Diagnostic and Statistical Manual of Mental Disorders - Coursework Example

DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS By Location Diagnostic and Statistical Manual of MentalDisorders Diagnostic and statistical manual of mental disorders refers to the benchmark of mental disorder that is always used by professionals in the mental health field in the United States of America. These standards can be applied over a wide variety of contexts. The standards can also be used by medics and researchers of varying orientation. Diagnostic and statistical manual of mental disorders is usable by psychologists, nurses, psychiatrists, rehabilitation therapists, and social workers. There are a number of editions of this manual ranging from the first one to the fifth one. This paper aims at using the fourth version of the diagnostic and statistical manual of mental disorders (DSM IV) and its diagnostic processes to solve a psychotic disorder case study. The case at hand is about a psychotic patient by the name John. John has the tendency of always suspecting other people’s motives of doing things. He seems to always suspect the intentions of almost everything people around him do. He also tends to feel that he is being exploited. As a result of this he has not been particularly good at teamwork. John also weirdly enjoys his own company. As a result of this weird characteristic he always isolates himself from his environment. He is also the type of person who is always detached. However, the main reason as to why he is seeking professional help is because of his hostility. He claims that people had noticed his tendency of getting hostile, even with the harmless and thus he had been advised to seek professional help. There are various possible causes of these psychotic symptoms. In this case, Diagnostic and statistical manual of mental disorders is going to help in determining which of the possible psychotic problems John is suffering from. John lost both his parents at the age of nine through a fatal car accident. After the death of his parents, he lived in three foster homes before he finally started living by himself after getting his first job. During his time in high school and university, he had several friends, but none of the lasted for long. He has only involved himself in a romantic relationship once, but things did not work as he expected. He was involved with a girl by the name Lisa, who apparently was romantically involved with another person. As from that day he discovered this John has never been in any other romantic relationship. He has even avoided close involvement with people from the opposite gender. He also claims that there is nothing like close friendships. His reasoning is that most friendships are always based on needs from both sides. In case you are not able to be of any importance to people, then you will never have friends. He also claims that he does not believe in forgiveness and that everyone should always face the consequences of their actions. Diagnostic and Statistical Manual of Mental Disorders (DSM IV) uses categorical classification to diagnose the actual problem with psychotic patients. When a patient has symptoms under a certain category, then the actual problem can be easily determined. Each category is completely different from the others. For the symptoms to be eligible for use in this process, they must be severe enough to cause significant impairment or distress in occupational, social, or any other essential area of human functioning (American Psychiatric Association 2005, p. 128). The categories involved in the process are always referred to as an axis. Thus, this system of categorization is called the axis system. Each axis depict a different type of mental illness and the manner in which the mental illness in question can be controlled. The first axis usually consists of clinical, learning, and developmental disorders. Under this axis it is always important to check for symptoms such as anxiety, panic, shock, and phobia. In the absence of these symptoms, it is always obvious that the psychotic disorder that is being diagnosed does not fall under this category. Given the symptoms that were observed in John, it will be impossible to think that the mental disorder that he is suffering from falling under this category. Psychotic disorders that fall under this category include social phobia, panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. Most of the disorders that fall under this category usually require immediate attention (First & Tasman 2011, p. 107). Having not been able to find the psychotic disorder that John is suffering from in the first axis, it will be wise to move on to the next axis. The second axis gives information on personality disorders. The axis always lists any personality disorder that might have influenced the results from the first axis (Pies 1994, p. 89). This axis also shows developmental disorders such as learning disabilities and retardation. The axis might also link some psychotic problems noticed in the patient from the first axis. For instance, a person with paranoid personality disorder or severe mental retardation can be more likely to show some symptoms under the first axis when they are experiencing major life stressors (Baker 1998, p. 54). This explains why even with some symptoms shown from the first axis it is still advisable for an individual to be diagnosed through the entire axis. Personality disorders always have something to do with distorted development of an individual’s personality. However, at some times these disorders are always results of a biological complication. Such circumstances are rare, though. The fact that personality disorders are a result of faulty personality development makes it even harder to treat because it spans all aspects of an individual’s life. This means that there is a high possibility that whatever John is ailing from is: histrionic personality disorder, avoidant personality disorder, paranoid personality disorder, borderline personality disorder, schizoid personality disorder, antisocial personality disorder, dependent personality disorder, narcissistic personality disorder, or obsessive-compulsive personality disorder (Chadwick 1997, p. 93). However, this does not mark the end of the diagnosis. In some occasions some medical influence patients to show some conditions that can be easily mistaken for the symptoms of certain psychotic disorders. For instance, a person suffering from severe asthma can have respiratory symptoms that can be easily mistaken for those for panic attack (Goldstein & Naglieri 2009, p. 119). This means that if such symptoms are just taken to be the case, then the patient will have undergone treatment for a psychotic disorder that they are not suffering from. This will mean that the real problem will not have been solved and can even lead to further complications. Luckily, for John’s case all the symptoms that were realized are purely psychotic. This means that there is no possibility of these symptoms arising from other medical conditions. The most commonly diagnosed conditions