Week 2 Discussion Response to Classmates

I NEED THIS 09/12/2020 BY 1PM

Please no plagiarism and make sure you are able to access all resources on your own before you bid. You need to have scholarly support for any claim of fact or recommendation regarding treatment. Grammar, Writing, and APA Format: I expect you to write professionally, which means APA format, complete sentences, proper paragraphs, and well-organized and well-documented presentation of ideas. Remember to use scholarly research from peer-reviewed articles that is current. Sources such as Wikipedia, Ask.com, PsychCentral, and similar sites are never acceptable. Each classmate’s document is attached so please respond separately.

Read your classmates' postings. Respond to your classmates' postings.

• Respond to all colleagues on how to incorporate culturally      sensitive practices into the diagnosis practice so that an individual or      population is not marginalized intentionally or unintentionally.

1. Classmate (N. Kim)

The process of development of the DSM system of diagnosis

The many different classification systems that were developed over the past 2000 years have differed in their relative emphasis on phenomenology, etiology, and course as defining features. The various classification systems were developed over the past 2000 years including numerous diagnostic categories. Work groups that generated a large number of papers, monographs, and journal articles were formed to create a research agenda for the fifth major revision of DSM (American psychiatric association, 2013). The APA first published DSM in 1844, and it functioned as a statistical classification of mental patients (American psychiatric association, 2013). DSM was operated as an element of the full U.S. census. APA formed the DSM 5 task force to begin revising the manual as well as 13 work groups focusing on various disorder areas, and the current DSM-5 offers guidelines for diagnoses that can inform treatment and management decisions.

The development of the DSM 5

It is somewhat surprising that homosexuality was considered as a mental illness, and was de classified as a mental illness in 1973. I have quite a few friends who are LGBT, and they seem to be just like the people who are heterosexual. The reasons that homosexuality was declassified were that many homosexuals are satisfied with their sexual orientation and demonstrate no generalized impairment (Toscano & Maynard, 2014). Moreover, it is quite surprising that DSM 5 includes an updated version of the Outline, an approach to assessment using the Cultural Formulation Interview (CFI) (American psychiatric association, 2013).

How the classification system of disorders in the DSM 5 has pathologized

The DSM can be treated as a living document, changing with clinical work. Gender dysphoria can be an example of DSM being influenced by societal critics. A major problem with pathologizing gender-atypicality is that there is a lack of consensus on gender appropriateness (Langer & Marint, 2004, p12). Anyone can struggle with the life stressors when formulating a new identity. It is important for counselors to find out if the client falls under criteria for a GD diagnosis and not suffering from an intersex condition, fetishism, somatoform disorder, or other disorder (Byne et al. 2012).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Byne, W., Bradley, S.J., Coleman, E., Eyler, A.E., Green, R., Menvielle, E.J., … Tompkins, D.A. (2012). Report of the American Psychiatric Association task force on treatment of gender identity disorder. Archives of Sexual Behavior, 41(4), 759–796. doi:10.1007/s10508-012-9975-x 

Langer, S.J., & Martin, J.I. (2004). How dresses can make you mentally ill: Examining gender identity disorder in children. Child & Adolescent Social Work Journal, 21(1), 5–23. doi:10.1023/B:CASW.0000012346.80025.f7

Marion E. Toscano & Elizabeth Maynard (2014) Understanding the Link: “Homosexuality,” Gender Identity, and the DSM, Journal of LGBT Issues in Counseling, 8:3, 248-263, DOI: 10.1080/15538605.2014.897296

2. Classmate (L. Shave)

Mental illness and associated symptoms have been prevalent for many years. In the 1800s, in the United States, professionals identified a need to begin to quantify and classify mental health disorders and to collect and to begin to interpret statistical information. As information was collected and observed in individuals who presented with mental health symptomology, categories of disorders based on symptomology, behavior, personality, and biological factors became classified and organized in a manner to create reliable diagnoses. This led to the development of the DSM-II. The DSM-III was developed and published in 1980 with adding more specific diagnostic criteria and developing a diagnostic system of five axes.  The five axes are as follows: Axis I provides the mental health diagnosis, Axis II provides the diagnosis as to personality disorders and mental retardation (intellectual disability,) Axis III provides any medical conditions that the individual may have that can affect their mental health disorder or impact the disorder, Axis IV produces specific environmental or psychosocial stressors that the individual is experiencing at the time of diagnosis and Axis V provides a number as to the individual’s level of functioning on the Global Assessment of Functioning for an adult, or from the Children’s Global Assessment of Functioning if the individual is a child.  The updated version of the DSM was developed to provide a more definitive diagnosis and substantiating the diagnostic criteria. The DSM-IV was published in 1994 after finding that the DSM-III demonstrated that some of the diagnostic information was not clear. This version of the DSM was developed with having mental health professionals and organizations review the literature and establish a firmer and more concrete basis to substantiate the changes. The DSM-5 was published in 2013 after many experts around the world created the manual based on evidenced-based findings to improve the ability to diagnose individuals and to facilitate treatment services in a variety of settings.

