Discussion: Analyzing Diagnostic CriteriaMarriage, couple, and family helping professionals work from a systemic vantage point—they view issues and change as relational. That being said, they must be familiar with the diagnostic criteria of the DSM-5 in order to work within the field of mental health care at large.
The DSM-5, of course, is individual rather than systemic in focus, and therefore it is wise for marriage, couple, and family helping professionals to view diagnostic criteria through a critical lens. Many of the disorders also are not based on clear, clinical cut-off criteria, and they require informed clinical judgment in order to be applied appropriately.Note also that helping professionals should consider intersections of physical, mental health, and relationship considerations as they relate to sexual dysfunctions, compulsions, and addictions.
For example, a physical examination by a qualified healthcare professional is typically warranted prior to making a diagnosis of a sexual dysfunction in order to rule out any physical causes for the symptoms.Analyze the diagnostic criteria of major sexual dysfunctions and disorders in the DSM-5.
Review the case study below and reflect on which DSM-5 sexual dysfunction/disorder might be the most reflective of the client’s symptoms. Then consider a counterargument as to why this dysfunction/disorder might not be appropriate for this client.Susan, age 34, is a married mother of two preschool-age children (ages 4 and 2). Her husband, Steve, age 35, works full time, and Susan works part time on the weekends but primarily is a stay-at-home mother to her children.The couple sought couples counseling, and their primary presenting concern was that Susan has not had any interest in sex with Steve for the past year.
The couple reports that they have had intercourse about three times in the past year (“always at Steve’s initiation”); they rarely display physical affection toward one another; and they fought frequently about their lack of sex for about the first 6 months of the past year, but lately they have not fought often about the issue.The partners indicate that, up until a year ago, Susan was very interested in sex, and they had sex approximately three times per week throughout their marriage (aside from immediately following the birth of their children). Susan states that she can’t pinpoint any particular reason for her lack of interest in sex and says, “Really, I just don’t want it anymore.
I’m not sure if I ever will again.” Steve says that he is very frustrated but doesn’t want to fight about it. He says, “I just want my wife back.”By Day 4Post by Day 4 identifying a DSM-5 sexual dysfunction disorder that might reflect Susan’s symptoms. Research the literature to further understand Susan and Steve’s situation. What biopsychosocial factors may be affecting the sexual aspects of the couple’s relationship?
By Day 6Read a selection of your colleagues’ postings and comment on a differing perspective.Respond by Day 6 to at least two of your colleagues’ postings, offering and support an opinion gained from your reading. Colleague: Maureen Epps RE: Discussion – Week 9COLLAPSESusan has been experiencing a low sexual drive during the past year. Susan low sexual drive led to the absence of sex in her marriage.
The couple did report having sexual intercourse three times within the past year. There is rarely physical affection between the two. The first six months included arguments about sex. A year ago, the couples sex life included sex three times a week aside from the birth of her children. The closest disorder that may resemble Susan sexual dysfunction according to the DSM-5 is 302.72 Female Sexual Interest/Arousal Disorder (F52.22) (American Psychiatric Association, 2013). Because there was no mention of ruling out of medical conditions this diagnosis would be the closest. According to the DSM-V Susan must meet a minimum of diagnostic criteria listed in section A.
The first indicator Susan meets is the absent/reduced interest in sexual activity (American Psychiatric Association, 2013). The second indicator that Susan meets is absent/reduced sexual/erotic thoughts or fantasies (American Psychiatric Association, 2013). The third indicator Susan meets no/reduced initiation of sexual activity, and typically unreceptive to a partner’s attempts to initiate (American Psychiatric Association, 2013).Justification of Diagnosis Acquired:
The disturbance began after a period of relatively normal sexual function (American Psychiatric Association, 2013).Generalized: Not limited to certain types of stimulation, situations, or partners (American Psychiatric Association, 2013).Mild: Evidence of mild distress over the symptoms in criterion A (American Psychiatric Association, 2013).Biopsychosocial FactorsOne of the biopsychosocial factors that may be affecting her sexual dysfunction is the dynamics of her current relationship in which sex is a stressor. Another biopsychosocial factor could be receiving support from her husband.
The adjustment of having two kids and being home all day is a possible factor for Susan sexual dysfunction. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental disorders (5th ed.). American Psychiatric Association. Colleague 2: Stephanie Bailey RE: Discussion – Week 9Week 9 Discussion: Analyzing Diagnostic Criteria Susan and her husband have sought out counseling due to concerns with Susan’s sexual interest with her husband. After reviewing Susan’s case, I would point to a diagnosis of Female Sexual Interest/Arousal Disorder 302.72 (APA, 2013). Susan has an absence in the interest of sexual activity, sexual thoughts and no longer initiates sexual activity that fits diagnostic criteria A (APA, 2013). Susan fits diagnostic criteria B as well;
the duration of these feelings has lasted more than the minimum six months (APA, 2013). Susan’s lack of desire for sexual intimacy with her husband has caused significant marital issues, which fits Diagnostic criteria C of clinically significant distress within the individual, which applies to the relationship issues and fighting (APA, 2013).
There are no known factors of intimate partner violence, mental problems, or substance or medication abuse that would otherwise cause the issue leading to Criteria D being met as well within the diagnosis (APA, 2013). At the point described in the case study, it presents a moderate, generalized, and acquired disorder that has exhibited itself after a previous time of normal sexual function, that is not limited to certain types of situations or stimulation that is evidence of moderate distress to symptoms of Criteria A (APA, 2013).
Women may experience sexual issues after having a baby. When Susan’s sexual interest changed, her second child was one, which means she recently had her and combined with the responsibilities and demands of having two children could have created a new stressor. Susan should be recommended to be evaluated by her doctor for any unknown illnesses such as diabetes or infections that may have developed or medicines she may have started taking around the time of her mood change.
Certain medications and illnesses can decrease sexual desire and the ability to orgasm (Mayo Clinic, 2020). In this case, sexual and medical history should be discussed, blood tests are done, and Susan needs to receive a pelvic exam to determine any possible underlying causes (Mayo Clinic, 2020). Other things can be assessed in the couple’s environment, such as alcohol use and any declines in Susan’s physical activity.
Physical activity is known to increase stamina and elevates moods which could improve or enhance Susan’s romantic and sexual feelings (Thomas & Gurevich, 2021). Some women, after giving birth, experience significant changes in their bodies, and Susan may not be happy with her body image after having her second child, which results in her considering herself not desirable in intimacy (Thomas & Gurevich, 2021).
These are some of the biopsychosocial factors that could be evaluated in assessment to create the appropriate intervention for the couple’s case.ReferencesAPA. (2013). Diagnostic and statistical manual of mental disorders, 5th edition: Dsm-5 (5th ed.). American Psychiatric Publishing.Mayo Clinic. (2020). Female sexual dysfunction. https://www.mayoclinic.org/diseases-conditions/female-sexual-dysfunction/symptoms-causes/syc-20372549?p=1Thomas, E. J., & Gurevich, M. (2021). Difference or Dysfunction?: Deconstructing Desire in the DSM-5 Diagnosis of Female Sexual Interest/Arousal Disorder. Feminism & Psychology, 31(1), 81–98. https://doi.org/10.1177/0959353521989536
