbelief due to lack of empirical and concrete knowledge; however, research in recent years has developed different psychotherapies that are applied for the treatment of borderline personality disorder in humans. In other words, psychiatrists cannot claim the most efficient treatment for BPD; however, such therapies may help the individuals in overcoming the problems related to it. It is observed that self-esteem and self-confidence of individuals are enhanced effectively by simple supportive therapy. (Zanarini, 2005) Dialectical Behavioral Therapy In the past, patients having suicidal behavior were intervened by dialectical behavioral therapy, which was then termed as a psychosocial treatment for borderline personality disorder. In such therapy, individual and therapist go through negotiations and exchange of ideas with the help of cognitive-behavioral strategies. A combination of rational and emotional dialogues is emphasized during such therapy by the clinicians, and experts try to convince clients to accept the unaccepted change, which may help in resolving the BPD related problems. (Freeman, 2003) Moreover, emotional irregularity of BPD is considered as a biological disorder in this therapy, which helps in better understand of social environment of the patient. It is indicated by statistics that cases of suicidal behavior and self-destructions have reduced significantly by the application of dialectical behavioral therapy. Until now, the paper has defined, discussed, analyzed, and assessed the borderline personality disorder in light of empirical data and literature research available. Now the paper will discuss similar aspects of another mental disorder, which is known as Dyspareunia. DYSPAREUNIA Introduction & Diagnosis A number of medical and psychological factors result in a painful sexual intercourse, which is termed as Dyspareunia in medical terminology based on the psychiatric analysis as per DSM-IV Personality Disorders 625.0, (American Psychiatric Association, 2000) which is the diagnosis code of this disorder. (Carey, 2001) Until recently, this disorder was considered for women exclusively; however, recent research has indicated that men also confront similar problems during their sexual intercourse. An interesting factor of such disorder is that even the cause of pain is removed by the treatment; individuals continue experiencing the Dyspareunia disorder, which is the reason that experts have given preference to psychological factors, as compared with physical causes of the disorder. It is indicated by experts that a physical cause results in the development of such mental illness; however, individuals continue feeling the pain even after a physical treatment, which then requires a psychological diagnosis for the patients. In specific, frequent genital pain is experienced by patients during, as well as, after the sexual intercourse, which is one of the foremost criteria for the diagnosis of Dyspareunia according to the Diagnostic and Statistical Manual of Mental Disorders provided by the American Psychiatric Association. (Collins, 2008) Moreover, it is essential that lack of usage of lubrication during the sexual intercourse should not be the exclusive cause of such pain, in order to qualify for diagnosis of dyspareunia. Clinically, experts confront a number of difficulties during the separation of vaginismus and dyspareunia, as the dyspareunia disorder often accompanies vaginismus with it, which makes it very difficult for clinicians to treat the disorders effectively. Furthermore, it is imperative that period of dyspareunia should be identified by the experts, as it may be situational, as well as, permanent, and thus, may require different diagnosis. Additionally, recent research has indicated that further inquiries should be carried out for the determination of cause of the pain, being physical or emotional, as it will decide the nature of treatment for the patient. In some cases, vaginal outlet is the primary location causing pain; whereas, some individuals feel intense pain due to thrust against the cervix. In other words, physical causes of pain can also be superficial, as well as, deep, and should be determined adequately during the diagnosis. Symptoms It is observed by analysis that pleasure and excitement is not felt by women due to distraction of dyspareunia through pain. In the result, reduction in excitement results in the reduction of vaginal dilation, as well as, vaginal lubrication that increases the intensity of pain during the sexual intercourse. In other words, phallus’ thrust may be very painful due to dry vagina. (Leiblum, 2006) It is indicated that seventy percent of women continue feeling the pain even after the physical cause of pain is removed through healing or any other treatment. This is the major reason that dyspareunia is considered as a psychological and mental disorder, rather than a physical order exclusively. Causes and Gender Features A number of studies have indicated different causes of dyspareunia, such as dryness of vagina known as xerosis, different infections, such as trichomoniasis, candidiasis, etc. It is observed that shrinking of introitus makes the process of usual penetration difficult, which results in the genital mutilation of female body, and thus, dyspareunia is experienced. A number of physical conditions may result in the feeling of pain during the sexual intercourse, which is the reason of complexity in the determination of actual causes during the physical examination. (Carey, 