Based on the history of the development of the DSM and intermittent updates as to the information provided in this manual until the most recently published of the DSM-5, I learned that the complexity of providing accurate diagnostics to be quite a challenge. Even though there have been revisions, I believe that in the future, there will be continued revisions indicated due to the complexity of an individual,  the environment that surrounds the individual and the changes that continue to occur in this country and around the world. Based on multiple factors that are difficult to take into account at the time of the development of the DSM-5, since that time, and in the future, there are other issues or potential effects that have not been fully explored or researched. Some of these factors include cultural issues, biological and neurological factors, and unpredictable events that can arise and continue to impact others.

One example of how the classification system of mental disorders has pathologized individuals with mental health issues remains the stigma attached to mental illness. There have been improvements with educating the general public at a local level and throughout the country with the use of education, however, the stigma associated with mental disorders remains evident and remains a barrier for individuals seeking treatment, leading to feeling a sense of shame, and being focused on by others, whether it be family or individuals in the community. People seem to lack the insight that a mental health diagnosis is something that can be treated successfully and that a mental health diagnosis is not necessarily a life-long label that an individual possesses. When an individual has a mental health diagnosis, the illness is a part of the person and not the entire person. In addition, a mental health diagnosis can change over time and have a sense of fluidity.  

3. Classmate (T. Roberts)

Main Discussion Post

The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association [APA], 2013) is the most used text for researchers and clinicians. This book was finalized and published in 2013 with about 13 work groups that focused on various disorder areas. The DSM- 5 helps determine diagnoses for people who suffer from mental disorders. Determining an accurate diagnosis is the first step toward treating a client appropriately.  It provides a common language for clinicians to communicate about their patients and establishes consistent and reliable diagnoses that can be used in the research of mental disorders. The DSM-5 also provides a common language for researchers to study the criteria for potential future revisions and to aid in the development of medications and other interventions (APA, 2013).

One thing that surprised me when it comes to the development of the DSM-5 is how many different revisions it has gone through throughout the many years it has been developed. When it comes to the DSM 5 it is clear and obvious that is an educated guess on symptoms that a person may suffer from. Not everyone is the same and will experience all or possibly none of the symptoms. This does not disqualify a client from not having the mental disorder. Another thing that surprised me is how symptoms are remarkably similar to other disorders. When it comes to diagnosing client’s, it is okay for a client to experience a symptom one week and in a month that client no longer has that same experience.

One example of how the classification system of disorders in the DSM-5 has marginalized diagnosed populations currently is because they treat some disorders as insignificant. For example, suicide is a current ongoing issue today. Suicide is not considered to be apart of the DSM-5 because many people who commit suicide do not have prior mental disorders (Oquendo & Baca-Garcia, n.d.). Although schizophrenia, alcohol use disorder or post‐traumatic stress disorder are all associated with significant risk for suicide attempt or death it is not seen as a separate diagnosis.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

Oquendo, M. A., & Baca-Garcia, E. (n.d.). Suicidal behavior disorder as a diagnostic entity in the DSM-5 classification system: advantages outweigh limitations. WORLD PSYCHIATRY, 13(2), 128–130. https://doi-org.ezp.waldenulibrary.org/10.1002/wps.20116

Required Resources

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

• Section      III, “Cultural Formulation” 


• Appendix, “Glossary of Cultural Concepts of      Distress” 

Kress, V. E., & Paylo, M. J. (2019). Treating those with mental disorders: A comprehensive approach to case conceptualization and treatment (2nd ed.). New York, NY: Pearson.

• Chapter 2, “Real World Treatment Planning:      Systems, Culture, and Ethics” 

Hargett, B. (2020). Disparities in diagnoses: Considering racial and ethnic youth groups. North Carolina Medical Journal, 81(2), 126-129. doi:10.18043/ncm.81.2.126



 

Toscano, M. E., & Maynard, E. (2014). Understanding the link: “Homosexuality,” gender identity, and the DSM. Journal of LGBT Issues in Counseling, 8(3), 248–263. doi:10.1080/15538605.2014.897296

Aftab, A. (2019). Social misuse of disorder designation, part 1: Conceptual defenses. Psychiatric Times. Retrieved from https://www.psychiatrictimes.com/dsm-5/social-misuse-disorder-designation-part-i-conceptual-defenses

American Psychiatric Association. (n.d.). DSM history. Retrieved December 10, 2019, from https://www.psychiatry.org/psychiatrists/practice/dsm/history-of-the-dsm

Spiegel, A. (2004). The dictionary of disorder: How one man revolutionized psychiatry. The New Yorker. Retrieved from https://www.newyorker.com/magazine/2005/01/03/the-dictionary-of-disorder

Required Media

Walden University (Producer). (2019c). Social misuse of diagnosis: Pathologizing marginalized populations. Minneapolis, MN: Author.