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Learning about DSM-IV TR Multiaxial System - Case Study Example

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Summary
The author examines the case of Rodrigo Mendoza with five psychiatric disorders and proposes that Rodrigo undergo behavioral and cognitive therapies to monitor his progress. Also, he should attend one on one psychotherapy so that the therapist may involve him directly in his monitoring.   …
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Learning about DSM-IV TR Multiaxial System
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The Mission First Last 20/11 The Mission I. Introduction Rodrigo Mendoza is a servant investor and a mercenary who generates an income by kidnapping the native individuals like the Guaranis and selling them off them to farm owners in close by farms. However, he is portrayed as gentle when he has love for his sibling and fiancée. Nevertheless, when his sibling develops a liking for his girlfriend and he discovers them in bed, he executes him by stabbing him out of anger. Due to this occurrence, he is affected with strong shame over his activity and then suffers great depressive disorders. Following his shame, he looks for to be pardoned by the Jesuit missionaries and yearns for them to create his reparation comparative to his evaluate of shame. Therefore he tells them that they should not make his penalty a light one. Father Gabriel takes Mendoza’s arsenal and has them linked in a satchel. He then connects the satchel across Mendoza’s hips. Though thoughtful, he delivers Mendoza to go up the Iguazu drops over and over again. Mendoza, bitter but extremely proud, refuses to take support and continues with the climbing of the drops. He lastly breaks and yowls out to God. One of the monks makes an effort to launch him from the struggling by untying the satchel from his hips so that he gets released from his penance. Mendoza however, reties the satchel. He states that he does not search for absolution from the clergyman but rather from the tribe. On this event, one group participant comes and reduces the satchel. He gets released from his penance. To indicate the tribe’s absolution, the shield gets tossed to the drops. Mendoza continues to create vows of chastity, hardship and behavior. He then becomes a Jesuit and gets approved by the same Indians he used to kidnap. II. Background Information Rodrigo Mendoza is first brought forth as a retched and ruthless man who oppresses the natives in a land where he himself is but a visitor. He kidnaps the natives and sells them to other rich retched farmers without any regard to the natives’ future or even to how the relatives of the kidnapped native will cope. He therefore gives out a negative aurora and causes great unrest to the native tribe. We learn that Rodrigo has a brother by the name Felipe Mendoza and a fiancée called Carlotta. Rodrigo Mendoza shows a complete reverse of the previous personality depicted earlier. He shows great love and concern for the two. This is a complete flip of his attitude towards the rest of the tribe. These two additional individuals are included in order to compare the two that Rodrigo Mendoza shows. As much as he is a monster to the rest of the tribe, the two individuals make a certain character present itself therefore showing his softer side. The two individuals are again introduced as they are the individuals that will cause the conflict of the plot be unleashed. The whole plot is dependent on these two characters transgressing and therefore disrespecting Rodrigo Mendoza. When the two disrespect Rodrigo Mendoza, he falls to deep depression therefore showing yet another personality for Rodrigo Mendoza. After killing his brother, Rodrigo Mendoza is befallen with deep remorse, regret and shame. This shows that he feels something after a bad deed contrary to what he shows with the native tribe when he terrorizes them with no regard to their feelings. It is therefore evident that the two additional individuals Felipe Mendoza and Carlotta are key characters in the development of this plot. III. Five-Axis Diagnosis • A five-axis diagnosis using the DSM-IV-TR The DSM-IV multiaxial system organizes each psychiatric diagnosis into five dimensions. Each dimension or axes relates to different aspects of disability or disorder. Axis I includes all the diagnostic classes excluding personality disorder and mental retardation. The disorders present are such as obsessive compulsive disorder, panic disorders, social phobia, generalized anxiety disorder and posttraumatic stress disorder. Rodrigo Mendoza suffered a high level of posttraumatic stress disorder when he kills his brother. He goes in to deep depression and hates himself for his action. Axis ii includes mental retardation and personality disorders. Developmental disorders are no longer included here. Disorders present are such as Borderline personality disorder, Dependent Personality disorder, Histrionic personality disorder and obsessive compulsive personality disorder. Rodrigo Mendoza appears to suffer from obsessive compulsive personality disorder when he terrorizes the native tribe. Obsessive compulsive personality disorder is characterized by individuals showing a pervasive pattern of disturbed thoughts and behaviors. This will be evident when they experience such of being significantly preoccupied with having control and order under their jurisdiction. Rodrigo Mendoza also shows signs of Histrionic personality disorder which is a condition in which people act in a very emotional and dramatic way that draws attention to them. When he kills his brother, he takes extreme consequences which obviously draws attention to himself. Axis iii includes physical disorders and general and acute medical conditions. The disorders found are such as MVP (Mitral Valve Prolapse) and Hyperthyroidism. Rodrigo Mendoza does not show signs of either Axis IV includes environmental and psychosocial factors that contribute to the disorder. They indicate the factors that contribute to, or affect, the current psychiatric disorder and treatment outcomes. They will include: 1. Legal problems 2. Social issues 3. Lack of an