2001) In this regard, detailed analysis of medical history of a patient can play a vital role in the contribution of treatment for the disorder. Women often experience pain due to vaginal infections in cervix, urinary tract, surgical scar tissue, etc. which cause physical pain during the intercourse. In addition, severe dyspareunia can be experienced by women going through a radiation therapy. A number of different factors can be causing dyspareunia, and thus, clinicians should determine the causes adequately, as a single mistake may result in the reversible outcomes. Recent research has indicated that a disease, Interstitial Cystitis is caused by the development of dyspareunia in the body, and experts now considered dyspareunia as one of the symptoms for such disease. In this disease, bladder pain is experienced during, as well as, after sexual intercourse by the patients. In specific, moment of ejaculation is the particular time for the occurrence of pain in men, which is experienced at the tip of the penis. (Leiblum, 2006) In addition, occurrence of small tears can be observed after the energetic intercourse, as well as, masturbation, which may result in extreme pain in men. On the other hand, pelvic floor muscles are thrust during the sexual intercourse, which results in the occurrence of pain the following day of sexual intercourse in women. Differential Diagnosis Pain during and after sexual intercourse has been categorized into three classes, vulvar, vaginal, and combination of vulvar and vaginal pains. Moreover, a number of subtypes of dyspareunia have been indicated by evidence from research, such as premenopausal dyspareunia, which is related with the menopause in women. Another subtype of dyspareunia is deep dyspareunia, which has been associated with gynecological factors related to ovarian cysts, pelvic bonds, etc. (Collins, 2008) In addition, premenopausal women are affected by dyspareunia most commonly by the Vulvar Vestibulitis Syndrome, which is one of the most common subtypes of dyspareunia. In such subtype, a cotton-swab test is carried out for the diagnosis of dyspareunia after several complaints of pain. Moreover, viral infection can be excluded by carrying out laboratory tests in case of dyspareunia. Finally, dyspareunia is worsened by a number of psychological factors, as sexual desire is reduced due to intense pain during and after the sexual intercourse. Thus, relationship problems are developed that creates frustration and depression among the partners. (Collins, 2008) Treatment Now the paper will analyze some of the steps that are carried out during the treatment of dyspareunia. It is very imperative that medical history of the patient should be carefully studied, in order to determine any event related to the occurrence of pain in genital organs of the body. During the treatment, pelvic is examined in detail by the clinicians for the identification of a specific place that is causing pelvic pain. (American Psychiatric Association, 2000) During this process, it is very significant that clinician should discuss everything with the patient, in order to avoid any adverse psychological outcomes of the treatment, and cause of the pain should be explained to the patient, as it is very important that the patient should be comfortable during the treatment, which will facilitate in effective treatment of dyspareunia. A number of options are available in medical science that can be applied for the removal of physical source of pain, and adequate option should be chosen to remove the source in human body. (Leiblum, 2006) It is encouraged that sexual lubricants should be used in large amounts during the sexual intercourse by individuals experiencing dyspareunia. However, clinicians discourage the utilization of petroleum jelly during the intercourse, which is considered hazardous for patients of dyspareunia. It is instructed during the treatment that insertion control should be taken by the receiving partner, rather than the giving partner, which may help in control of pain during the intercourse. (Leiblum, 2006) Clinicians also recommend frequent changes in coital positions during the sexual intercourse, which may help in the reduction of dyspareunia. CONCLUSION Conclusively, the paper has discussed, analyzed, and assessed the borderline personality disorder and dyspareunia disorder in a Psychodiagnostic manner. Both disorders have been associated with physical factors; however, psychological factors play a vital and crucial in the development, as well as, reduction of such disorders in the human body. A number of researches have been carried out to identify the actual causes and factors of such disorders; however, further research will help in better diagnosis of mental illnesses. Lastly, it is hoped that the paper will beneficial for students, teachers, and experts in better understanding of the topic. References American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Publishing. Arthur Freeman. (2003). Borderline Personality Disorder. Norton. John G. Gunderson. (2001). Borderline Personality Disorder. American Psychiatric Press. Mary C. Zanarini. (2005). Borderline Personality Disorder. Taylor & Francis. Michael P. Carey. (2001). Sexual Dysfunction. Guilford Press. R. Douglas Collins. (2008). Differential Diagnosis in Primary Care. Lippincott Williams & Wilkins. Sandra R. Leiblum. (2006). Principles and Practices of Sex Therapy. Guilford Press. Total Words: 2582 Words Checked by Copyscape.com & Turnitin.com Read More