under this axis are Hyperthyroidism, and Mitral Valve HYPERLINK "http://heartdisease.about.com/cs/mvp/a/MVP.htm"Prolapse (MVP). When it comes to the fourth axis details of the patient’s past that might have led to their current situation are always looked into. The details that are often looked into include absence of a reliable support system, educational problems, financial difficulties, social issues, work related problems, legal problems, and others (Corynell 1996, p. 101). These problems are always characterized by incidents such as divorce, loss of loved ones, loss of job, accidents, and many others. The knowledge of such details may help in determining the actual psychotic problem and its cause. In John’s case there are a number of things that happened in his life in the past that could lead to possible psychotic disorders. Losing both parents at such a tender age can affect a person negatively. His psychotic problem might also have resulted from the experience he had at the foster homes. The fact that he had to live in three different foster homes shows that there must have been a problem in these foster homes, especially the first two foster homes. The problem might even have been with him. Consideration should also be made in the way has been relating to people around him. He barely had friends throughout his youth life and has only had one romantic relationship whip apparently did not have a happy ending. These events from his previous life can help in determining the root and cure of the psychotic disorder that he is suffering from. The fifth axis is commonly referred to as global assessment functioning. Global assessment functioning is a scale with 100 points that professionals in the psychotic field use to show the patient’s general level of performance in typical day-to-day activities. This includes academic, social, occupational, and interpersonal functioning (Bhugra 1996, p. 33). The higher the points on the scales, the better the performance of the patient. However, it has been noticed that there is no one who will be able to reach the 100 points on the scale. This is because it is always given to individuals with no signs of any problem. These points are also awarded to individuals with superiority in the way they function in several areas. Such people are hard to find and almost impossible to find among psychotic patients. A person of John’s calibre is definitely not going to earn such points from the diagnostic process. John’s case can be rated 48. The rating in between 41 and 50 is usually for patients who have shown serious symptoms. Someone can also be rated under this category if they have serious impairments in occupational, social or school functioning (Weiner & Craighead 2010, 157). John’s case can be termed as serious because of the way he has exhibited socials impairment. This is evident in the way he has been showing hostility and the way he isolates himself from his environment. Characteristics such as mistrust for people’s motive can also affect his occupational functioning. The fact that he is not good at teamwork might even further make his occupational functioning worse. These are the reasons as to why it will be correct to term John’s symptoms as serious ones. By the time a patient would have gone through the five axis, it will be easy to take some information gathered through each axis and come to a conclusion of the particular case. For instance, a psychotic professional can go through the result from each axis eliminating the most unlikely psychotic disorder. By doing this they will be able to remain only with the most realistic psychotic disorders. Going through to the last axis, professionals are able to come into conclusion on the disorder that the patient being handled is suffering from. Looking at the first axis the only symptom that can be seen in John is a phobia. John cab be said to be suffering from social phobia. This can be explained by the way he chooses to isolate himself from other people. However, John’s treatment cannot be based on this single symptom, because the other symptoms say otherwise. According to the second axis it can be noticed that whatever John is suffering from must be a personality disorder. Almost all the symptoms that he shows prove this. His hostility, the lack of trust for other people, and fear of being exploited all arise from a person’s personality. This helps in knowing that the disorder that John is suffering from is a personality one. Despite having a clue that the disorder that John is suffering from is personality related, it will be good to proceed to the other axis just to make sure that such a conclusion would not be faulty. Moving to the third axis one will notice that John does not have any medical condition that would have resulted in the symptoms that he is showing. However, from the fourth axis there are several events in John’s past that can be linked to his current psychotic problem. The grief he had for his parents, discomfort in foster homes, unstable friendships, and unsuccessful romantic relationships can all be linked to his current status. Looking at the symptom most of them are related to lack of trust and belief which can be clearly connected to the past events (Durand & Barlow 2010, p. 147). Looking at the symptoms and the possible causes it will be correct to conclude that John is suffering from Paranoid personality disorder. It is clearly evident that the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) is effective in diagnosing psychotic disorders. This is because of the categories that help in looking at the patients’ symptoms, possible causes, and possible misinterpretations. Looking at John’s case the manual was able to give a guidance that was able to lead to the proper diagnosis of John’s problem. This is a clear indication of its effectiveness. Bibliography American Psychiatric Association 2005, Diagnostic and statistical manual of mental disorders: DSM-IV-TR. American Psychiatric Association, Washington, DC. Baker, C.A 1998, ‘Cognitive processes in auditory hallucinations: attributional biases and metacognition’, PubMed. [25 February 2014]. Bhugra, D 1996, Psychiatry and religion, Routledge, London. Chadwick, P. K 1997, Schizophrenia: the positive perspecitve. Routledge, New York. Connell, A. M 2011, ‘Maternal depression and child psychopathology: a meta-analytic review’, Clinical child and family psychology review, vol 14, pp. 1-27. [25 February 2014]. Durand, V. M., & Barlow, D. H 2010, Essentials of abnormal psychology. Wadsworth/Cengage Learning, Australia. First, M. B., & Tasman, A 2011, Clinical Guide to the Diagnosis and Treatment of Mental Disorders. John Wiley & Sons, Hoboken. http://public.eblib.com/EBLPublic/PublicView.do?ptiID=819211 Goldstein, S., & Naglieri, J. A 2009, Assessing impairment: from theory to practice. Springer, New York. Pies, R. W 1994, Clinical manual of psychiatric diagnosis and treatment: a biopsychosocial approach. American Psychiatric Press, Inc, Washington, DC. Weiner, I. B., & Craighead, W. E 2010, The Corsini encyclopedia of psychology. Wiley, Hoboken, NJ. . Read More