adequate support system 4. Financial difficulties 5. Problems with work 6. Financial difficulties 7. Educational problems 8. Other psychosocial and environmental problems Axis V is for the GAF or global assessment functioning. This is a 100-point range that the mental medical expert uses to explain the persons overall level of performance in regular activities and social, work-related, educational and cultural performance. IV. Risk and Resilience Factors: • An explanation of your client’s risk and resilience factors. Some of the supple aspects that Mendoza showed consisted of the following. A powerful and helpful atmosphere, especially through the unbiased and selfless objective where he was accepted by Father Gabriel. This assisted him a lot in knowing his acceptability in the group. Having signed up with that objective, he got engaged with the cathedral group in battling against the administrative concept. This participation also assisted him get a feeling of participation to the matters of the group in a significant way. Then, having powerful public abilities like assurance, he was able to find his floor back after the situation. Self-esteem was another strength aspect which assisted to be able to maintain self-worth despite having been engaged in a killing and getting into depressive disorders. Other resilience factors shown were: 1. Supportive people around them 2. Thinking in a positive, optimistic way 3. Having good problem solving skills Risk factors Depression symptoms have been known to happen between teenager time and the 30s. However, it has been mentioned to happen at any age. Females are more susceptible to depression than men. However, part of the reason for the great statistical levels for ladies is their great likelihood to search for treatment for depression. Though the accurate cause of depression is not known, certain aspects have been incriminated to particularly lead to the incident of depression. These include traumatic encounters in child years, the female gender, genealogy of depression, traumatic circumstances like hereditary family members, a small social pattern and other personal connections, latest delivery, past record of depression, having a serious medical problem like melanoma, heart disease, diabetic issues, and HIV. In addition, particular character like low self-respect or negativity and medication use may predispose a personal to having depression. When a personal takes medicines such as for hypertension and sleep aids, there may be depressive adverse reactions. V. Psychosocial and Family Issues The major cause of depression for Mendoza was certainly family and psychosocial issues. When he realized that his brother was having a relationship with his wife, he was overwhelmed with rage and slain him. Realizing that he had killed his kin, he broke down. This was a great family issue which, according to him was unforgivable. He sought for refuge in the church, and was accepted. Slave trade is an immoral act, and this played a great role in causing his guilt. Mendoza realized that he had been wrong in his trade, and had dehumanized several people when he kidnapped and sold them as slaves. His realization of the offenses he had committed in the society caused him to have deep guilt, which caused an emotional imbalance. However these emotions had not been previously exploited and were brought to light only after he killed his brother. After realization of the harm he had caused, his humanity was touched and prompted him to seek forgiveness for the inhumane acts he had done to the native tribe. VI. Career and Vocation For Rodrigo Mendoza, the only source of income he had was from the sale of slaves to other farmers. This was an inhumane act. He took away natives from their families and sold them off as slaves. Other than making him money, this also fed his ego and his want to have control and order in his hands. He only realizes how wrong he was in doing that after he loses his brother and assumes that that is the same feeling that the other natives had when he took away their loved ones. VII. Legal and Ethical Issues Slave trade is an illegal business venture where perpetrators through hostile means capture victims and subject them to a life and system of servitude. Mostly the victims are peasants that have to work hard to appease their masters. Rodrigo Mendoza was involved in the capturing of these peasants who mostly were the poor natives who seeded solace in where they lived and were dependent on what they grew. This is a serious offense that is punishable by law. It is also an inhumane business as is evident when Rodrigo Mendoza realizes what he was doing to them and tries to seek forgiveness. Another legal issue that Rodrigo Mendoza faced was murder. He had killed his brother in rage when he found him sleeping with his fiancée. This is a major offence that is also punishable by law and according to him is also unforgivable. He goes to great lengths in an effort to redeem himself. VIII. Continued Assessment A continued assessment is very important for Rodrigo Mendoza because he had such a change in his personality after facing such horrific events as losing his brother. Before the big change, Rodrigo Mendoza was a big shot in the tribe, negatively. Everybody feared him and he had a lot of command to the people. However now that he changed his personality people are not afraid of him anymore and he might see this as dis-respective. Continued assessment is important in order to make sure he does not go back to his old ways. IX. Follow-up Recommendations for Treatment I would propose that Rodrigo Mendoza undergo behavioral and cognitive therapies to monitor his progress. Also he should attend one on one psychotherapy so that the therapist may involve him directly in his monitoring and also help him cope with the changes that he has undergone. References 1. Hersen, M., & Beidel, D. C. (Eds.). (2012). Adult psychopathology and diagnosis (6thed.). Hoboken, NJ: John Wiley & Sons. 2. American Psychiatric Association. (2000). Diagnostic and statistical manual of Mental disorders (4th ed., text rev.) (DSM-IV-TR). Washington, DC: Author. Read More
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