How Mental Diagnosis Leads to Therapy - Research Paper Example

Jennifer C and the DSM-IV The DSM-IV is a book which contains information about mental disorders, such as their symptoms and other information, as well as suggestions for how they may be treated. Currently the DSM-IV Text Revision, which is the latest version, contains information on more than 300 different disorders, which are split into about eleven categories including several subcategories. The categories are: adjustment disorders, anxiety disorders, dissociative disorders, eating disorders, impulse-control disorders, mood disorders, personality disorders, psychotic disorders, sexual disorders (including gender identity, paraphilias, and sexual dysfunctions), sleep disorders (including dyssomnias and parasomnias), and somatoform disorders. In addition there are five “axes” used by the DSM-IV which can help to create a more specific diagnosis. Each axis provides information about a specific part of the disorder. Axis 1 provides a clinical term for the disorder. Axis 2 describes developmental problems. Axis 3 lists physical problems which may cause further problems for the disorder. Axis 4 lists “psychosocial” stress points which may make it worse. Finally, axis 5 suggests how well the person is functioning based on the other four axes. There are many benefits and some disadvantages of using the DSM-IV to arrive at a diagnosis for a patient. Two of the benefits are that it lists out in a clear, concise format the criteria for diagnosing a particular disorder and that it also lists other useful background information about that disorder, such as its prevalence or associated disorders, which may assist the clinician in diagnosing a patient when they are not experts on the . One disadvantage is that the advice and diagnoses the manual offers may not necessarily fit for members of diverse cultural groups, as explained by the introduction to the DSM-IV-TR (xxxiv). This is because some cultures act in ways which clinicians who are unfamiliar with those cultures might not expect, and this might cause them to mistakenly judge the person as having a particular disorder when they are actually healthy (xxxiv). In the case study, the problem that Jennifer C presents is that she has been unable to keep up with her schedule as a student, employee, and daughter. The study lists quite a few reasons why she might be having problems, and although she has several symptoms, there are three that seem most important in reaching a diagnosis of her specific disorder. The first of these is her feelings of guilt. The second symptom she shows is her lack of general interests. And the third symptom is Jennifer’s frequent crying spells. Based on these symptoms, the best diagnosis for Jennifer C would seem to be that she is having a major depressive episode, or DSM-IV code 296.3. As the DSM-IV says, this is a “period of at least two weeks during which there is either depressed mood or the loss of interest or pleasure” (349). Major depressive episodes are also common in people who have feelings of guilt like Jennifer describes, and can make it hard “to think, concentrate or make decisions” (350). This clearly fits what Jennifer is describing. An interesting fact about major depressive episodes is that in some cultures they might actually be explained in different terms, like calling them “nerves” or “imbalance” or “heart-broken,” and that some cultures may even experience things like “crawling sensations of worms or ants” which may be mistaken for hallucinations (353). One other possible diagnosis for Jennifer might be that she has a dysthymic disorder. This is similar to a major depressive disorder, but is longer-lasting. Some symptoms which are similar are the poor appetite, insomnia, low energy, and poor concentration, all of which must have been present for at least two years (380). Although both of these may be reached using the same symptoms, that is not really a problem with the DSM-IV, as the clinician will be the person who uses the book to come to an understanding of the patient based on other things the person says and does. Since the clinician is trained in understanding both the DSM-IV and people’s mental health, they are able to use the tool properly without relying on it too much to do their job for them. The treatment for this disorder would vary depending on the therapist. A psychoanalyst would probably focus on the different traumas that Jenny has experienced. For instance, her parents’ divorce and her sisters death might be seen to have created long-lasting negative feelings for her. To produce therapeutic change, the psychoanalyst might examine what he or she believes to be the unconscious reasoning these experiences have caused, and work with Jennifer to help her change this reasoning. They might have Jennifer talk out her problems over the course of many sessions, until she comes to terms with her past. Cognitive therapists, on the other hand, would focus on “maladaptive cognitions,” or negative thoughts, such as Jennifer’s feelings that she is not a good daughter, or that her breakup with Kevin and her poor performance in school are due to things that are wrong with her, and not external circumstances. Also, the fact that she feels it is her fault that her sister died. These cognitions would be regarded as what is causing Jennifer’s feelings of guilt and despair, and the therapist would attempt to change these thoughts by teaching Jennifer some techniques to try out and to get her to use them in daily life to make her thoughts more positive and so to bring her out of her depressive state. In a client-centered approach, the therapist would basically use a positive attitude of his or her own to show Jennifer C how to come to believe in these traits about herself. For instance, the therapist might show empathy to her unfortunate childhood events, or positive regard in highlighting Jennifer’s success in school despite all the negative things life has thrown at her. By doing this, Jennifer would come to realize that she does have positive aspects of her personality, and could grow from her depressed state into a more well-rounded, realistic person. Although each of the three therapies would no doubt show results, in my opinion the most effective to treat Jennifer’s depression is cognitive therapy. The reason for this is because of its focus on how to change any negative thoughts Jennifer has, and not necessarily on their root causes. I believe that while a focus on the negative causes of Jennifer’s problems might help her to come to terms with them in the long run, it might only make her feelings of guilt worse in the short term. However, helping Jennifer change the way she thinks would have both immediate and long-lasting results by helping her to think more positively about herself and surroundings. This treatment would also be the best one because it has the best chances of producing long-lasting results. Although Jennifer no doubt wants to recover immediately, her problems are not immediately life-threatening, so it seems that she would benefit more from a total cure than a quick, but short-term fix. If Jennifer feels like she is going to take her life, or that her life is in danger from her disorder, medication could be prescribed to accompany the therapy. However, ideally she would not have to take any, as any medication produces side effects, and these may have a bad effect on her mental state that outweighs the benefits provided by the drug. References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. Read More