The DSM-5 Process of Diagnosis
The DSM-5 process of diagnosis involves series of critical steps aimed at creating a comprehensive formulation and medical care plan. According to the American Psychiatric Association (2013), DSM-5 ensures that clinicians from any part of the world establish a consistent and sound diagnosis useful in the exploration of mental disorders. DSM-5 often carries with it a clear description, signs and criteria for pinpointing a mental disorder. However, DSM-5 usually does not contain the treatment guidelines (Frances, 2013). Described in this paper is a detailed analysis of the case study on the vignettes of the three clients, Alex, Maggie and Phil. They had been presented by their next of kins to the clinicians for evaluation after they developed unusual behaviour. According to the clinician, each of their clients had the disorders described below.
Alex's Neurodevelopment Disorder
Alex exhibited symptoms and reactions that were in accordant with the DSM-5 diagnosis of neurodevelopment disorder. According to the descriptions of his behaviours and how he reacts, Alex made at least four required criteria for the diagnosis of neurodevelopment disorder. First, according to Nolen-Hoeksema and Rector (2015), children suffering from the neurodevelopment disorder are often distractive. According to his father’s report, Alex was often distractive and was frequently in trouble at school. Secondly, according to Frances (2013), children suffering from neurodevelopment disorder are often impulsive and find it difficult to control their tempers. Alex was very impulsive and unable to control his temper. His father reports that Alex often engages in a physical fight with other kids whenever he got mocked. Thirdly, according to Andrews et al. (2009), children exhibiting neurodevelopment disorder often find it difficult to keep up in school. In this case, Alex could not complete his homework at all, a situation which led to a drastic drop in his academic performance. Finally, children suffering from neurodevelopment disorder often have poor problem-solving skills (Nolen-Hoeksema & Rector, 2015). Alex could resort to fighting instead of seeking the appropriate channel for solving issues that often arise when his friends tease him. Such cases brought many problems rather than solutions to his life. Also, Alex could shoplift whatever he wants, for example, DVDs and iPod, instead of requesting his parents to get it for him. Such cases also brought problems to him and their family. Therefore, one can note that Alex could be diagnosed with neurodevelopment disorder since he had the minimum criteria for such diagnosis. Alex also had impairments similar to those of a hyperactive disorder. For example, Alex could overreact by engaging in a fight with other kids whenever he is teased. However, Alex could not be diagnosed with this disorder since he does not meet the required criteria for such diagnosis. Therefore, it is evident that Alex could be suffering from neurodevelopment disorder only since he does not meet the criteria for the diagnosis of the hyperactive disorder.
Maggie's Depressive Psychotic Disorder
Similarly, according to DSM-5, Maggie would probably meet the criteria for the depressive disorder, which could either be a psychotic, postpartum or Bipolar disorder. In her case, she had several required impairments to justify so. According to Ketter (2010), most people suffering from psychotic disorders often have several cases of depression without psychosis. In our case, Maggie had had several instances of depression without psychosis. Examples of such circumstances include the death of her mother and the fact that she could not communicate well with her siblings until her mother’s funeral when they reconnected for once fifteen years ago. Secondly, according to Green et al. (2010), people suffering from psychotic disorder often have feelings of hopelessness. Maggie had been hopeless and pessimistic for long since her husband had been alcoholic and very violent and had passed on three years ago. Reports from her daughter, Peg, indicate that she had been depressed and had to depend on the anti-depression bill to relieve her. Finally, Maggie often had auditory hallucinations, i.e. perceiving that things that do not exist do exist. Therefore, it is clear that Maggie had all the required criteria for the diagnosis of a psychotic disorder. Maggie, however, cannot meet the required impairments for the diagnosis of postpartum and bipolar disorders. That could not happen because Maggie was too old for postpartum disorders which usually affect young mothers, especially those who just gave birth. Additionally, Maggie failed to meet the criteria required for bipolar disorder since her depression was too prevalent; hence contradicting with Greens et al. (2010) argument that bipolar is not always too frequent. Therefore, it is evident that Maggie had a depressive psychotic disorder.
Phil's Avoidant Personality Disorder
Finally, Phil, our third client could be diagnosed with avoidant personality disorder. According to the description of his recent behaviours and how he reacts to things, Phil exhibits at least four of the required impairments for an avoidant personality trait. First, people suffering from avoidant personality disorder often avoid professional activities involving interpersonal contacts due to fears of disapproval (American Psychiatric Association, 2013). He prefers completing his task independently and could not coordinate other workers while he was an assistant manager. Thus, DSM-5 affirms that a person suffering from avoidant personality traits often limits their educational opportunities. Secondly, such people also often feel uneasy with new interpersonal circumstances (Ketter, 2010). Phil is stressed and hopeless since he lost his job and the fact that his wife had left him. The third criterion often asserts that people suffering from avoidant personality disorder show repress with intimate relationships (Hebert, 2007). They believe that if others know them entirely, then definitely, they will be criticized. In this case, Phil does little to manage other workers for fear of revealing his true self. Also, Phil would dare clean up the kitchen in case he founds it too messy. The fourth criterion that is typically exhibited by people suffering from avoidance personality trait is their unwillingness to interact with people unless they are assured of acceptance (Andrews et al., 2009). Most often, they tend to think that if they get along with them, they will be disapproved. In this case, Phil, after his wife left him a year ago, has not attempted to get her back. Phil feels that his wife will disapprove him if he tries. Therefore, it is evident that Phil had avoidance personality traits. Despite this, Phil seems sensible and reasonable. Phil knew that he had a problem and thus presented himself for evaluation. Additionally, he is humorless and sensitive to setbacks. The two are the impairments associated with delusion disorder. However, Phil could not be diagnosed with it because he does not meet the minimum criteria required for him to be diagnosed with that delusion disorder. Therefore, it is evident that Phil had an avoidant personality disorder.
Treatment of DSM-5 Disorders
In conclusion, the primary objective of treatment for people with DSM-5 disorders is to make them realize their full potential (Nolen-Hoeksema & Rector, 2015 ). Several considerations, such as the patient’s age, general health, patient’s medical history, and even family preferences, are taken into account before any treatment commences. Also, the type of disorder that one has determines their mode of treatment. According to Moffitt et al. (2015), supportive services are the most recommended ways in which Alex and any other person suffering from a neurodevelopment disorder can be treated. Such supportive services include parental counseling, family therapy, and even behavioral intervention. In their article, “Is Adult ADHD a Childhood-Onset Neurodevelopmental Disorder?” published in 2015, Moffit et al. affirm that the most significant tragedy occurs when a child’s parents are not trained to support the requirements of their children as most of them will then tend to overprotect them. Secondly, family therapy is recommended since it addresses issues that some of the family members may not dare to express, for example, low self-esteem and helplessness. As a psychological professional, one should make sure that every family is informed about the importance of addressing issues about them in their home settings (Moffit et al., 2015). Additionally, a psychological professional should ensure that parents are well trained to deal with the needs of their children. From these studies, it is evident that several disorders affect the standard health potential of any individual. Such disorders often go unnoticed while others, for example, neurodevelopment disorder explained above; have had severe impairments that make it difficult to go unnoticed.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Andrews, G., Goldberg, D. P., Krueger, R. F., Carpenter, W. T., Hyman, S. E., Sachdev, P., " Pine, D. S. (2009). Exploring the feasibility of a meta-structure for DSM-V and ICD-11: could it improve utility and validity?: Paper 1 of 7 of the thematic section:‘A proposal for a meta-structure for DSM-V and ICD-11’. Psychological medicine, 39(12), 1993-2000.
Ketter, T. A. (2010). Diagnostic features, prevalence, and impact of bipolar disorder. J Clin Psychiatry, 71(6), e14.
Frances, A. (2013). Saving normal: An insider's revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma and the medicalization of ordinary life. Psychotherapy in Australia, 19(3), 14.
Green, J. G., McLaughlin, K. A., Berglund, P. A., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., " Kessler, R. C. (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Archives of general psychiatry, 67(2), 113-123.
Herbert, J. D. (2007). Avoidant personality disorder.
Moffitt, T. E., Houts, R., Asherson, P., Belsky, D. W., Corcoran, D. L., Hammerle, M., ... " Poulton, R. (2015). Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study. American Journal of Psychiatry, 172(10), 967-977.
Nolen-Hoeksema, S., " Rector, N. A. (2015). Abnormal psychology. Boston: McGraw-Hill.
